Spinal anesthesia is the most common type of anesthesia for cesarean section. I have other hubs on the subject of spinals, but wanted to address the specific fears of a reader facing a cesarean section with spinal anesthesia. So...
This hub is in response to a specific question about spinal for c-section. The question, quoted directly from ruthp6 is as follows:
"I am having a spinal block for a c section. Nevee had a surgical procedure and terrified hardly sums up my fears. I am concerned about meningitis, not being able to breathe, the lower portion of my back is very sensative and I am deathly afraid of getting a spinal. I know thar I will be numbed before the actual injection, but it hardly seems enough. Will Emla cream stop the pinch of the needle? One last thing, I know that much is off limits because of baby, but is there any sedative that I can have before I waddle to the OR? So very nervous!!!!!" (copied as written).
I wanted to answer you thoroughly and the system told me my answer was too long and prompted me to write a hub about it. So, here it is. I hope you find this and feel better after reading. I have answered the basic questions and will add info on exact statistics and so on when I find them, but wanted to get the answer out to you and others who may be wondering the same thing.
Rest assured, complications are rare. No one should tell you they CAN'T happen, but they are rare.
Again, this is not a comprehensive article about spinals or their potential benefits or risks. It is just meant to address specific questions. And, as always, no medical advice is given or implied in my online articles.
I'm Terrified of Spinal Complications.
The things mentioned in the question are risks of spinal anesthesia. They are very, very rare though. I have no idea how many thousands of spinals I've placed and I've never had/seen an infection or other serious complication. They happen, but rarely.
Risk of Meningitis after Spinal Anesthesia
Infection: The risk of infection (meningitis) is estimated at lower than one in 25,000 to 50,000 spinal anesthetics. Even in the cases reported, the circumstances around the infection were not clear (did the woman have pre-existing infection, fever, immune system problems, etc). The exact incidence is not really known, but these cases are published individually as case reports when they occur as they are sufficiently rare.
Breathing Problems with Spinal Anesthesia
Breathing: You will likely FEEL like you are not breathing well because the sensory nerves around your ribs can get numb. This makes it so that your brain can't consciously tell that your chest is moving. Some women don't notice this, BUT women who are really scared or expecting something to be wrong will notice and sometimes get a little freaked out. The anesthesiologist WILL be watching your breathing and oxygen level, so let them know if you feel this way so they can reassure you.
Does it Hurt to Get a Spinal for C-Section?
Pain: The injection for the numbing medicine is a tiny, tiny needle. EMLA probably won't make much difference and they won't want you to put anything on the injection site before the procedure anyway. It feels like a pinch and burn (I have had it several times) and it really isn't bad. If you are very fearful of this part, let the anesthesiologist know so they can warn you or have you take a deep breath, or hold the nurse's hand. It only lasts a few seconds- honestly.
The spinal needle, likewise, is super-thin- much thinner than the IV needle used to start the IV. Usually, you won't feel this except some pressure. Occasionally, you will feel a zing or electric-like feeling in one side or the other (sometimes, you just feel a cramp). This doesn't mean anything is wrong, just tell the anesthesia doc so they can adjust their position if needed.
Why Can't I Be Sedated for My Cesarean?
Sedation: I can tell you that you most likely will not receive a sedative, as this is really, really an unnecessary risk (the goal of anesthesia for c-section is to minimize risk).
Do tell the anesthesia doc that you are so nervous. We sometimes forget that while we do this all day long, every day, that patients do not!! If they know you are freaked out, hopefully he or she will take the time to help allay your fears.
Practice relaxation and breathing, starting now. When you start to feel anxious about the spinal or c-section, pay attention to your breathing and muscles. When you notice your breathing speed up and your muscles tighten, take control of them. Focus on slowing your breathing, think calming thoughts about how it will all be worth it when you see your baby and how lots of women do it and you can too. Relax your muscles. Focus on a part of your body at a time and command your muscles in that area to relax. Practice this and take this new skill with you on surgery day. You will be surprised how much it can help.
For the Practioner
For More Information...
- Post Spinal Anesthesia Side Effects
Post spinal anesthesia side effects can result from the needles, the technique or the medications used. Most side effects are minor and short-lived, but knowing that they are not harmful can be very reassuring if you are going to receive a spinal ane
- Insider's Guide to Spinal Anesthesia: What you should know.
Spinal anesthesia is commonly used for cesarean sections, knee and hip replacements and other surgeries on the lower half of the body. Learn the most important facts about spinal anesthesia, what to expect, side effects and potential complications to
TahoeDoc (author) from Lake Tahoe, California on August 26, 2012:
I want to make it clear that I am truly sorry that I can't give you the info you seek. I wish I could help everyone, but that just isn't possible. Again, if this is a big issue, schedule a consultation before you are in labor or schedule your cesarean section. You will be able to decide with the doctors, the best course of action for your unique situation.
TahoeDoc (author) from Lake Tahoe, California on August 26, 2012:
Sorry I did not intend for this to be a comprehensive article covering every potential issue with every patient facing a c-section. In fact, this hub was an answer to one questions posted by one reader. I attempted to answer the question with factual information.
Conscious sedation and anti-anxiety agents are not usually options for c-sections, therefore they were not discussed here. I did have a section here that explains why this is the case. If that isn't going to work for you, please, please discuss this with your physician. I am giving information on the most common scenarios. I'm sorry you find that uncaring. Be assured that if I was truly uncaring, I wouldn't spend my time trying to help by writing articles here.
Since nothing I write should be taken as medical advice, anyway, it would be better to seek specific advice from your own health-care team. The information is only here to present information that may or may not apply in a specific situation. It just isn't possible to specifically provide advice or guidance for each individual, although I do try to respond to each comment. I'm sorry you were disappointed, and I can only hope this and other articles will be helpful to some people.
The other option for c-section is usually general anesthesia. Once patients understand how much more dangerous that is, they usually opt for the spinal or epidural for the sake of their baby if that is at all possible.
Thanks for reading and I hope you find the information you need, even if I am unable to provide it.
Guest on August 26, 2012:
Sorry, this did NOT in any way address the options for people with needle phobias, or being phobic of being cut into while conscious. "Suck it up" isn't an option if you're going to have a full-blown panic attack, and seems very uncaring (not to mention, surely a panicked patient is a health risk during surgery). Please discuss conscious sedation, anti-anxiety agents, etc.
Ann Leung from San Jose, California on May 25, 2012:
I had two C-sections for my two girls years ago and I still remember the needles... I am glad it's over now. Great hub. Pinned and shared.
TahoeDoc (author) from Lake Tahoe, California on May 20, 2012:
Thank you Marcy! You are so kind. I hope it is understandable and useful. As with many things, it's hard to scratch the surface and do justice to the topic. But, to thoroughly understand took years...and there are still things about spinals and c-sections that have to be decided on a case-by-case basis with judgement calls. So, I appreciate your comments.
Marcy Goodfleisch from Planet Earth on May 20, 2012:
As always, a wonderful job here of explaining things in real English and giving objective, thorough information. Wish I'd had this information when I had my children! Thanks!
Voted up and up, and socially shared!
TahoeDoc (author) from Lake Tahoe, California on May 18, 2012:
Yikes- sounds like your spinal went higher than they would ideally like. It's such a helpless feeling when you can't move and to not be able to move anything, that's really tough. Usually, the numbing follows a relatively predictive pattern, but every once in a while, it spreads too far. The good thing is that you are monitored so closely and the spinal WILL wear off and you get better.
I'm glad you did so well- good job on staying tough until it wore off. I know it can take a few hours.
I had a C section with twins on May 18, 2012:
I had a spinal block, the doctors numb me from the neck down, and it was terrifying, I felt my body go lymb, I could only move my head and that was it, nothing else. The nurse kept coming in to check on me after I delivered the twins, to see if I had any feelings in my toes. It took a while to gain feeling back, I was having involuntary muscle jerking, and I had no control over it, the nurse said it was common. I tried not to think about the fact I could not move.
Mmargie1966 from Gainesville, GA on May 18, 2012:
I had 2 babies naturally, and never had the option of this type of anesthesia. I swore if I had to have surgery, I never would choose this method for fear of complications. You have put me at ease, Doc. If I ever have to make a decision, I'm much more comfortable now.
Thanks! Voted awesome!
LaMamaLoli from London on May 18, 2012:
I have had two caesarians, two epidurals and I have a phobia of needles. I was terrified of having the injection, but I have to say it was so worth it. Nothing beats being able to hold your baby as soon as he/she is born. The reality is not as bad as the fear before the birth- for me anyway!
Robie Benve from Ohio on May 18, 2012:
Very interesting, you did a great job clearing up some confusion about side effects of spinal anesthesia. I had two babies with natural deliveries, and did not want an epidural. I did definitely regret it with my 9lb 11oz one...