In 1853, Queen Victoria of Great Britain, pregnant with her eighth child, expressed interest in the use of a novel anesthetic, chloroform, to alleviate pain during her birth. Not surprisingly, her wish was granted. We can assume she had a positive experience, as she requested chloroform inhalation for the birth of her ninth and final child. What followed was a cultural revolution in terms of acceptance and credibility in obstetric anesthesia. Although reserved for the wealthy, the notion of having a pain free birth was born.

You would think that, almost 200 years later, advances in anesthetic technology would improve the maternal experience. Many studies have shown a worrisome trend, specifically that epidural anesthesia, a commonly used method of pain relief for labor in the U.S., often leads to patient dissatisfaction.

Often, when I get paged for an...

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