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:
294. 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.
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