Anaesthesia for a caesarean section is almost always performed using a spinal anaesthetic, as this is best for both you and your baby.

For elective caesareans we like to see you in our rooms with your partner prior to your surgery.  We take the time to explain the procedure to you both and answer any questions you might have in a relaxed and private setting.  We are happy to make an appointment time for you at a suitable time for you both, including evenings.  Please call our rooms to make your appointment.  This consultation is billed along with the bill for your surgery and is at no additional cost.  On the day of your surgery we will see you again briefly.   For emergency caesarean sections we will see you as soon as possible before your operation.  If you already have an epidural in place we may use that, although this is very similar to a spinal.  Sometimes we may decide to perform a spinal, even though you have an epidural in place.

Your partner or other support person can remain with you the entire time, including while your are having your spinal.

A spinal anaesthetic is usually a quick and straightforward procedure.  We first insert an intravenous drip and then we will get you to sit on the bed and lean on your partner who will be in front of you.  We paint your back with antiseptic and then put some local anaesthetic in your skin.  We put a special needle into the space between the spines I  your back into the sac of fluid your spinal cord floats in.  We put a mixture of anaesthetic and pain killer into the spinal fluid, which will make you go numb from your chest down.  It varies slightly how quick this happens, from seconds to a few minutes.  It is also possible for you to still feel some movement and light touch.  Very occasionally you can still feel and move your toes.  Sometimes the spinal needle can brush against the nerves and cause some pins or needles or a muscle twitch, this is nothing to worry about.

Once the spinal is finished we will lay you down and tilt you slightly to one side, this is to roll baby off the big blood vessels in your abdomen.  Your obstetrician will then prep and drape your abdomen.  At this time the staff will ask you lots of questions, these are a safety check that we have to go through before every operation.

You will probably feel some movement during the procedure and as your baby is being delivered it is often necessary to press quite firmly on your abdomen. As soon as your baby is born it will be looked after by the paediatrician.  Your partner will usually be given the chance to cut baby's cord at this stage.  As soon as the paediatrician is happy you will be able to hold your baby.  You can take as many photographs as you like, but please ask first.  The staff are happy to help and take photos of you, your partner, and your baby.

Like any other anaesthetic procedure there are some possible complications.  About 2% of spinals do not produce complete numbness.  Usually you can only feel touch and movement, but not pain, although some people find this distressing.  It is extremely rare for you to feel pain, if you do, you should say so immediately so we can ensure you are comfortable.  Only very rarely do we need to convert your anaesthetic to a general anaesthetic.  It is common to feel nauseated during the procedure.  You should tell us if you feel nauseated straight away. There are several causes of this, all can be treated easily.

Sometimes the spinal needle can bruise the nerves in your back.  If this happens you can be left with a small area that feels funny, tingly, or numb and this can last from 6 days to 6 months.  This happens about 1 in every 500 spinal anaesthetics.  Very occasionally, about 1 in every 5000 spinals, this spot never gets better.  Serious nerve damage is very rare.  The pain killer used in the spinal gives good pain  relief for up to 24 hours after your surgery, however it almost always makes you feel itchy and often can make you nauseated.  The nursing staff on the ward will be able to give you medication to help relieve both of these problems.

We will see you again after your caesarean to make sure everything is going well.  If you have any questions or worries while you are in hospital ask the nursing staff to call us, we will come back and see you as soon as possible.  If you have any questions, worries, or concerns you think might be due to your spinal after you leave hospital please do not hesitate to call us at our rooms.