Obstetric anesthesia in Latin America: a workforce and clinical practice survey (2025)

This study offers the first comprehensive assessment of the obstetric anesthesia workforce in Latin America. It aims to describe workforce composition, clinical practices, and safety protocols, and compares findings with United States data.

A web-based, anonymous survey was administered in August 2025 to national leaders in obstetric anesthesia from 24 Latin American countries. The survey tool was adapted from the United States Obstetric Anesthesia Workforce Survey. Responses were descriptively analyzed and averaged after weighting for national birth rates. Comparisons with United States data were descriptive.

Of 62 anesthesiologists contacted from 19 countries, 50 responded. Most respondents (90%) worked in high-risk referral hospitals, and 54% in academic centers with residency programs. During daytime, 50% reported non-obstetric concurrent duties, increasing to 60% after hours. Neuraxial labor analgesia was provided in 69% of cases (epidural 37%, combined spinal epidural 23%, dural puncture epidural 3.4%, single spinal 3.8%); 26% of laboring patients received no analgesia. Spinal anesthesia was most common for planned cesarean delivery (86%), with intrathecal morphine used in 83% of centers. Enhanced Recovery protocols were used in 27%. General anesthesia was reported in 18% of urgent cesarean deliveries. Safety measures-massive transfusion protocols, advanced life support training, and ultrasound-were available in 79%, 69%, and 87% of centers.

The survey reveals strengths including high rates of neuraxial analgesia and safety protocols, but substantial variation in staffing, analgesia, and techniques. Opportunities exist to expand coverage, standardize practices, and improve maternal safety in Latin America.