Anesthesia and Pregnancy | Effects on Mother and Fetus

| Reviewed By Amanda Lundberg, BSN, RN

Having knowledge about pain relief options during pregnancy, labor, and childbirth is crucial. While anesthesia is a widely used technique, its safety during pregnancy remains a question. How does it function and what possible side effects should be considered?

Does anesthesia cause hair loss? Anesthesia slows down cell division, a rapid process on which hair follicles rely. This condition is known as Telogen Effluvium and is usually resolved on its own within six months. While it’s believed that the two are connected, there is limited research on the link between anesthesia and hair loss.

From general anesthetics to an epidural, here’s everything you need to know about anesthesia in pregnancy.

Anesthesia and Pregnancy: What To Know

There are many different types of anesthesia that vary in effectivity, concentration, and duration.

These anesthetics can help manage pain and discomfort during otherwise intense surgeries and dental procedures during pregnancy. 

Is Anesthesia Safe During Pregnancy? 

Yes, anesthesia is safe for both mother and baby while pregnant. The rate of birth defects and abnormalities does not change among those who are exposed to anesthetic agents as opposed to those that are not.

That said, anesthesia is usually accompanied by surgery in which the risks to the mother and baby change depending on the severity and location of the operation. 

Anesthesia Drugs To Avoid in Pregnancy

There are four main types of anesthesia – local, regional, sedation, and general. Of these, local and regional anesthetics are preferred to sedation and general anesthetics during pregnancy. 

Local anesthesia is considered the safest. This type of anesthesia is injected into a small and particular part of the body. Consciousness is maintained, but pain and sensation are temporarily numbed. 

Regional anesthesia provides pain relief and numbing for larger parts of the body. This type of anesthesia also allows you to remain conscious. Epidurals and spinals both fall within this category and are used during labor.

General anesthesia is most often given via IV, though it can be given through a breathing mask. It carries the patient into a state of unconsciousness.

This is not recommended during pregnancy because it poses a slightly higher risk of complications. 

Sedation anesthesia is typically given in liquid form through an IV. There are two forms of sedation: moderate and deep.

Moderate sedation is the more acceptable method of the two during pregnancy. Sedation, though probably safe, is generally avoided during pregnancy alongside general anesthesia.  

Surgery While Pregnant First Trimester

The average fetal death rate across all three trimesters of pregnancy is 5.8%. Surgery while in the first trimester of pregnancy presents a higher rate of fetal death at 10.5%.

This shows that surgery in the first trimester poses almost double the average risk of surgeries during pregnancy. For this reason, non-emergency surgeries are often postponed to the second trimester.

Anesthesia While Unknowingly Pregnant

If you didn’t know you were pregnant, you’re most likely early in the first trimester. Remember that anesthetics themselves don’t pose a known risk to the baby.

However, the surgery that follows can negatively impact fetal development depending on the location and intensity of it. 

If you have concerns about early exposure to anesthesia, it’s best to consult your doctor. 

General Anesthesia 4 Weeks Pregnant

General anesthesia is riskier than other anesthetics since it requires the patient to be completely unconscious. This is often due to the fact that general anesthesia is given for more invasive surgeries compared to local or regional anesthetics.

However, general anesthesia at 4 weeks pregnant carries a 10.5% chance of fetal death, which is similar to other types of anesthesia. 

Anesthesia and Pregnancy Second Trimester

The second trimester is the safest time to undergo anesthesia. Surgeries that are determined necessary, even during pregnancy, are forgone until this point.

The fetal death rate associated with anesthesia and surgery in the second trimester is half that of the first trimester. 

A pregnant woman sitting in an examining room consulting with her doctor.

Anesthesia Third Trimester

Unless absolutely necessary or in the event of labor, anesthesia is not recommended in the third trimester of pregnancy. This is primarily due to the associated risk of premature birth.

Regional anesthesia is the primary pain management method for vaginal labor and delivery. For a cesarean section, a spinal block is typically used, but general anesthesia can be used as a very last resort. 

Local Anesthesia When Pregnant

Local anesthetics are generally considered safe during pregnancy. They are used in a variety of situations from dental work to when stitches are necessary.

On rare occasions, local anesthesia can cause itching, swelling, and irritation at the injection site. 

Is Dental Anesthesia Safe During Pregnancy? 

Local anesthesia is generally considered safe during pregnancy after the first trimester.

In fact, it is recommended not to postpone necessary dental work during pregnancy due to the risks associated with infection and poor dental hygiene. 

When selecting the dose and type of anesthesia with your provider, the trimester of pregnancy, history with anesthesia, and status of pregnancy should be considered. 

Spinal Anesthesia in Pregnancy

Spinal anesthesia can be used during labor and delivery to manage pain. This type of anesthesia is injected one time directly into the dural sac.

Spinals only last a couple of hours, but they act quickly. There is no difference in risk between a spinal and other forms of local or regional anesthesia like the epidural. 

Effects of Anesthesia on Hair and Skin

Anesthesia has been linked to temporary hair loss but only through limited studies. These studies suggest that the delayed replication of cells due to anesthesia impacts the hair follicles.

However, this has no bearing or connection to long-term hair loss such as androgenetic alopecia. 

Effects of Local Anesthesia on Fetus

To say that anesthesia is considered safe during pregnancy is not to say that it is without risk or impact.

Local anesthesia passes through the placenta from the mother to the fetus, which means that the baby is also exposed to it. Improper dosage can lead to changes or damage to the fetal central nervous and cardiovascular systems. 

Effects of General Anesthesia on Fetus

General anesthesia is not recommended during pregnancy because of the risks it poses to the fetus.

The largest concern with general anesthesia in terms of fetal health is the interruption of oxygen exchange, neonatal depression, and cardiovascular dysfunction.

In the event that general anesthesia must be used, doctors will monitor the mother and fetus closely. 

Related Questions:

Does Anesthesia Cause Memory Loss? 

General anesthesia does cause temporary memory loss. This was designed intentionally to ensure that patients wouldn’t remember traumatic parts of their surgery.

However, there is increased evidence establishing a link between anesthesia and decreases in memory retention and recall in older patients. 

Is It Safe To Have Surgery While Pregnant? 

1 in 50 pregnant women will require surgery during pregnancy. The safety of mother and baby varies based on the procedure method, location, duration, underlying cause, and recovery time.

For this reason, necessary surgeries should be withheld until key points in pregnancy and elective surgeries should only occur outside of pregnancy. 

Conclusion

While anesthesia is generally safe during pregnancy, surgery is sometimes not. Authoritative bodies suggest refraining from elective anesthesia and surgery until after pregnancy.

In addition, they recommend withholding necessary surgery until at least the second trimester. Anesthesia can pose risks and side effects to both maternal and fetal health.