Managing pain during childbirth is a significant concern for many expectant parents. While many pain relief options allow the birthing person to remain awake, “being put to sleep” refers to general anesthesia, a medical procedure that induces a complete loss of consciousness and sensation.
When General Anesthesia is Used During Childbirth
General anesthesia is not a routine choice for childbirth. It is reserved for specific, medically necessary situations, particularly during surgical deliveries like C-sections. It is used in emergency scenarios when rapid action is needed and regional anesthesia, such as an epidural or spinal block, is not feasible or effective. This includes situations where there is not enough time to administer regional anesthesia, or if it is not providing adequate pain relief.
General anesthesia may also be used when regional anesthesia is contraindicated due to certain maternal health conditions. These can include severe bleeding, blood clotting disorders, or certain spinal issues or infections. While it can be administered quickly, it is generally avoided for routine deliveries because it causes a complete loss of consciousness, preventing the birthing person from actively participating in the birth. In the United States, general anesthesia is estimated to be used in approximately 6% of all C-section deliveries.
Administering General Anesthesia
Administering general anesthesia during childbirth involves rapid sequence induction (RSI) to quickly induce unconsciousness and secure the airway. This begins with intravenous medications that rapidly cause unconsciousness, followed by a drug to relax muscles and facilitate intubation.
Once medications are given, a breathing tube is inserted into the windpipe to ensure a clear airway and allow for mechanical ventilation. This helps prevent the aspiration of gastric contents into the lungs, a potential complication. The anesthesia care team continuously monitors the patient’s vital signs throughout the procedure to ensure safety and manage the depth of anesthesia.
Considerations for Mother and Baby
For the mother, potential effects of general anesthesia include a longer recovery time compared to regional anesthesia, and common side effects like sore throat, nausea, and vomiting, often due to the breathing tube. The mother will be unconscious and unable to experience the immediate moments of birth, which can sometimes lead to feelings of disconnection or an increased risk of postpartum depression. Studies have shown that general anesthesia for C-sections may increase the likelihood of postpartum depression by 54% and suicidal ideation or self-harm by 91%.
For the baby, anesthetic agents cross the placental barrier, meaning the baby will be exposed to the medications. This can lead to temporary effects such as drowsiness or mild respiratory depression at birth. Medical staff monitor for these effects, and babies may sometimes require temporary breathing support or other interventions to help them adjust. A longer interval between the administration of general anesthesia and delivery can increase the baby’s exposure to the drugs, potentially affecting Apgar scores and increasing the need for resuscitation.
Other Pain Management Options in Childbirth
Several common and preferred methods of pain relief are available during childbirth. Epidural anesthesia is widely used, involving a small catheter inserted into the lower back to deliver continuous pain medication. This numbs the lower body while allowing the mother to remain awake, enabling continued participation in labor and adjustment as needed.
Spinal anesthesia provides rapid pain relief, often used for planned C-sections or when a quick, short-term block is needed. It involves a single injection into the spinal fluid, providing immediate relief that typically lasts one to three hours. Nitrous oxide, or “laughing gas,” is another option, inhaled through a mask to reduce anxiety and ease contractions, with effects that wear off quickly. Intravenous pain medications, such as opioids, can also be administered to lessen pain, though they may cause drowsiness in both mother and baby. These methods are generally favored as they allow the mother to be awake and engaged in the birth experience, with fewer systemic effects compared to general anesthesia.