Pain during cesarean delivery is not “just pressure,” and it is not rare. We dig into why inadequate pain control during C-section remains underrecognized even as patient-reported data suggest it may be one of the most common anesthetic complications in obstetric anesthesia, with consequences that can reach far beyond the operating room including PTSD, postpartum depression, disrupted bonding, and lasting distress about birth.We walk through what the research has measured so far (conversion to general anesthesia, neuraxial replacement, and intravenous rescue medications) and what those markers can miss when the team does not recognize pain in real time. Patient stories, including lessons highlighted in The Retrievals podcast, make the safety gap impossible to ignore and help explain how bias, hierarchy, and cultural norms can quietly normalize suffering. We also unpack how language choices, especially the casual overuse of “pressure,” can minimize pain and derail clear assessment.From there, we get practical. We talk about shared decision making, objective ways to identify intraoperative pain, and how teams can escalate care: pause when possible, optimize neuraxial anesthesia, use evidence-based adjuncts, and move to general anesthesia when regional anesthesia is not sufficient. We also cover why systems matter, from reliable block testing to OR readiness for safe obstetric general anesthesia and postoperative follow-up when pain occurs.Subscribe for more anesthesia patient safety conversations, share this with a colleague on L&D, and leave a review so more clinicians can find it. What is one change you want your team to make after listening?For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/315-pain-during-cesarean-delivery/© 2026, The Anesthesia Patient Safety Foundation

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