Anesthesia involves a medical procedure to sedate or numb a patient to undergo a medical procedure. Anesthesia can use a variety of methods to provide pain relief, immobilize a patient, or make the patient unconscious. The most common methods of anesthesia during childbirth are epidurals or local anesthetic. General anesthesia is less common but is sometimes used in emergency C-sections.
Although anesthesia, spinal blocks, and epidurals are common, they are not without risks. Anesthesia can be a significant event for the brain and body. Pregnant mothers may have concerns about the risks of anesthesia that the doctor downplays or ignores. However, after a birth injury, the doctors may still not admit that they did anything wrong.
There is always a risk of complications during anesthesia, both for the mother and the child. When the anesthesiologist or doctor fails to follow the standard protocols, makes a mistake, or fails to properly monitor the patient, it can lead to birth injuries.
Anesthesia Procedures During Childbirth
Many people are nervous about the effects of anesthesia during childbirth. Parents may worry that the anesthesia will affect the child. Anesthesia is a broader term that can refer to a number of procedures to reduce pain, immobilize a patient, or numb certain parts of the body. Types of anesthesia can include:
- Monitored sedation and analgesics
- Local anesthesia
- Regional anesthesia
- General anesthesia
Monitored Sedation and Analgesics
Monitored sedation, conscious sedation, or twilight sedation, is generally used for pain control and to reduce anxiety. Analgesics are drugs that provide a sense of calm, while providing some relief from pain. The patient may still feel pain and pressure in the area treated but the effects may be reduced. Sedation and analgesia may be combined to increase the relaxation and pain-relieving effects.
Analgesics in childbirth may include opioids or nitrous oxide. Nitrous oxide is generally safe for the mother and child but opioids may have more serious side effects. Opioids can slow the child's breathing and heart rate, which may have more serious side effects if the breathing or heart rate is slowed too much.
Local or localized anesthesia is generally used for a specific area of the body to provide pain relief or numbness for patient comfort. In general medical practice, local anesthesia may be used for a minor procedure, like stitches or fillings for cavities. In childbirth, it can be used to provide pain relief in areas where the mother is feeling pain from delivery. Local anesthesia may also be used in an episiotomy to repair tissue after childbirth.
Some people may have an allergic reaction to local anesthetic or suffer complications if the dosage is too high. Local anesthesia is generally given just before delivery or after delivery and does not generally have an effect on the child.
Regional anesthesia is more common in childbirth to numb larger regions of the body. During labor, epidurals, spinal blocks, or combined spinal-epidural (CSE) blocks may be used to numb the body below specific regions of the spine, such as the lower back down or the waist down. This anesthesia is provided directly to the spine and affects the peripheral nervous system below that point on the spinal cord.
With regional anesthesia, or an epidural, the patient is generally alert and awake but the injection blocks feeling from the nerves at that area of the spinal cord. With vaginal delivery, the amount of regional anesthesia, along with analgesics, may still allow the mother to push the baby through the birth canal. However, with a cesarean section delivery, the amount of anesthesia may be increased to provide greater relief from pain and sensation.
Spinal blocks and epidurals involve an injection or shot directly into the nerves of the spinal cord. This can carry a risk of injury to the spinal cord of the mother. Injury to the spinal cord can cause hemorrhage or spinal bleeding, or nerve damage, which can lead to paralysis, paraplegia, or quadriplegia.
General anesthesia is what people think of as “going under.” With general anesthesia, the entire central nervous system activity is suppressed. The patient is unconscious and unable to feel sensation while under the effects of the anesthesia. General anesthesia is usually used before any long or invasive surgical procedure, including anything from removal of wisdom teeth to heart bypass surgery.
After receiving a dose of general anesthesia, the patient will shortly lose consciousness. The patient may have to be intubated to keep the airway open and use a ventilator to maintain a steady oxygen supply to the heart and brain while the patient is unconscious.
General Anesthesia in Labor
General anesthesia is not common in childbirth and may only be used for emergency situations. There are a number of short-term and long-term risks associated with general anesthesia, and many of those risks are still being evaluated. General anesthesia may be used in an emergency C-section where it is the fastest way to perform the delivery.
During anesthesia and recovery, the patient needs to be closely monitored by the anesthesiologist. Possible complications include airway support, low blood pressure, and hypothermia. Other risks of anesthesia include aspiration which can lead to pneumonia, intubation injuries, and oxygen deprivation.
Who Performs the Anesthesia Procedure?
Anesthesia is performed by an anesthesiologist. Anesthesiologists are doctors with a primary focus on pain relief. They provide analgesics, sedatives, and anesthesia to people who are about to undergo medical procedures. Anesthesiologists are specialists, who have to go through all of the same educational requirements and training as doctors, in addition to training and certification to specialize in anesthesiology.
Between 1999 and 2006, there were more than 2,200 anesthesia-related deaths in the United States. These fatalities included anesthetic overdose, adverse effects of anesthesia, and complications of anesthesia in pregnancy and labor. Some examples of medical malpractice by anesthesiologists include:
- Not adjusting the anesthesia to match the patient's weight and condition
- Using more or less anesthesia than is acceptable
- Not properly monitoring a patient once the anesthesia has been administered
- Not properly monitoring a patient during emergence from the anesthesia
How Anesthesia Can Lead to Birth Injuries
Many of the risks of anesthesia to the patient can extend to the child. In some cases, the fetus or child may be more at risk of injury if the mother receives anesthesia because of the child's developing brain. The risks of birth injury depend on a number of factors, including the extent of anesthesia, drugs involved, and complications relating to delivery.
Anesthesia Drug Complications
One of the ways anesthesia can cause injury to the mother and baby is through drug interactions or complications. Some patients may be allergic to certain antibiotics or muscle relaxants.
If the mother is allergic to an anesthetic or analgesic drug, it can cause an allergic reaction. A mild allergic reaction may only cause itching, redness, or discomfort. However, a serious allergic reaction could put the child at risk of serious injury.
A serious allergic reaction may cause anaphylaxis or anaphylactic shock. Anaphylaxis in a pregnant patient can cause itchy skin, difficulty breathing, tightness in the chest, swelling of the airways, pain, and uterine contractions. Allergic reactions can be deadly for the mother and baby, without proper treatment.
Even if the allergic reaction of the mother does not put the mother at risk of serious injury, the body's reactions could risk fetal brain damage. Maternal hypotension, or low blood pressure, can lead to intrapartum asphyxia, reducing the supply of oxygen to the baby's brain.
Lack of oxygen at birth can cause developmental delays. It only takes a short period of time before the lack of oxygen begins to damage brain cells. The longer the child's brain goes without oxygen, the more extensive the damage can be, leaving the child suffering permanent brain damage.
When a mother begins to suffer an allergic reaction because of anesthesia, analgesics, or other drug interactions, the medical professionals must address any serious reactions. Delayed treatment or failure to monitor the fetus can risk serious injury to the child. Anaphylaxis may require an emergency cesarean section to give the child the best chance of survival and recovery.
Lack of Oxygen and Blood Flow Caused by Opioids
The lack of oxygen and blood flow to the child's brain presents the greatest risk of birth injury to a child after the mother receives anesthesia. Lack of oxygen can be caused by the low blood pressure, reduced oxygen intake, slower breathing, or a slower heartbeat.
Certain drugs, like opioids, may be given to relieve the mother's pain during labor and childbirth. These drugs can suppress the central nervous system, which may lower the heart rate and breathing rate. If a mother's heart rate or breathing is too low, it may not provide enough oxygen and blood to the fetus.
Drugs, like opioids, can also be absorbed by the fetus when given to the mother. The drugs may have a similar effect on the child, slowing the heart rate and breathing rate, putting the child at risk of anoxia or hypoxic brain injury.
One of the common birth injuries caused by oxygen deprivation is cerebral palsy. Cerebral palsy may have multiple causes, but one cause involves a lack of oxygen to the brain. A baby's brain may be able to recover from a short hypoxia event if quickly alleviated but brain cells can start dying less than 5 minutes after they are cut off from oxygen. After brain cells die, brain damage may be permanent.
Anesthesia and Airway Compromise
General anesthesia can impair the body's cardiovascular system and brain function. Under general anesthesia, the patient may be unable to keep the open airway or continue breathing. If the patient's airway is not maintained and they are not receiving enough oxygen, it can cause brain damage for the patient and the unborn child.
Brain damage to the mother or child caused by anesthesia may be caused by administering too much anesthesia or failing to properly monitor the patient.
Long-Term Effects of Anesthesia Birth Injury
A child's brain is very sensitive to injury while developing. This includes during development in the womb, as a neonate, infant, and on into childhood. Any damage to the sensitive brain can cause significant damage to the child that may be permanent.
The effects of brain damage caused by an anesthesia injury include physical and cognitive dysfunction. Cognitive effects of a brain injury can include:
- Limited brain function
- Difficulty speaking
- Difficulty hearing speech
- Hypersensitivity to sound or light
- Vision problems
- Attention deficit
- Memory deficit
- Aggression or agitation
Motor and physical dysfunction after a brain injury can include:
- Impaired motor skills
- Inability to crawl or walk
- Spastic movements
- Impaired balance and coordination
- Difficulty swallowing
- Risk of aspiration
Anesthesia Birth Injury Damages
A parent may be happy to have their child survive a traumatic birth. However, the parents may have to face the costs of raising a child with serious birth injuries. The costs of medical care for a child with a birth injury may not be covered by insurance and could cost the family more than $1 million. If the birth injury was caused by medical negligence, a medical malpractice birth injury lawsuit can help parents recover damages.
A child with anesthesia-related birth injuries may require regular care for the rest of their lives. Medical care may include:
- Speech therapy
- Physical therapy
- Occupational therapy
- Mental health services
- Educational services
- Home modifications
Anesthesia Birth Injury Attorneys
After a traumatic birth, the family may not know the extent of their child's injuries. It may take months or even years before the parents find out that their child has developmental problems. To make it even more difficult for parents, the doctors, hospitals, and healthcare providers may not tell the parents that something went wrong during labor. If confronted, the hospitals and insurance companies may deny and wrongdoing and make things as difficult as possible for parents to recover compensation for their child's birth injury.
If parents have questions about the anesthesia procedures during labor and suspect that something went wrong, they should call a birth injury attorney for help. An experienced medical malpractice attorney can help the family recover damages and hold the doctors and hospitals accountable for their failures. Do not hesitate to contact Gilman & Bedigian today for a free consultation.