Obstetric anesthesia is the use of a variety of measures to control sensation in laboring women for the purpose of making delivery safer and more comfortable. This includes both true anesthesia, where an anesthesiologist will use medications to block sensation, as well as analgesia, the provision of pain management to help patients control their pain more effectively. These services are available through an anesthesiologist or anesthesia technician, and an obstetrician can also play a role in pain management for a patient who needs it.
In the case of Caesarian sections and other surgical procedures, anesthesia is critical for patient care. An anesthesiologist can numb sensation below a certain point on the spine to allow a doctor to work without hurting the patient. Partial blocks are also available for laboring patients who experience discomfort during vaginal deliveries and want more effective pain management. Historically, obstetric anesthesia also included practices like twilight anesthesia, where the doctor induced a euphoric state in the patient with drugs to help her forget the delivery later.
Pain during childbirth has been a cause for concern in medicine for centuries, and some of the earliest approaches to anesthesia were in the delivery room. Early obstetric anesthesia dates to the mid-1800s. Providing anesthesia for laboring mothers is a complex process, as the wrong anesthetics can potentially harm mother, baby, or both. The doctor must calculate the dosage carefully, selecting a drug appropriate for the need, to avoid causing problems like a weak suckling reflex after birth.
Childbirth can also be medically challenging because it can rapidly switch from a routine event to a medical emergency. Part of obstetric anesthesia involves monitoring the patient for signs of distress and being ready to take action if an emergency medical intervention is necessary. Patients who need surgery will require constant monitoring by an anesthesiologist who responds to input from the surgical team to adjust the level of anesthesia and keep the patient stable and comfortable. Anesthesiologists will also play a role in postoperative analgesia, addressing pain as patients recover from surgery.
While in anesthesiology residency, doctors receive training in how to administer obstetric anesthesia safely and effectively. It is also possible to pursue fellowships for advanced training in this medical field. A fellowship will provide doctors with more experience and skills they can use to treat their patients, and may also offer research opportunities for doctors with an interest in improving pain management in obstetric cases.