With a spinal anaesthetic the 'dura mater' tissue is punctured. In some cases it is possible for small amounts of the cerebral spinal fluid (or CSF), to leak from this puncture site once the needle is removed. The leakage of CSF fluid reduces the fluid pressure around the spinal cord and brain. This can cause a severe headache. If the headache comes about, it will do so within 12 to 48 hours after the spinal is given and will usually be felt towards the front or back of the head. Statistics on the frequency of this side effect vary but it ranges from about 2 to 10%.
The headache will usually go away on its own within a few days, but in some cases will last for up to a week or more. It is generally worse when the woman stands and is relieved when she lies flat (not ideal for a new mother!). Other symptoms can include feeling nauseated, vomiting, dizzy, having a stiff neck, hearing a 'ringing' sound in the ears and not being able to tolerate bright lights (known as 'photophobia').
Treatments of a spinal headaches include lying flat, taking some mild pain relieving tablets (ask your caregiver) and drinking stimulant fluids such as tea, coffee and cola. These fluids have been known to help (although this may 'stimulate' the baby if you are breastfeeding). Stimulation of wrist
acupressure point PC6 has been shown to decrease nausea and vomiting after a Caesarean birth for around 50% of women.
If the headache is prolonged and severe, then a 'blood patch' may be used. This is when the anaesthetist takes about 15 to 20 mls of blood from the woman's vein in her arm and inserts the blood into the epidural space through a needle, just outside of where the spinal needle penetrated the dura mater (and the CSF fluid is leaking from).
The blood then clots and seals up the hole, preventing any more spinal fluid from leaking. It used to be thought that blood patching was up to 80% - 90% effective, making its use in recent years nearly routine in many places.