Emily Oster

3 min Read Emily Oster

Emily Oster

Should I Get a General Anesthetic for My C-Section?

Q&A on pain management

Emily Oster

3 min Read

Is there any research about using general anesthesia during C-sections? My husband is a surgeon and is horrified by the prospect that I could have a C-section with anything less than general anesthesia; he considers the procedure to be one of the most intense types of surgery and is astonished that women are expected to have it while awake. I imagine there are reasons why the procedure is not routinely done under general anesthesia … right? Does it endanger the baby? Do the medications affect breast milk, or otherwise prevent a new mother from breastfeeding right away? Of course, there are many risks associated with undergoing general anesthesia that should not be taken lightly. But are there any associated with C-section specifically?

Additionally, I would only have a C-section if it was medically necessary: does the research indicate if there is a difference between using general anesthesia in an emergency C-section vs. a planned one?

Thank you for your time and consideration.

—Genuinely Considering General

More than 95% of C-sections in the United States are performed with what is called “neuraxial anesthesia” — basically, with epidural anesthesia rather than with general anesthesia. The primary reason for this is that most women want to be awake for the birth of their child and to have a partner present. Both are possible with neuraxial and would not be with a general-anesthesia approach.

There are a few other possible advantages to the epidural route. One is that pain medication can continue to be delivered post-birth through this route, delaying the need for opioid painkillers (which pass to the baby through breast milk). A second is that airway intubation, which is necessary during general anesthesia, can be more complicated for someone who is pregnant. Some literature cites an increased risk of postpartum depression if general anesthesia is used, but this seems likely to be due to differences in the circumstances under which they are used, not the anesthesia itself.

There are some circumstances in which general anesthesia will be used. The main ones are an emergency in which there is not time for an epidural or a circumstance in which the epidural does not work. These are both very rare — even in an emergency, a spinal anesthesia may be preferred to a general, and can be done quickly.

I hear your husband — this is major surgery! But an epidural is effective and lower-risk overall, and enables you to be present when your baby arrives.

Community Guidelines
Subscribe
Notify of
0 Comments
Inline Feedbacks
View all comments
A heavily pregnant person with her feet up at her office closes her eyes.

Mar. 21, 2022

10 min Read

Labor Induction and C-Section

The facts behind the "cascade of interventions"

A teddy bear wears a stethoscope and mask against a blue background.

Nov. 18, 2022

2 min Read

Will a C-Section Leave My Baby with Fewer Helpful Antibodies?

Hi Emily. There’s been a Dutch/Scottish study that found that babies born via C-section have half the amount of protective Read more

Folded pink paper hearts are arranged on a pink background.

Mar. 17, 2023

2 min Read

How Long Do I Have to Wait to TTC After a C-Section?

Hi Emily, I have a four-month-old son who unfortunately had to be born via an emergency C-section. My husband and Read more

A person with a c-section scar reclines while two children snuggle with her.

Jul. 14, 2023

2 min Read

Should I Worry About Having a Third C-Section?

I have two children, and had C-sections with both (both breech). I want to have a third baby, but the Read more