How cesareans are anesthetized

Almost all are awake. A minority are not.

In a 2025 national survey of US hospitals, about 85% of scheduled cesareans were performed under spinal anesthesia, and about 86% of urgent cesareans under some form of regional anesthesia, with 14% under general anesthesia.

There are three routes:

Spinal. A single injection into the spinal fluid. Fast, dense, reliable. Most common for planned cesareans.
Epidural top-up. If you already have a labor epidural, stronger medication is given through the existing catheter.
General anesthesia. You are put fully to sleep with a breathing tube. Used when there is no time, when a regional block fails, or when a regional block is unsafe.

Where this comes from

Bucklin BA, Hawkins JL, Asdigian NL, Kennerley V, Pattee J, Traynor AJ. Obstetric anesthesia workforce survey: forty-year update. Anesthesiology. 2025;143(2):330-344.

Covered in the class

2Module 2. The five ways your pain can be controlledAn epidural, a spinal, a general anesthetic, medicine through a drip, and local. What each one is, when it is used, and what it costs you. 5Module 5. How a cesarean is anesthetized, and what the room is likeAwake for almost all of them. What is placed, what is raised, and what you will hear and smell.

Continue

Read this inside the full program, with the questions to take to your next visit and a record of what you have covered.

Obstetric Anesthesia Preparedness →

More from Anesthesia

Side effects of a spinal during the operationLow blood pressure, nausea, shivering and itching are all common. General anesthesia: the breathing tube and the stomachTwo specific risks that make obstetric general anesthesia harder. General anesthesia: awarenessObstetrics carries the highest awareness risk of any surgery. Pain during the operationThe single most under-disclosed fact in cesarean consent.

This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you.