A VERY hypothetical question about c-sections and anesthesia... - Page 2 - Mothering Forums

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#31 of 50 Old 04-08-2008, 02:43 PM
 
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#32 of 50 Old 04-08-2008, 03:31 PM
 
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My sister had GA with her placenta previa.

She said she was still coughing a week later to get that junk out of her lungs.

Coughing and a repeat c-sec scar are not a good combination.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#33 of 50 Old 04-08-2008, 03:35 PM
 
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Originally Posted by Storm Bride View Post
It seems very strange to me that doctors won't give a woman GA "just because she wants it", but people can choose to have totally elective cosmetic surgeries done - just because they want them - under GA. There's something there that doesn't quite add up, yk? Or...maybe there just isn't as much money in providing GA for terror as there is in providing facelifts for vanity?
Cosmetic surgery takes hours unlike a CS which, if it's an emergency, will take less than an hour. When breast implants are done the patient is on her back then, after the implants are placed, the patient is sat up so the doc can get a look at them in the "natural" position. Multiple procedures are often done so the patient is also moved around a lot. It's a lot of moving around, I doubt someone wants to lay there for five hours while in surgery and a spinal won't last that long. In the case of a facelift I can't see how you can do it while a patient is awake "Ok, I'm gonna peel back your forehead and scalp for a minute here..." The whole deal with the curtain is to keep the woman from seeing what's going on, if that helps or not is debatable. I know I don't want to see it on myself even though I've participated in many. GA also takes a while to recover and most moms want to see the baby right away and bond.

As far as the baby is concerned the medications given in GA go directly in the blood stream and quickly to the babe. Meds like propofol act quick and take a while to wear off (I've weaned multiple patients off propofol and it's slow). Anesthesia isn't just one med but a combinations of meds to gain the desired effect all which will get sent to the baby directly. The patient also has to be intubated which carries it's own risk. The meds given in a traditional CS do reach the babe but have to cross the blood/brain barrier so it takes longer and the babe receives less.

If I had to have a CS I'd be nervous about a spinal but I'd suck it up knowing that it's better to have a spinal than GA.
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#34 of 50 Old 04-08-2008, 04:12 PM
 
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Spinal anaesthesia is MUCh easier to recover from than GA is. It's actually what they use for other surgeries these days too. My dad had his hip replaced last October and had spinal anaesthesia for that too. I think they gave him something to relax too, so that he didn't care so much. (Orthopaedic surgery especially is filled with all sorts of unpleasant sounds and smells).

Plus, no matter how awful you would feel about the whole experience, I imagine you'd definitely want to see and hold (and breastfeed) your baby as soon as possible once it was over. They only use GA if they need something very quickly and don't have time for a less impactful method.

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#35 of 50 Old 04-08-2008, 04:15 PM
 
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Here's my experience...

I was not at all happy about the idea of an epidural, which is why I'd labored without any pain meds for about 20 hours in the hospital (another 20 at home before that). Unfortunately, I had pre-eclampsia, so I had to be there. When the time finally came for the c-section, the anesthesiologist said that my BP was too erratic for an epi/spinal, so she'd have to do general anesthetic. We were warned ahead of time that if that happened, DH would not be able to be there for the "birth."

When I got into the OR, I was still having STRONG contractions and was in agony. So when they put that mask over my face, I just breathed in as deep as I could... and that's all I remember.

Coming awake was torture. I was dreaming that I was wondering around this old, falling down house looking for a way to breathe. I knew that if I didn't find air soon, I was going to die. I could feel myself dying, because I couldn't breathe. (I was intubated and couldn't "feel" myself breathing, so I thought I wasn't breathing) I wanted to find air so that I could see my baby before I died.

In hindsight, it's tough to have been under GA for my son's birth, but it also may have been for the best. From what they told me later, the c/s was fairly harrowing, and my BP dropped extremely low and I lost a lot of blood. I'm not sure that I'd want to be awake for that.

But, if I had to have another cesarean, I'd want to be awake. I felt so disconnected to my son for months afterwards (now that he's 2 I sometimes still want to blame it on the c/s, but no, he's just 2!), and would hope that if I were awake for the surgery then I wouldn't have that feeling of "this isn't my child."

Danell - Craft Savvy mama to Evan (3/31/06) and Andre (8/29/07)
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#36 of 50 Old 04-08-2008, 07:32 PM
 
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I had general anesthesia with my 28 weeker. I developed HELLP syndrome on the night of his birth and had to be delivered ASAP. Decision to incision in about 10 minutes.

They were toying with the idea of me having epidural anesthesia, but two things made them lean toward the general. 1. My condition was worsening rapidly. 2. I had been on heparin while on hospital bedrest to treat a clotting disorder and they were worried about bleeding issues.

I was sad that neither my husband or I were "at" my son's birth, but in a way relieved. He was a small IUGR 28 weeker at only 1.5 lbs. We weren't entirely sure he would survive. I think that would have killed me to be awake and maybe he didn't make it. The general anesthesia contributed to a lower 1 minute apgar for him also. So docs generally don't like to do GA unless it is really required.

On a positive note, my son is now 2.5 y/o weighs in at 32 lbs and is 39 inches tall. You would never know he started out life so small.
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#37 of 50 Old 04-08-2008, 07:37 PM
 
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Cosmetic surgery takes hours unlike a CS which, if it's an emergency, will take less than an hour. When breast implants are done the patient is on her back then, after the implants are placed, the patient is sat up so the doc can get a look at them in the "natural" position. Multiple procedures are often done so the patient is also moved around a lot. It's a lot of moving around, I doubt someone wants to lay there for five hours while in surgery and a spinal won't last that long. In the case of a facelift I can't see how you can do it while a patient is awake "Ok, I'm gonna peel back your forehead and scalp for a minute here..." The whole deal with the curtain is to keep the woman from seeing what's going on, if that helps or not is debatable. I know I don't want to see it on myself even though I've participated in many. GA also takes a while to recover and most moms want to see the baby right away and bond.

As far as the baby is concerned the medications given in GA go directly in the blood stream and quickly to the babe. Meds like propofol act quick and take a while to wear off (I've weaned multiple patients off propofol and it's slow). Anesthesia isn't just one med but a combinations of meds to gain the desired effect all which will get sent to the baby directly. The patient also has to be intubated which carries it's own risk. The meds given in a traditional CS do reach the babe but have to cross the blood/brain barrier so it takes longer and the babe receives less.

If I had to have a CS I'd be nervous about a spinal but I'd suck it up knowing that it's better to have a spinal than GA.
I understand the difference. My point was that the woman can have GA for an entirely elective procedure, but when a procedure is being forced on a woman, she can't elect to have GA. There seems to be a bit of a double standard there (although I do realize there's the factor of GA being more dangerous for a pregnant woman).

I'm not "nervous" about spinals. They freaking terrify me. I find spinals about equal to the surgery itself in terms of how scary they are. Quite honestly, I've wished a few times that they'd just skip the anesthetic completely - at least that way, they couldn't pretend, to themselves or me, that they aren't hurting me when they cut into my abdomen.

All that said, I wanted general last time, but tried to get a spinal, so that I could see my baby and dh could be there. Stupid me. If I hadn't tried to have a spinal, my son might still be alive. I'll just go with whatever junk they want to stick me with next time, although I'm refusing that morphine crap that makes me want to tear my skin off.

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Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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#38 of 50 Old 04-08-2008, 07:39 PM
 
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Spinal anaesthesia is MUCh easier to recover from than GA is.
Yeah - but once I woke up from the GA last time, I felt mostly okay (different from my first, but they've changed the "cocktail" a lot since '93), whereas the time I spent in post-op after a spinal, watching a bp monitor, waiting to feel my legs, and desperately wanting to hold my baby, felt like an eternity.

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Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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#39 of 50 Old 04-08-2008, 07:42 PM
 
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But, if I had to have another cesarean, I'd want to be awake. I felt so disconnected to my son for months afterwards (now that he's 2 I sometimes still want to blame it on the c/s, but no, he's just 2!), and would hope that if I were awake for the surgery then I wouldn't have that feeling of "this isn't my child."
FWIW, I've only had that feeling with one of my children, and she was delivered by scheduled section, with a spinal. I got over it, but it was hard. I don't know if the disconnect was more because the labour/birth hormones just weren't there, yet (she was taken at 39w, 2d - if her two full brothers are any indication, she wanted at least another two weeks), or more from the sheer terror of having a spinal and being awake, or from being separated from her for "so long" (only an hour and a bit, vs. 14 hours with ds1, but I was unconscious for that whole 14 hours, and wide awake the whole time with dd) or what...but it didn't happen with any of the others.

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#40 of 50 Old 04-08-2008, 07:52 PM
 
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Yeah - but once I woke up from the GA last time, I felt mostly okay (different from my first, but they've changed the "cocktail" a lot since '93), whereas the time I spent in post-op after a spinal, watching a bp monitor, waiting to feel my legs, and desperately wanting to hold my baby, felt like an eternity.
: The 7 hours until my legs had feeling again were the longest in my life (I don't know why it didn't occur to me to either lie to the staff or demand I could hold him sooner - I was such a doof back then). With the GA, once I was awake and in my room (about an hour), I was awake and fine (A little sore throat, but that's it). I was much more alert and oriented once I was awake from the GA than I was with the spinal; it took me several hours to stop feeling dopey when I had the spinal.

I think everyone recovers and handles things differently. : Cause I hate, hate, HATED the spinal. And the GA was, well, fine.

I didn't have any disconnect feelings with either baby, so I can't give any anecdotes about that, but I feel badly for any mamas who have.

Heather, WAHM to DS (01/04)DD (06/06). Wed to DH(09/97)
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#41 of 50 Old 04-09-2008, 04:45 AM
 
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Completely off topic but, Heather I just noticed your sigline, and the ribbon ...

My bf's mom just had a double mastectomy... and my good friend also had a mastectomy... my friend isn't doing nearly as well ... she already had it years ago but it came back and now isn't responding to chemo. It's an issue that is very close to my heart right now.
I forgot to respond to this. Thank you so much! My mom is AWESOME. She's an inspiration to me...big hugs back to your friend and bf's mom.

Heather, WAHM to DS (01/04)DD (06/06). Wed to DH(09/97)
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#42 of 50 Old 04-10-2008, 11:36 PM
 
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It was.
I was only given the spinal, and I was calm and collected. I made it clear that I did not wish for any "calming" drugs unless I demonstrated that I needed them.
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#43 of 50 Old 04-13-2008, 04:08 PM
 
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They had warned me that because of my extremely high bloodpressure that I most likely would be put under GA during my c-section. They didn't, but I felt so bad that I really didn't care what they did to me at that point. The c-section was not enjoyable at all for me, but most of that came from the fact I felt like I was going to die and I was throwing up non-stop. I am glad I was a little aware of what was going on because I got to hear her first cry and give her a kiss before they took her to the NICU. I am also glad that my dh got to be there to see her being born.


Right now the thought of GA scares me.

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#44 of 50 Old 04-14-2008, 12:32 PM
 
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I might be in the minority but I didn't have a bad Spinal experience with either birth other than a bad headache about a week later.

My last birth was an emergency c-section and it was NEVER suggested that I have GA. I had the spinal, the surgery took less than an hour, I was in recovery until I could move my toes again (less than 20 minutes) and DH got to stay with baby until I was able to have him. He latched on as soon as I held him and I was up and walking around in less than 8 hours and he stayed in the room with me the whole time we were at the hospital. I was nervous during the surgery but nothing unbearable and nothing beats hearing your baby cry for the first time.

I can understand someone not wanting to be awake for it and everyone reacts differently to different meds. I just happen to be lucky in the way I react.
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#45 of 50 Old 04-14-2008, 12:37 PM
 
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I was only given the spinal, and I was calm and collected. I made it clear that I did not wish for any "calming" drugs unless I demonstrated that I needed them.
If you had an intravenous solution, you probably had some mild pain relieving and mood altering substance in there. This is so routine, it is rarely even mentioned in the records, but should be. There is so much going on that the hospital staff takes great liberties with what drugs you are getting that way.

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#46 of 50 Old 04-14-2008, 01:00 PM
 
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Posting w/ out reading all the responses... Just wanted to share my own personal experiance.

I was put to sleep for my 1st c-section (it was an emergency) and I had a spinal w/ my 2nd and 3rd. I was/am deeply sad about missing my oldest child's birth. I wasn't really lucid until the next morning (he was born at 8pm) and it made breastfeeding and bonding difficult. I didn't even know if I'd had a boy or a girl. I don't remember those first 2 days of his life. My spinals and recoveries from them were fine, other than being nauseous. I got to see, bond, and breastfeed my LO's within the hour.

Sarah : , mama to Lucas (8) , Ryan (5) : , Andrew (1yr) , and someone new : due early Dec.
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#47 of 50 Old 04-14-2008, 01:03 PM
 
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If you had an intravenous solution, you probably had some mild pain relieving and mood altering substance in there. This is so routine, it is rarely even mentioned in the records, but should be. There is so much going on that the hospital staff takes great liberties with what drugs you are getting that way.
A med can't be given unless it's ordered and charted. A med that is given for pain relief or to "relax" a patient will fall into the category of a controlled substance (counted and dispensed by the pharmacy). It has to be charted at least once or the pharmacy will notice, and be pissed. It's not like we're pulling Fentanyl and Ativan because we feel like it. I have to chart twice, in two different places, that I pulled and gave the med. If I don't pharmacy will hunt me down. Our MD's don't even have access to the machines that dispense medications. The anesthesiologist's have a kit that is counted and returned to the pharmacy who count what they get back. If the count is off, it has to be corrected on the medical & pharmacy records. So, even if you weren't told you were gonna get medication, it will be charted.
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#48 of 50 Old 04-14-2008, 09:00 PM
 
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As PP's have said regional anestheisa (epidural, spinal) carries less risk than general anesthesia and would be the preferred anesthesia if time and situation would allow.

My first was an emergency c-section under general anesthesia...It was very strange and disconnected to be told you had a son but not being awake/aware for the birth.
ITA, it was very unsettling. i didn't even remember why i was there at first, seriously. it's not right. my 2nd birth was at home. while i love my dd1 (and did from the start) immensely, i feel a different kind of conection with dd2. i was love struck with my first, but with #2 there is this feeling of her being "intensely mine" that was not there for me the first time.

honestly, the thought of going under for another birth horrifies me.

Banana, doula wife to Papa Banana and mother to Banana One, Banana Two, Banana Three, Banana Four...

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#49 of 50 Old 04-14-2008, 09:29 PM
 
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If you had an intravenous solution, you probably had some mild pain relieving and mood altering substance in there. This is so routine, it is rarely even mentioned in the records, but should be. There is so much going on that the hospital staff takes great liberties with what drugs you are getting that way.
I didn't have any mind altering anything during my c-section. As soon as my epidural was dosed for surgery, I was pain free for the first time in many, many hours, and I was able to relax and kind of enjoy the birth of my son. The relief of being pain free was relaxing in and of itself. I didn't need anything else.

I do realize that other people might not have had that experience, but it is possible.
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#50 of 50 Old 04-14-2008, 10:05 PM
 
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If you had an intravenous solution, you probably had some mild pain relieving and mood altering substance in there. This is so routine, it is rarely even mentioned in the records, but should be. There is so much going on that the hospital staff takes great liberties with what drugs you are getting that way.
I assure you, I was not given anything. This was discussed with both the OB and the anest. I also felt very clear headed, and had none of the foggyness associated with surgery in the past. I have my reports and they list what I was given and there are no calming down meds in there.

Not all women freak out at their cesarian births, and not all medical providers lie. I was very calm and understood and supported mine.
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