Obstetric anesthesiologists not only relieve pain, they save lives

Obstetric anesthesiologists not only relieve pain, they save livesA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

As an obstetric anesthesiologist, it is my responsibility to make sure expectant mothers are comfortable during labor and delivery. It is important women understand their pain management options during childbirth by having discussions with their anesthesiologist and obstetrician. However, as an obstetric anesthesiologist, my role often extends beyond merely being a “pain reliever.”

While most labors and deliveries go very smoothly, on occasion things can go wrong suddenly – the baby might get “stuck,” the placenta may fail to deliver properly, or one of a dozen other complications may arise which can put the mother’s and the baby’s safety, and even life, at risk. In these situations, the years of training anesthesiologists undertake can make a profound difference in the outcome of a delivery.

I work in a university hospital, where teaching anesthesia residents is part of our daily routine. A few years ago, while caring for a young woman during delivery, one of those serious complications developed. Shortly after delivery, the placenta failed to detach as it should, and a trickle of bleeding became a torrent. While the obstetricians worked to surgically correct the problem, my resident and I spent more than two hours during the emergent surgery administering blood and resuscitating the woman to allow the surgery to be completed. Several hours later, the new mother was stable in the recovery room.

The following day, my resident went to visit the woman, who was sitting in bed breastfeeding and smiling at her new baby girl. Afterward, the resident said to me, “I guess we did okay yesterday.”

“No,” I replied, “you did more than okay – you literally saved her life. Never forget that.”

Sitting here today, I do not remember the woman’s name, and wouldn’t recognize her if we met on the street (or she, me, I am sure), but somewhere nearby, a mother and daughter are alive, and hopefully happy. Sometimes an obstetric anesthesiologist can make a profound difference.

In some parts of the world, when a woman becomes pregnant and delivers a baby, she has a greater than 1 in 1,000 chance of dying, simply because she got pregnant. The risk in this country and most of the “developed” world is much lower, and a large part of the difference is due to the availability of anesthesiologists to care for these women. Obstetric anesthesiologists not only help relieve pain, they save lives.

Craig M. Palmer is Chair, ASA Committee on Obstetrical Anesthesia. 

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