The following is a step by step guide to what is usually involved with having an epidural anaesthetic for a Caesarean. The woman will need to have a drip inserted into her vein so that the anaesthetist can administer fluids and medications if required.
Pre-operative visit and consent
Positioning the woman
Inserting the needle
Testing for the location
Inserting the epidural catheter and medications
Taping the catheter in place
Pre-operative visit and consent. If the Caesarean is planned, the anaesthetist will usually speak with the woman before the operation to ask her questions about her general health and medical history and discuss the best type of anaesthetic to use, including if the woman has any preferences. They will usually explain the procedures involved and obtain a consent for the anaesthetic.
Positioning the woman. The woman is helped to lie on the bed on her side (right or left). Some anaesthetists prefer the woman to sit up on the side of the bed leaning over a pillow on her lap, with feet resting on a chair or a footstool. Either way the woman needs to curl up in the fetal position (like an 'angry cat') on her side or over the pillow, to curve her back and help separate the spaces in the bones of her spine. This will help the anaesthetist pass the epidural needle between the bones, to reach the epidural space.
Image 8-14 shows the woman in position for the insertion of the epidural.
If the Caesarean is unplanned and the woman is in labour, this position will need to be maintained for about 1 to 3 contractions (the woman staying as still as possible), while the anaesthetist inserts the needle and the epidural catheter. It may be that the partner or another caregiver will help to gently 'hold' the woman in that position while the procedure is being performed. The anaesthetist will try as much as possible to carry out this procedure in the rest periods between the contractions.