Your anesthesiologist is a physician with specialized training and knowledge of anesthesia who is skilled in bringing that knowledge to the required care for a particular patient.

Both the anesthesiologist and obstetrician will be involved in your care before, during, and following the birth of your baby. Both will discuss with you the options to have “natural” childbirth (without pain medication) or some kind of pain control (anesthesia). They will talk with you about the various ways of providing pain control and which would be best for you to make the birth of your baby as safe and comfortable as possible. This discussion will include ways of introducing anesthesia after labor has begun, if it becomes necessary, even when natural delivery has been planned.

As a specialist with a separate medical practice, your anesthesiologist will submit a separate bill for services rendered.

Types of Anesthesia

Pain control is achieved by local anesthesia, regional anesthesia, or general anesthesia. In general anesthesia you are unconscious. In local and regional anesthesia medicine is given to achieve reasonable comfort while allowing some feeling to remain so that you are able to assist in the delivery by “pushing” with contractions just before the birth of the baby.

Local Anesthesia

Local anesthesia controls pain only in the vaginal area. It is given to ease the vaginal pain of delivery or as anesthesia for an episiotomy—an incision to relieve stretching and prevent tearing of the vaginal wall.

Regional Anesthesia

Regional anesthesia numbs the entire lower part of the body while leaving you awake during delivery. There are 2 types—epidural and spinal.

Epidural Anesthesia

After active labor has begun, the anesthesiologist places a needle in your back with a small tube (catheter) attached through which medicine is delivered just outside the spinal sac. The medicine will dull the nerves and block feeling in the lower part of your body. The catheter is installed while you are in a sitting position or lying on your side. The lower back is cleaned and numbing medicine given before the catheter is put in place. The placement sometimes causes a brief tingling in your leg, which you should mention to your anesthesiologist. Your anesthesiologist should also be told if you have any dizziness, sudden lower-body numbness, lightheadedness, odd tastes, or ringing in your ears. After the medicine is given, it may take 15 or 20 minutes for full numbness to occur.

Your anesthesiologist will closely monitor you during delivery. In the event your blood pressure drops, you may need to be given medicine and perhaps fluids through a previously installed intravenous catheter. Occasionally, the spinal sac may be entered during placement of the epidural catheter. This can result in a headache lasting 1 to 3 days and rarely longer. Usually the headache can be treated successfully with pain medication, fluids and lying flat.

This can result in a headache lasting 1 to 3 days and rarely longer. Usually the headache can be treated successfully with pain medication, fluids and lying flat. Sometimes it is necessary to perform a blood patch to treat the headache. This is when your own blood is injected into the epidural space to "patch" the small leak in the dural sac. The anesthesia department performs this procedure.
While epidural anesthesia is often used for vaginal delivery, the medication given through the epidural catheter can be quickly augmented to allow for a Cesarean Section should that become necessary

Spinal Anesthesia

When a Cesarean Section is planned in advance spinal anesthesia is often used. Rather than inserting a catheter as in an epidural, spinal anesthesia is given by injecting a small dose of medication directly into the spinal sac. Lower-body numbness is produced more quickly than with an epidural. The risks with spinal anesthesia are the same as with epidural anesthesia and are given the same treatment. Many practitioners at LAA like to combine the epidural with the spinal. This allows the use of the spinal for the C-section while allowing the epidural catheter to be used post-op for pain control.

General Anesthesia

As mentioned above, with general anesthesia you are unconscious. Sometimes this option is planned in advance. It is important to not eat or drink anything once labor begins unless permission is given to do so by your physician. Regurgitated food or liquid may enter the lungs during unconsciousness. As a further precaution, you might be given medicine to reduce stomach acid and a breathing tube might be inserted while you are unconscious.

Rarely, your condition and that of your baby may require an immediate Cesarean Section. In that instance, your anesthesiologist may decide to use general anesthesia by injecting medication through your intravenous catheter. This provides quick unconsciousness so that your baby can be delivered safely without further delay by means of an incision through the abdominal wall and the uterus.

Finally, nothing is more special than having a baby. It is the hope of Loudoun anesthesiologists that the above information will be helpful in lessening any anxiety you have and preparing you for a delivery that is as comfortable as possible. Please let your anesthesiologist know of any questions you might have before, during, or after delivery.