Anesthesia for C-Sections and Safety

Anesthesia has improved, and become safer for women in labor or those who have to have a operation for the birth of teir baby.  But women will ask at their prenatal visit exactly how save it is to have a C-section , and one of the topics to cover is the topic of anesthesia safety. In the 1980s women still had to remove their nail polish for operations because we had no means better than monitoring the amount of oxygen in the blood stream other than seeing if the nail beds still had normal color! But today we have instruments which measure the amount of oxygen in the blood stream, and this has been a huge stride forward in safety. How safe is anesthesia in pregnancy with respect to some of the other causes of serious complications in labor?The CDC has been tracking this since 1987 when they established the Pregnancy Mortality Surveillance System, and all the states provide them with copies of actual death certificates for them to glean data to help improve the health of women. From 1900 to 1990 the chance of dying in childbirth decreased by 99%. In the US when we look at the cause of deaths from maternal causes, we look at the group of women who suffered a complication compared to total live birth rate. In other countries they often look at miscarriages, pregnancy terminations as well as tubal pregnancies, so be careful if you are comparing us to other places as counting varies from population to population. A group of researchers from the University of Florida noticed that from a stand point of the gravest complication of pregnancy, death, the two most common causes of serious problems were blood clot (embolism) and high blood pressure made up most of the complications. Furthermore they noted that the women who suffered the greatest were women who did not get in for prenatal care. When the researchers looked carefully at medical records, they discovered that almost all women who die from an anesthesia related complication have had a C-section, that epidural and spinal anesthesia is safer than having general anesthesia, and that its still extraordinarily safe with an only one in a million chance of dying from anesthesia. So when approaching your pregnancy and thinking about your chances of having a c-section, find out from your doctor if there are any reasons you cannot have a spinal or an epidural. Remember, when it comes to safety there is no time that is too soon to have a talk on how to maximize your safety.

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