Why Do I Need To See An Anaesthetist During My Pregnancy?

When you are in labour   

We will give you ranitidine. This is a pill or injection that helps to reduce the acidity in your stomach, which is important if you need a General Anaesthetic.

After you have had your baby

It may be necessary to give you heparin injections for a few days. This is to prevent blood clots in your legs or chest, which are more common during and after pregnancy and even more likely in women with raised BMI.

One of the aims of care during pregnancy is to identify those women who may need extra help with the delivery of their baby. Doctors and midwives know that one factor that increases the risk of this is a high Body Mass Index – BMI (Body Mass Index is a relationship between your height and your weight).

Women with a high BMI are more likely to need forceps delivery or a Caesarean section which will require an anaesthetic. A General Anaesthetic may be more difficult if you have a high BMI. For example there is a higher chance of developing a chest infection. Therefore it is safer and preferable to have an epidural or spinal anaesthetic.

A spinal or epidural anaesthetic is when you are awake, but sensation from the lower body is numbed. Being awake for a Caesarean section or forceps delivery has many advantages to a woman and her baby.

However, it can take longer to find the correct place to put the needle for the spinal or epidural injection if you have a raised BMI.

You should think about having an epidural earlier rather than later in labour. Putting the epidural in may take longer than usual and it is best done before you get too sore. If you go on to need help to deliver your baby we will be able to use the epidural to avoid emergency general anaesthetic.

When will I see the anaesthetist?

As your BMI is greater than 40 you will be offered an anaesthetic clinic appointment. This will allow us to see you and examine you and to discuss pain relief and anaesthetic choices for your labour and delivery with you in relaxed surroundings, rather than trying to explain things when you are having labour pains.

To summarise:

• If your BMI is above 40, you are more likely to need some form of help with the delivery of your baby then someone with a lower BMI.
• It is generally better to stay awake for delivery, avoiding a General Anaesthetic.
• It can be more difficult to do epidurals and spinals.
• When you are admitted to have your baby you should tell your midwives that you need to see the anaesthetist on duty.

For more information on Obstetric Anaesthesia please access: www.labourpains.com and click pain relief in labour.

This leaflet was produced by the Consultant Anaesthetists in the Simpsons Centre for Reproductive Health, Royal Infirmary of Edinburgh and St John’s Hospital, Livingston.

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