Spinal anesthesia is the usual choice for elective Cesarean section. Spinal anesthesia is most often chosen because it provides very good comfort for the mother and safety for the baby. It is chosen more often than epidural because perfect comfort is more reliable and because it is easier and therefore more comfortable to administer.
Spinal anesthesia is a form of local anesthesia in which an injection of local anesthesia is made in the low middle part of your back. The effects of local anesthesia injected this way are to make you numb and weak from the middle of you down to the tips of your toes. Its very important to know that you will become weak as well as numb so the leg weakness does not surprise and alarm you. The numbness and weakness are part of every spinal anesthetic and will go away when the spinal anesthetic wears off. Often the anesthesiologist will add a small dose of narcotic to the local anesthetic injected with the spinal. This will not effect the baby. It will help you to stay comfortable for about 12 hours after the section is over.
To start the spinal anesthesia, the anesthesiologist will gently attach a blood pressure cuff, a heart monitor, and the pulse oximeter. He will ask you to wear an oxygen tube under your nose. Then he will ask you to turn on your side and pull your knees up toward your chin. A nurse will help you to get into the proper position. Please try very hard to get into a good position as this makes the injection easier. The doctor will wash your back with an antiseptic solution, then numb a small dot of skin with a bit of local anesthetic placed just under the skin. You will feel pressure as the spinal needle is inserted and nothing as the local anesthesia is injected. When the needle is removed, you will be helped to turn back on your back. Within a minute or two, you will begin to feel warm and tingly, then numb and weak. These sensations will start in your bottom and move down into your legs and up into your abdomen and probably the low part of your chest. Most people find this a comfortable, though possibly strange feeling.
After you turn back on your back the nurse will wash your abdomen with some cool, brown solution and towels and drapes will be placed in such a way as to obscure your view of your abdomen. At this time your support person will be invited to join you at the head of the operating table. The anesthesiologist will also remain at the head of the table during the section.
During the section you may feel somewhat sleepy. You may shiver. You may feel slightly short of breath. You may have some nausea. You may feel some pulling sensation. Most people are very comfortable. You will be able to talk with the obstetrician and your support person if you wish. You will be told when the baby is born and hear its first cry. You will be awake and able to participate in the birth. After it has been examined by the neonatologist, the baby will be brought to you and you will be able to hold it. After you have held the baby it will be taken to the neonatal unit for weighing and observation.
After the incision has been closed, the drapes will be removed. You may see some blood. This is ok. About a pint of blood is lost with most births. The pregnant body is prepared for this and tolerates it well. You will be unable to move yourself back to your bed because of weakness in you legs. The operating room team will move you gently back to your bed, and then roll you back to your room.
It may take several hours for your feeling and strength to return to normal. The narcotic injected with your spinal will help you stay comfortable for about 12 hours after the section. The comfort it provides is not perfect, and you may need some medicine by mouth in addition. If you do, ask for it.
All anesthetics have risks. Possible complications of spinal anesthesia include spinal headache, low backache after recovery from anesthesia, and failure to establish spinal anesthesia. There is a very tiny possibility of having permanent nerve damage from spinal anesthesia. The best protection against anesthetic complications is a qualified, experienced anesthesiologist. This you will have.