The American Society of Anesthesiologists (ASA; Schaumburg, Illinois) House of Delegates recently approved the “Statement on Pain during Cesarean Delivery” from the Committee on Obstetric Anesthesia, advising all practitioners on the pervasive problem of failure to achieve pain-free cesarean delivery. Parturients experience pain during cesarean delivery at an alarming 15% rate, with some prospective studies reporting rates as high as 23%. With 1.3 million cesarean deliveries annually and a 15% pain rate, about 195,000 parturients experience pain during cesarean delivery in the United States each year. We can and must do better!

Pain during cesarean delivery has significant consequences including adverse experiences during a memorable lifetime event, psychologic distress, an increase in postpartum post-traumatic stress disorder, and an associated increased risk of litigation. Assessing the quality of neuraxial labor analgesia, considering early replacement for inadequate analgesia, and adequate dosing for conversion to cesarean surgical anesthesia can...

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