general anaesthetic for elective c section
, Sep 15 2017 12:59 PM
43 replies to this topic
Posted 15 September 2017 - 12:59 PM
i am aware that a GA for an elective CS
is not common but curious to know of anyone who has opted for this and their experiences with bonding, breastfeeding and general recovery both emotionally and physically ?
I am considering this option due to two previous natural but traumatic births resulting in no living children.. .
I am completely unresolved as to what to do; be awake or be asleep. I am not expecting anyone here to answer this for me but am hoping for some personal experiences in order to best prepare myself..
thanks in advance xx
from a very anxious Mama
**edited to add words**
Edited by gmcas2, 15 September 2017 - 01:15 PM.
Posted 15 September 2017 - 01:10 PM
In that situation if it was me, I would opt for an elective C-section, its very planned and calm.
Posted 15 September 2017 - 01:14 PM
Thank you for your reply sandgropergirl
... i must not have made myself clear. it is an elective c section as i can no longer have a natural birth...
my question is regarding the anaesthetic; spinal block/epidural vs a general
Posted 15 September 2017 - 01:15 PM
I'm so sorry for your losses
I had one for an c/s. It was not elective, but not a sudden or scary emergency if you know what I mean.
The GA itself wasn't a bad experience at all. The only thing is that I don't remember meeting DS for the first time. A midwife put DS to my breast in recovery and took some photos for me which I treasure but it's not the same as a memory.
I don't think there were any issues with bonding. It took ages for my milk to come in but I don't think that was due to the GA.
Best wishes whichever you decide.
Posted 15 September 2017 - 01:20 PM
I have had both, GA or spinal/epidural with my eight c/sections. The reason I chose the GA was due to a traumatic c/section prior. At the time choosing the GA was the best way I could cope. It would have been nice to be awake for those first moments with baby. As for bonding, breastfeeding and recovery I was more sleepy/groggy after the GA. Long term it didn't have an effect on breastfeeding and bonding. It does however put baby at more risk and the outcome was that my baby's first apgar score was only 1 at 1 minute. No long term effect that time but you always think about what could have happened.
Following this, with support I was convinced to go with the spinal and I can only describe this birth as amazing. It was so wonderful, to be there, at the moment they first see your baby's crop of hair and your first view as they lift them out.
Another point was that my husband was unable to go in when I had the GA.
The decision will be entirely up to you but if you think you can do it, I would. Those first few moments are priceless.
Posted 15 September 2017 - 01:22 PM
I didn't have a GA when I was having a tear repaired, even though I really, REALLY wanted one. The anaesthetist said that the GA can be passed through into your milk and affect the bub, so I had a spinal instead. Had some very fancy bruises on my back, but that's all. They actually used gas as well, so it was more like twilight sedation, in that I don't remember anything.
I had an elective C after that, and it was very pleasant (as pleasant as it can be!) and calm. The local hurt more than anything else.
Good luck with your decision.
Posted 15 September 2017 - 01:23 PM
I am really sorry for your losses, I can only imagine how anxious you must be about this birth.
I have had two elective c-sections after a first traumatic natural delivery. Both were done with a spinal block but in separate hospitals, in the first I had DS with me in recovery, and in the second DD stayed with her Dad while I was in recovery. Initially, I hated the idea of being away from her straight after the birth and worried about bonding, but I can honestly say it made absolutely no difference at all. The moment we were reunited was very special and our bond developed quickly and has always been strong. I know this isn't the same as GA, but wanted to share just in case it does help.
Do you have support from the hospital? Given your history, I would imagine that having some sort of counselling or support leading up to this birth would be very important, and would give you an opportunity to address all of your concerns.
Posted 15 September 2017 - 01:24 PM
Oh Hun I have no experience in having a ga for a cs.
I think it would depend on the reasons for having a ga? For your anxiety?
To be honest for me honestly I was looking at having a ga for my first cs due to reasons I won't say here but traumatic births before was part of this.
In the end I had a awake cs and I thought it was the best thing ever. He was prem though so that came with its own bonding and breastfeeding issues on its own.
I honestly loved my cs and my next birth after was a planned cs.
I won't pretend to have any idea of what you are going through right now but I will say this as gently as possible if there is any expectation that it may also end up with a non living child i would possibly also have a ga.
However if the expectation is that the reason for the cs is to have a living baby then I would want to be awake. However a cs is not like a vb. it's planned and they have procedures and it's very clinical and controlled. Not that it's a bad thing thing.
A lady I know had a ga for her cs and she bonded fine. I think her milk was slower coming in due to the ga but other than that no issues.
Have you spoken to the hospital social worker? They will be able to link you to counsellors and other services that may be able to help with your decision.
I think also it would be helpful to note things down that should you be awake or asleep you would like to happen. Eg: weighing of baby should be held off until mum is awake and alert. Or if awake until mum is back in her room after recovery. Is there anything that may make you sway one after the other if able to? The hospital I would think would make exceptions for you to accomodate you. Ie: immediately baby given to mother after birth, no separation. Or if ga baby is to only be held by partner until mum is awake and back in her room.
Does the decision need to be made prior? Can you decide on the day?
There is no right or wrong answer here. The only right answer is the result that you want.
Best of luck Hun xoxo
Posted 15 September 2017 - 01:26 PM
I'm very sorry for your losses and trauma, gmcas2. That is a big thing, going through another pregnancy and birth.
I have had an elective Caesarean with a spinal (so, awake). It is very fast, from the moment you have the anaesthetic to the moment the baby is born. Well, not 5 mins type of fast, but there isn't much waiting. Are you concerned about the anxiety of being 'present' for another birth? I can understand that.
More time is spend stitching you up etc. after the birth than the birth itself. All the medical staff were relaxed and in very good spirits.
I was told that if a General had been required (not due to an emergency, but in a very small number of cases they are unable to get a spinal to work) my husband would have to leave.
I'm sorry I can't give you a GA experience to compare.
I think it's perfectly reasonable to opt for one if you feel you couldn't handle any unexpected emergencies due to your previous experiences though. They must have been incredibly scarring, and again I'm so sorry that you experienced that. GAs do come with a few more risks than the spinal though, as mentioned by a PP, which might be something to consider.
Posted 15 September 2017 - 01:27 PM
I am very sorry for your losses.
My cousin had a GA with her first baby (emergency CS after drawn out and dangerous labour). She spent some time in recovery but then was able to be with her baby and bonded fine, breastfed successfully etc. Her baby was able to go straight to her husband, so was able to bond with him while she was in recovery.
Posted 15 September 2017 - 01:27 PM
Can you talk to an anaethistist beforehand and discuss things? I assume you are worried about freaking out?
Maybe there's a mild sedative they could give you before and try to see if you handle a spinal? Or attempt a spinal but be prepared for a GA?
The actual surgery is very quick and a GA has all the groggy/sleepy issues and does take a few days to work out of your system. My planned CS was very calm, music playing and the staff chatting and laughing, so much better experience.
Posted 15 September 2017 - 01:30 PM
I had a general for my emergency CS (after epi and spinals failed) - DS and I are beautifully bonded and at almost 3 years old he is still breastfed without issue.
Posted 15 September 2017 - 01:34 PM
There are mild sedatives available prior to a c-section. I have had 3 x c-sections. First was an emergency, the other two elective. I was a bit nervous and was told I could have a drug similar to valium, so I would be very relaxed and slightly out of it if that makes sense. In the end the staff were so fantastic I found I could manage without it.
Best of luck,
Posted 15 September 2017 - 01:48 PM
Firstly I'm sorry for your losses.
My first birth was an emergency csection and whilst I was awake for the birth they gave me a GA shortly after the birth. I remember next to nothing of the birth or much of the lead up nor the aftermath. I wasn't able to hold him until I was back in the room (not even in recovery), I don't remember a lot about the first few days. We were never able to establish a breast feeding relationship (not just due to the GA but I believe that played a part in my milk not coming in) and it took me a while to bond. I didn't have an instant connection - he was hours old before I could hold him and I wasn't able to give him his first feed (DH did). I didn't get a chance to feed him (and it was a bottle) til 4 days I think. A nurse in theatre took a photo of my DH and DS1 - in the back ground you can see me with tape on my eyes in the background!
My second son was an elective csection, with a spinal and no GA. I was able to hold when he was born and breast feed him in recovery. My milk came in and i was able to feed him for a few days 100% breast milk (before we moved to comp feeding and then within a few weeks bottle feeding). I had no issues with bonding with my second son. I think partly because I wasn't so sick after from the GA, and because I was able to hold immediately- and was lucky enough my boobs worked for a few days. I also remember the moment he was born and having him meet his grandparents and aunts and uncles and his big brother. Something I don't remember fromDS1.
I wouldn't go the GA if I had a choice. I don't believe the GA was the sole reason for my issues with Ds1 but I think it played a part. I can understand why it might be an option for you though and your well within your rights. I would talk to your medical team and come up with a plan.
Posted 15 September 2017 - 01:53 PM
Hi gmcas2, firstly my sincere condolences for the losses of your babies.
I had an elective cs with a general just 4 weeks ago. I chose a general because of previous trauma caused by emergency cs with my first child.
Honestly there has been absolutely no effect on my bonding with DD or breastfeeding and my recovery/wellbeing is so much better this time around - partially because it was a planned cs without hours and hours of labour beforehand and also because I slept through the whole thing without the anxiety/trauma.
DD was groggy & sleepy because of the ga, but she recovered from that quickly and there aren't any lasting effects.
The only issue I had was they initially gave me too much morphine - because there is no pain relief with a ga, they estimate an about of morphine to give you so you don't wake in pain. In my case it was too much for me (possibly I don't tolerate it very well) and for the first 24 hours my oxygen levels kept dropping so I was on oxygen. Whilst it was concerning at the time (I kept passing out momentarily), I was never in any medical danger and the worst of it passed within a few hours.
For the people saying the actual birth part is over quickly - yes it is but for me that part was the trigger for my anxiety/trauma and so the length of time was irrelevant.
DH wasn't allowed in the theatre because of the ga, but he sat immediately outside the room and DD went straight to him while I was in recovery. DH & DD had skin-to-skin time while waiting for me and it was a great bonding time for them.
Because of the morphine my memories are hazy of the hours after and I don't remember meeting DD for the first time. But equally because of the trauma with DS my memories of his first day are even sketchier!
"Missing out" on these early moments really didn't factor in my decision. There are plenty of other moments for bonding and my mental wellbeing far outweighed any desire to experience those moments.
For me personally a ga was the best decision - I feel so much better about DD's birth than I did with DS.
It's your decision and only you can make it, I wish you the best of luck with which ever option you decide on.
Posted 15 September 2017 - 02:10 PM
Thank you all so much for sharing !!
All of your experiences are invaluable to me on this journey..no matter the questions i ask my 'care team' i seem to always get the 'whatever you need' response.
which is great- but also a little stressful because i am making the decision, no-one is making it for me.
Yes, my main reason for considering this is my anxiety and the possibility of something going wrong during labour. Baby, thankfully, is healthy and well
but there is no guarantee once i am opened up that all will be well with me.
Thankfully for me i do have a perinatal psychiatrist who is a great help, and actually suggested i reach out to other mothers and ask these question
Im so glad i did. And so appreciative of all your support and kind words. There are also some wonderful suggestions here and insight !!!
please continue to share if your reading this and haven't shared yet xx
Posted 15 September 2017 - 02:21 PM
I've had three caesars.
First was an emergency and the anaesthetist at the time didn't give me a choice. He gave me a GA. That DD is now 14 and to this day I don't remember being told that I'd had the baby and it was a girl. I'd been through 16 hours of labour beforehand and baby was sitting on my spine so everytime I had a contraction I got intense back pain. I am sure he gave me a GA just to shut up my screaming. Having said all that, once I woke up properly I don't remember having issues with bonding. I did have issues feeding but that's been a common factor for all of my babies.
DD2 was a planned caesarian. I had an epidural so I was awake when she was born. However I don't think it worked properly as I could feel everything (I know you're supposed to "feel tugging" but I was in massive pain so then ended up topping up my epi until I was knocked out and then finished stitching me up. I woke up from this a lot better than the first GA, and again had no worries with bonding with baby.
DD3 was also a planned caesar. I wanted an epidural and they couldn't get the needle in - apparently my spinal bones are VERY close together (I think this is partially why the epi for DD2 didn't work properly) so apart from a huge bruise where you could see all 8 individual pin pricks where they tried to get the needle in, I didn't have an epi - ended up having to have a GA. Was bitterly dissapointed however I came out of this surgery probably the best. POssibly because I really knew what to expect this time ??
Posted 15 September 2017 - 02:46 PM
I am very sorry for your losses.
Nothing to add, and I wish you all the very best this time.
Posted 15 September 2017 - 05:37 PM
There is a middle ground. Discuss it with the midwife or ob looking after you. See if you can have an anaesthetic assessment beforehand. You could then ask the anaesthetist about anxiety reducing medication before the birth. You could then be awake for the birth but free of anxiety.
Posted 15 September 2017 - 05:55 PM
I'm sorry you've been through such agonising losses. I can understand your reservations about both. Lots of good suggestions already.
I know this is very much about you, but does your partner have any opinion on what his preferences are? Just as importantly, do you have any preferences regarding him?
With an epidural, your partner can be there, and they can either stay with you, or go off with the baby. We chose the latter option. Given I could barely move for three days (reasons for the elective caesar in the first place turned up in spades afterwards), he did any changing, bathing etc while he was there, although i did have to insist one day that they not bath her, but wait for him to do it. The amount of morphine I needed afterward didn't help with milk etc but that was to do with the complications, not just the caesar.
I've had lots of surgery, and must say there's a very jolly atmosphere in the room with an elective caesar. Anaesthetist offering to take the camera and take group shots etc., As per pp, the baby's out relatively quickly, it's the stitching up that takes the time. At that point there were all talking about house prices and what not. It was quite surreal.
I second what people have said about sedative beforehand. I had that once, when unrelated back pain was giving me grief, and it worked amazingly well. You kinda float through.
All the best with your decision.
Posted 15 September 2017 - 06:53 PM
I've had 2 Caesars, one GA and one spinal. I didn't have a choice with the GA because it was an emergency.
Physically I recovered well from my GA, baby was a bit floppy at birth though and had low apgar scores.
Bonding and breastfeeding didn't seem to be effected.
The only thing upsetting was my husband wasn't allowed in the theatre (understandably) and I was asleep, so neither of us got to witness the birth of our baby.
Good luck with your decision
Posted 15 September 2017 - 07:03 PM
Hello. I'm so sorry for the loss of your babies.
I've had two planned c-sections with spinals. Both times the anaesthetist had difficulty putting the spinal in properly (I think my spinal anatomy might be a bit unusual). This took three attempts I believe during one birth. I imagine this could add stress if you're already concerned given your history. Can you have a pre-birth consult with the anaesthetist to discuss a plan?
As an aside, you mention bonding and breastfeeding. I did have troubles here, I think a big factor was my son's stay in special care nursery. While we didn't have that immediate bond, it came with time. So please don't worry if you find yourself feeling similarly.
Posted 15 September 2017 - 07:12 PM
I have had both a spinal block and a GA. The spinal block was really good because I was awake and her dad was there and he got to cut the chord. Because it was an emergency C-section (but not a mad quick scary one) she was taken and looked over by a paed before being given to me but it was very quick. She also went out to recovery with her father while they finished stitching me up, I breastfed (or tried to) in recovery.
My GA was not by choice, my platelets were very low and my blood pressure was sky rocketinng, so there was no alternative. My partner had to wait outside the theatre, but as I understand it the babies were taken straight out to their Dad by the midwife as soon as the paed had looked them over (again, they were twins, I don't think it is the norm). I didn't see them for 2 hours, because of my health not theirs, and when I did see them it was because I repeatedly asked to (they and their dad had been taken up to the ward to wait for me but I wasn't allowed to leave recovery for much longer than is usual). It did not stop me feeding them or bonding. In fact they both latched on immediately which is not what happened with their sister who I fed much sooner.
Goiod luck with your decision, I don't think there is a wrong answer here
Posted 15 September 2017 - 09:20 PM
I'm so sorry for your losses.
One of my friends had a history similar to yours and discussed a number of options with her anaesthetist. Ultimately she had an epidural and very light sedation, which was "turned off" as soon as the baby was out safely. So she was pretty much asleep for birth, but then awake to seek the baby just after birth and for recovery. Her anaesthetist was primed to put her back under if she found being stitched up too triggering, but she didn't. She found it a good middle ground. Perhaps discuss something like that with your caregivers.
Posted 15 September 2017 - 09:45 PM
Ì had anxiety issues with my 3 and had GA c section. Best thing ever. Dr took look of photos of birth which i could look at in my own time and I bonded with all 3 really well breastfeeding them till 3 years of age. Do what is best for you? I disassociate under stress and if so stressed wouldnt be good for bubs anyway. This way it was controlled and safe for all.
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