Obstetric Anesthesia

The Basics About Obstetric Anesthesia

Anesthesia is routinely used to help relieve pain during a medical procedure, which often includes common occurrences like childbirth. Many individuals are familiar with epidurals and their primary use of reducing pain during the birthing process, but there are also a few other options available for expectant patients of Ko’olau Women’s Healthcare.
To determine which type of obstetric anesthesia is best for you, be sure to discuss each of your options with your doctor or midwife before labor begins. It is also important to remember that in some situations, additional obstetric anesthesia may be needed suddenly during the delivery process to reduce the mother and child’s risk for birthing complications. Call (808) 230-8500 for our Kailua office and (808) 888-3449 for our Honolulu office today to schedule a consultation!
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Types of Obstetric Anesthesia

As previously mentioned, epidurals are commonly used during childbirth to help manage the mother’s pain. This injection is administered by your obstetrician or midwife to the lower back. Once used, the epidural will require approximately 10-20 minutes before the patient will feel its numbing effects.

Individuals who receive an epidural will be completely numb throughout the area where the medication was injected, though they will retain sensation in the rest of the body, thus allowing women to stay alert for the duration of their birthing process.
Similar to an epidural, a spinal block may be used on the lower back to desensitize the area. Spinal blocks tend to take effect a bit more quickly than epidurals, and usually only require 1-2 minutes before the patient’s discomfort will start to dissipate.
For those that want the quickness of a spinal block in combination with the long-lasting effects of an epidural, there is an anesthetic available called a combined spinal-epidural, or CSE. Patients who elect for a CSE often retain the use of their legs to support their weight if they would prefer to walk around a bit during labor to use the restroom if needed.
To relieve pain of the vagina and rectum before a child is born, a pudenal block may be given. This anesthetic is named for the area which it numbs, the pudenal nerve, which is located between the vagina and anus. A pudenal block is especially helpful if your doctor determines that an episiotomy is needed, which is a surgical incision made to widen the birth canal.
Narcotic substances may be given to women who would prefer to avoid an injection in their lower back. While opioids will provide relief from the pain, they can affect both the mother’s and the baby’s breathing, which can cause further complications during childbirth.
Like narcotic medications, tranquilizers may also make patients feel particularly drowsy. For this reason, they are not often used during childbirth, though they can be beneficial for women with significant anxiety during labor and delivery.
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When to Use Obstetric Anesthesia

Natural births have become much more popular in recent years, and are certainly not a poor choice so long as mothers are able to ensure the safety of themselves and their babies throughout a natural delivery. There are a variety of conditions that can raise the risk of a natural birth, which may exist prior to a woman’s pregnancy or may only arise during delivery.
Existing Health Issues Before Pregnancy
Many women are categorized as being in a “high-risk pregnancy” for one reason or another. Most often, this has to do with a known medical condition that may affect the development and/or birth of their fetus. Such conditions include:
  • Uterine fibroids.
  • Diabetes.
  • High blood pressure.
  • Epilepsy.
  • A thyroid disorder.
  • Depression.
  • Asthma.
  • Obesity.
  • HIV and other sexually transmitted infections (STIs).
Once properly diagnosed, your OBGYN will be able to routinely monitor these types of preexisting health problems throughout a woman’s pregnancy to help prevent any sort of serious complications. In these situations, it is best to speak with a specialist about your condition and strategize for how to best complete a safe birth.

Common Labor Complications to Be Aware Of

Women can also encounter problems during labor even if they had no issues during their pregnancy. This can result from a number of causes, including:
  • Mispositioning in the birth canal.
  • Excessive blood loss from the mother.
  • Rapid labor.
  • Fetal distress.
  • Uterine rupture.
  • Shoulder dystocia.
  • Failure to progress naturally in the delivery.
  • Placenta previa.
  • Fetal breathing problems during or following labor.
  • If the baby’s head is too large to fit through the birth canal (cephalopelvic disproportion).
Serious conditions of this nature require intervention from a medical professional as soon as possible, which often involves the use of additional anesthetic to avoid pain that may be felt during more complex procedures, such as a cesarean delivery (C-section).

KO'OLAU WOMEN'S HEALTHCARE