Waking up to having your guts cut open is the stuff of horror movies. Yet, recent research has shown that this is a more common reality than we think — as up to two out of every 1,000 people will wake up during surgery.
The phenomenon, called accidental awareness during general anesthesia (AAGA), has not been studied much as “historically, when faced with a report of AAGA, there was a tendency to disbelieve the patient’s account,” as the authors put it.
The study, done by the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland, looked at records for thousands of surgeries and hundreds of accounts by people who said they’d woken up during surgery. Patients reported being able to hear noise or voices and feel touch, yet were unable to move or communicate. Half of patients who reported experiencing AAGA suffered long-term psychological effects afterward. And while those findings are terrifying enough, women have particular cause for concern as a C-section was ranked as the surgery where this was most likely to occur, with one in 670 women experiencing this.
Becky Evans, a mother of three, experienced this real-life horror story during the C-section of her first child.
Like many first-time moms, Becky knew exactly how she wanted her delivery to go. She hired a nurse-midwife and planned a peaceful water birth. Yet, when her blood pressure skyrocketed during a routine prenatal exam, she saw her carefully laid birth plan go out the window. Preeclampsia, a life-threatening condition, meant she had to be rushed to the hospital and labor was induced immediately. What followed was 24 hours of excruciating pain. Exhausted, scared and hurting, she finally asked for an epidural.
“I guess I should have known then that something was wrong when I got up and walked to the bathroom after [getting the epidural]. But, what did I know? It was my first time,” she says.
Despite changing positions and techniques, the baby wasn’t coming and, worse, his heart rate was dropping. So, the doctor made the decision to do an emergency C-section. The next few minutes were a blur of scrubs, doctors, nurses, lights and noise.
“The next thing I knew, they were cutting me open in the ER and it was incredibly painful,” she recalls. “Before they cut me, I remember them asking if I felt their touch and I told them I did, but I guess they didn’t believe me.”
“I am a [physical] therapist and I often ask patients to rate their pain on a scale from zero to ten, with ten being the worst pain they have ever felt. In those moments, it seems silly, but the only thing going through my head was, ‘This is a 10!!! This is a 10!!'” she says. “I had tears streaming down my face. I remember the intense burn as he was pulled out of me.”
At this point, her husband noticed something was wrong and alerted the doctors. The anesthesiologist quickly upped her meds, and she was out in time to get stitched back up. But, the pain didn’t end there.
When Becky was aware enough to meet her son she says, “What I had expected to be a joyous moment of bonding could not happen because of the pain I was still under. I remember being repulsed by this alien-being that had ‘done this to me.’ It was not at all like the loving experience I had planned on.” She adds that because of the emotional and physical trauma, it took extra long for her body to recover and that the healing of the C-section scar was affected. She ended up having to have the incision re-opened and packed by home health nurses daily for two weeks postpartum.
Eventually, Becky and her husband decided they wanted more children, but she was understandably terrified. When she shared her fears with her new doctor, he dismissed her saying that could never happen and that if it had, it must have been a fluke. Becky has another theory about the pain though, pointing out that new research has shown that redheads, like her, are more sensitive to pain and require higher levels of anesthesia than their blond or brunette sisters. Regardless, she chose to have a VBAC (vaginal birth after cesarean) for her last two children.
The report says that patients experience varying levels of problems afterward, writing, “Some may only be troubled by PTSD symptoms for a matter of weeks. Others will be disabled for many years, possibly for the rest of their lives.”
Now a happy, healthy mother of three, Becky says that while her main emotion is relief that both she and her son survived the ordeal, she will never forget exactly how painful and scary his birth was.