Women’s reported experience of conversion to general anesthesia for cesarean delivery with inadequate neuraxial anesthesia: a qualitative prospective multicenter Danish study

Overview

This qualitative study examined women's experiences of conversion to general anesthesia during cesarean delivery when neuraxial anesthesia proved inadequate. The research focused on understanding the psychological and experiential dimensions of intraoperative pain, early maternal-infant bonding, and potential posttraumatic sequelae following such anesthetic failures.

Methods and approach

A prospective multicenter qualitative design was employed across Danish centers. The study captured women's reported experiences of anesthetic conversion and inadequate neuraxial coverage during cesarean delivery. Data collection and analysis methodology centered on lived experiences and phenomenological accounts of the intraoperative period and its psychological aftermath.

Results

The study identified that intraoperative pain during conversion to general anesthesia substantially affected women's subjective delivery experience and early bonding trajectories with neonates. Pain experiences correlated with increased risk indicators for posttraumatic stress responses. Anesthesiologist communication patterns, acknowledgment of intraoperative pain, and clinical decision-making processes were identified as significant variables influencing women's psychological outcomes.

Implications

Anesthesiologists can mitigate adverse psychological outcomes through structured perioperative communication protocols. Providing timely information before, during, and after cesarean delivery, coupled with explicit acknowledgment of pain experiences without shifting clinical responsibility to patients, represents a modifiable intervention pathway. Follow-up consultations following inadequate neuraxial anesthesia may serve as a mechanism to address psychological sequelae and facilitate processing of delivery experiences.