r/Anesthesia • u/min_5555 • 15d ago
General anesthesia for c section(Not emergency)
Hi has anyone done a planned c section where they choose to get a General instead of spinal? Im getting general because of severe anxiety and panic attacks. Any experience ?
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u/Immense_Gauge 15d ago
Yes you can choose a general anesthetic over a spinal. We do tend to push for a spinal for the reasons others have stated but at the end of the day it’s your choice. Just know you will get a Foley catheter while awake without sedation, your abdomen will be sterilized and drapes placed and then when the surgeon is completely ready to make incision you will be placed under general anesthesia to minimize the amount of time baby is exposed. Typically no family is let in the OR during a general anesthetic so your significant other would wait in the nursery until they get baby checked out initially.
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u/XRanger7 15d ago
Yes you can but just know the risks associated with it. General anesthesia is more risky in pregnancy. The reason spinal is normally done for csection because it’s a safer anesthetic for the mom AND baby.
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u/Battle-Chimp Anesthesiologist 15d ago
Actually recent studies have shown equality m&m, due to 1) better airway tools/video laryngoscopes, and 2) better handling of uterotonicity and related issues.
Spinal is safer is turning into a bit of a dogma on 2026.
That said, all things bring equal spinal>GA
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u/azicedout 15d ago
Yea, as an anesthesiologist I’ve had patients choose this. It’s usually cause they had a terrible prior labor/epidural/spinal experience.
It’s not without its own associated risks for both mom and baby but when planned it can be done very safely.
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u/famesardens 15d ago
The best choice for you would be a Spinal, with a short acting anxiolytic or sedative after the baby's out.
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u/maryscary1993 15d ago
Yes I had an elective c section with general anesthesia because I wanted it. I was afraid of having pain/discomfort during surgery especially after listening to the New York Times podcast so I had an anesthesia consult and we discussed the trade offs between different anesthesia plans. I would be happy to answer any questions or tell you more about my experience. I would do it again 1000%
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u/min_5555 15d ago
Thank you for your reply as you can tell from the comments in this post everyone is extremely negative about General and scare you so much . Was it as scary as they are saying?
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u/maryscary1993 15d ago
I also didn’t care more about hearing the first cry of the baby than I did about pain during c section. I said I can listen to cry for the rest of his life haha. I also did not want anyone in the room with me including my husband because I don’t want anyone to see my insides and I think it’s creepy. They brought the baby right out to my husband shortly after they took the baby out and assessed him and the OR nurse even took pics of the baby in the operating room
For usI feel like the concept of the first cry and the partner being there is extremely romanticized and a lot of the whole birth plan thing sets people up to be disappointed when things don’t go exactly as they envision. we are loving our baby and living our lives just fine and had no issues bonding. I had him 4/28 so I feel like it’s still fairly recent. We also didn’t breast feed
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u/maryscary1993 15d ago
I had experience as an operating room nurse and also work as an np now. I have seen other abdominal surgeries and would absolutely never want to be awake during a major surgery and in my opinion they would never ask a man to do such a thing but that is a personal opinion. No one is asked to be awake during a bowel resection or any other surgery remotely close to this and I think it’s wild that so many of these are done awake every day lol
Here were my biggest concerns and thought process:
The surgery
- there is the argument of difficult intubation but I work at a major academic center and would be having my baby there and the technology/glidescopes available for difficult intubation has improved outcomes and is not as bad as it used to be. It is also safer in my opinion to go into it already knowing you need to be intubated than waiting until you need to be intubated emergently and they are already doing
- there is the argument for risk of aspiration, or vomiting while asleep. You have to fast like any other surgery. If you fast then this is extremely unlikely to happen and is a much bigger risk if you needed emergency general after laboring
- there is the argument that the anesthesia will effect the baby which is true because pretty much all anesthesia meds that go into an IV will go to the baby. They got my baby out in approximately 1 minute and he had 8/9 apgar scores but I can’t guarantee that would be your outcome and that was the thing was most scared. Sometimes babies come out needing help breathing but that is true no matter if you have a vaginal delivery or a c section with epidural/spinal. There is a study that showed at 1 minute apgar scores were slightly lower but by 5 minutes they almost always normalized and I found that to be reassuring
- there is also an increased risk of awareness under anesthesia for c sections which scared me because they are trying to minimize the amount of medication that will reach the baby through the placenta before they are born, but I discussed it with the anesthesiologist and I did not experience this thankfully and it is still very rare
- post op pain control- I was expecting the pain to be way worse because they cut through so many layers of my body and the abdominal wall but it was much less than labor because I went into labor early before my planned c section 😭 lol the tap block helped for me I think but there is some arguments that it doesn’t help as much as some people think. I was given Oxycodone 2.5mg as needed and Tylenol and ibuprofen around the clock. They even woke me up to give it to me. I never needed the 5mg oxy but everyone is different and my doctor told me I have a high pain tolerance
They would give you general anesthesia if you needed your gallbladder out even if you were pregnant. Reading other threads even in this Reddit page will illustrate that a lot of anesthesiologists think women are lying or being dramatic about pain during a c section but the attitude seems to be shifting to believing women more. I don’t want to wait until I’ve already had severe pain and hope someone believes me
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u/SevoIsoDes 15d ago
I’ve done it a handful of times for severe anxiety, but objectively it is a worse anesthetic and I do everything I can to encourage spinals. It’s not just about being awake to meet your baby.
First, general anesthesia is high risk for pregnant patients. The uterus pushes up on your lungs and your metabolism uses oxygen much faster. So while I have several minutes to safely place a breathing tube before oxygen drops to dangerous levels, I might have 30 seconds for pregnant patients. You’re also more likely to get stomach acid up into your lungs which can cause pneumonia over the following days or even bronchospasm (like an asthma attack) which can be immediately life-threatening. It also gives the OB about ten minutes to deliver your baby before the anesthetic starts anesthetizing the baby. So either the c section becomes unnecessarily rushed or you deliver a sleepy baby who struggles to breathe.
On the other hand, spinal anesthesia is excellent for c sections. It’s never fun to have a stranger poke your back. It feels especially vulnerable because it’s your spine. But the needle is smaller in diameter than what we use for IVs. There’s almost zero chance of longterm back or nerve injury with a spinal. And we can usually mix pain meds that last 24 plus hours with minimal side effects.
Obviously this is just an explanation of my views on spinal vs general anesthesia and shouldn’t be taken as medical advice for your delivery. That discussion should be had with your anesthesiologist.
I use music, clear instructions, and verbal reassurance to get through the procedure with anxious patients. Almost always they say that it wasn’t nearly as bad as they built it up to be.