When you're about to have a C-section, a lot is going through your mind. (I mean, the thought of your baby being literally cut out of you is already too much, right?) But one concern you might have is the anesthesia they'll use for the surgery. You might end up being administered something called a “spinal block” — which sounds objectively scary. But, what you need to know about getting a spinal block during a C-section can make you feel a lot better.
I spoke with OB-GYN Dr. Kimberly Langdon of Ohio, and she assures me that these are common procedures that are done every day. She tells Romper that spinal blocks are “done for scheduled procedures like cesarean sections, or in a laboring woman who has no epidural but needs a cesarean section for some reason.”
It's different from an epidural in how it is administered, though the pain relief and effects are similar. “A spinal block is injected into the cerebrospinal fluid or the spinal or subarachnoid space that directly bathes the spinal cord and nerves," Langon says. But don’t worry, you’re given topical anesthesia before the big stick. I’ve had a spinal block, and it wasn’t terrible — just very tingly and weird. “The needle goes through the dura and is removed after the medication is injected.” But unlike an epidural, which provides a drip of medication, Langon says that a spinal block is just one dose of the medication you need.
OB-GYN Kecia Gaither of New York City Health and Hospitals tells Romper, “Spinal and epidural anesthesia are both types of neuraxial anesthesia in which an anesthetic is injected near the spinal cord and nerve roots. What this accomplishes is to block pain from an entire region of the body — the abdomen and legs. It is utilized for the most part during childbirth, but may additionally be utilized for other types of surgical procedures.”
And though these are considered routine and safe procedures, she notes that there are risks to spinal block, namely low blood pressure, which can lead to fetal heart rate fluctuations. Gaiter notes that the most common negative side effect is a headache. And readers, let me tell you from personal experience, spinal headaches are unpleasant. Thankfully, they’re easily treatable.
You might also experience itching, nausea, vomiting, or you may form a hematoma (a collection of blood beneath the skin), or in more serious cases, “spinal shock, cardiac arrest, injury to nerves, and trouble breathing if the medication goes too high in the spinal canal and affects the diaphragm which controls breathing,” according to Langdon. “The biggest risk is if the medication is injected into the vein around the dura in the epidural space. If this occurs, cardiac arrest can occur as can seizures.”
I get that it sounds terrifying, but the benefits outweigh the risks.
Something else that you need to know about getting a spinal block during a C-section is that unlike an epidural, it lasts only a finite amount of time, so if you’ve had a previous birth and you can remember all those hours of numbness and the inability to move your legs, this is different, according to Langdon. And thank heavens for the small favor of being able to move your legs to get more comfortable after having your baby — if you are able bodied. Also, there is truly nothing worse than hearing your baby cry from the hospital bassinet next to your bed, and unable to move to get them.
The Mayo Clinic has rated both the pros and cons between an epidural and a spinal block. The organization noted that, like Langdon said, a major pro of a spinal block is that it only lasts for a small amount of time. But the cons definitely include the headache, and itchiness or soreness in your back. For an epidural, one of the pros is that it doesn't slow down labor, but if you're headed in for a C-section anyway, that's not really a "pro" you'll miss out on.
All in all, a spinal block is one option for anesthesia that doctors employ to bring your baby topside, and it works beautifully. But don't worry about choosing between a spinal block or an epidural. Your doctor and your anesthesiologist will make the safest choice for you and your baby.
OB-GYN Dr. Kimberly Langdon
OB-GYN Kecia Gaither, MD, MPH, FACOG of New York City Health and Hospitals, Lincoln
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