Congratulations! The day of your child’s birth is one of excitement but also uncertainty and it is your Anaesthetist’s job to keep both of you safe and comfortable during this process. Below is some general information regarding Anaesthetists and your care during pregnancy and delivery. If you have further queries regarding any aspect of your care please do not hesitate to ask when you meet.
Labour Analgesia
There are a variety of methods to manage pain during labour including supportive person, breathing exercises, massage, TENS, medications and epidural. Anaesthetists are involved in providing Epidural Analgesia.
Epidural Analgesia
An “Epidural” is a small catheter inserted into the space surrounding the nerves of the lower back. They are similar in design to intravenous cannulae used to give medications or fluids. Medication is delivered via this catheter to reduce sensation to the areas that signal pain during labour and the catheter remains for the duration of labour to provide pain relief for its entirety. Once your labour is complete the epidural can be removed and sensation will return to normal within hours.
Although epidurals sometimes do not completely remove pain, they often provide enough pain relief for patients to sleep through the early contractions. Minor effects of the epidural include fever and shivering. There is no evidence that epidurals increase the risk of caesarean or forceps delivery during labour. Other risks of epidurals are rare and your anaesthetist can explain them further when you meet.
Anaesthesia for Delivery
In order to deliver the safest care for you and your newborn your anaesthetist must determine general and specific risks for your method of delivery, your child and your medical conditions. The common methods of anaesthesia for delivery are general anaesthesia or neuraxial (spinal and epidural) anaesthesia.
Neuraxial Anaesthesia
Neuraxial anaesthesia is a form of anaesthetic delivered to the nerves of the back that supply the skin and tissues in the rest of the body. This technique usually involves an injection of local anaesthetic medication (similar to what you might have at the dentist or GP) prior to surgery. There will be no painful sensation during the surgery but you will have vague sensations of touch and movement. Although unusual, these sensations are generally very well tolerated and your anaesthetist will warn you of them.
As with any procedure there are risks but serious complications of neuraxial anaesthesia are very very rare in pregnancy. The more common side effects are minor and include shivering or nausea.
In Australia, this is generally the preferred method of anaesthesia for delivery as the any medications given to mother are transferred to the baby. These medications are minimised during neuraxial anaesthesia and as a bonus, you will be awake to meet your new baby!
General Anaesthesia
General anaesthesia involves a combination of medications administered orally (premedication, analgesics), medications administered via an injection (intravenous anaesthetics, analgesics, antibiotics, anti-nausea medications), medication administered via a face mask or breathing tube (anaesthetic gases). During the anaesthetic, you are unaware of your surroundings and have no recollection of the procedure. Your anaesthetist stays with you throughout the entire procedure administering medication and managing your consciousness, comfort, breathing, and heart function.
This method of anaesthesia may be preferred when there is a reason you cannot receive a neuraxial anaesthetic.