Using General Anesthesia During Labor: Risks to Mother and Baby
Being informed about general anesthesia will help prevent mothers from being caught by surprise in the unlikely event that it might be necessary. General anesthesia causes a total loss of both sensation and consciousness.
It is rarely used for childbirth because a mother’s conscious participation is regarded as highly important for a safe and efficient birth.
The following are RARE situations in which a health care provider might decide to administer General Anesthesia:
- Emergency cesarean when a rapid loss of sensation is required
- In rare cases where an epidural or spinal block cannot be placed
- When the woman cannot tolerate a regional anesthetic
- When the benefits of general anesthesia clearly outweigh the risks
How is it given?
Step 1: A muscle relaxant, such as succinylcholine, is given intravenously. This quickly makes the woman feel very relaxed and semiconscious.
Step 2: She then inhales a gas called nitrous oxide which causes total loss of consciousness. A tube is inserted into the woman’s trachea to keep her airway open and allow administration of the anesthetic. Because an unconscious person might vomit, the tube helps prevent the possibility of inhaling the vomited material.
What are the risks to mother and baby?
Research strongly indicates that the rate of maternal death due to general anesthesia may be at least double the death rate from regional anesthesia. The primary cause of maternal death from general anesthesia is a difficulty with airway management.
The greatest concern for the baby is the decrease in uterine blood flow and neonatal depression. According to Danforth’s Obstetrics and Gynecology, the prolonged neonatal effects have led to the virtual elimination of the use of general anesthesia during labor and birth.
Compiled using information from the following sources:
Obstetrics and Gynecology: Just the Facts. Duff, Patrick, et al, Ch. 23.
Danforth’s Obstetrics and Gynecology Ninth Ed. Scott, James R., et al, Ch. 3.