C-Sections in the United States are most commonly performed using epidural or spinal anesthesia. General anesthesia is more rare and used either for true emergencies or if there is a contraindication to epidural or spinal anesthesia. Epidural or spinal anesthesia is safer for both the mother and the baby than general anesthesia. Epidural or spinal anesthesia allows the mom to see and hold the baby within minutes of delivery. With epidural or spinal anesthesia a support person is usually allowed to be in the operating room with the mother. With general anesthesia the mom typically is not able to see the baby for about an hour after the birth and her support person is generally not allowed in the operating room.
Epidurals are typically used for c-sections when a patient already has an epidural from labor. About 10-15% of women that come to the hospital expecting to deliver vaginally end up requiring a c-section. If they had an epidural for labor, that same epidural can usually be used for the c-section. Additional medication is placed through the epidural catheter to achieve the anesthesia required to perform the c-section comfortably.
The overall c-section rate in the United States is about 30-35%. the majority of the c-sections are repeat c-sections, these are c-sections performed because the patient had a c-section with a previous baby. Repeat c-sections are scheduled. For these types of c-sections spinal anesthesia is typically used. Spinals work more quickly then epidurals, they give a deeper block making the c-section more comfortable, and additional medication can be given with the spinal to keep the mother comfortable for 18-24 hours after the surgery.
General anesthesia is medication that puts the mother completely asleep. Medication is given through an IV to put the patient to sleep. A breathing tube is than placed and anesthetic gas and oxygen is given through the breathing tube. General anesthesia is used less commonly for c-sections. The most common reason to use general anesthesia is in an extreme emergency in which the baby needs to be delivered as quickly as possible. General anesthesia can be administered much more quickly than either spinal or epidural anesthesia. In situations where minutes can make a difference in the health of the baby, general anesthesia is used. Occasionally a patient will have a condition that makes spinal or epidural anesthesia unsafe, in these cases general anesthesia is used as well.