Improved Nursing Assessment and Escalation of Care for Patients With Unrelieved Pain During Cesarean Birth

Unrelieved intraoperative pain during cesarean birth is an underrecognized complication with important clinical and psychological implications. Evidence indicates that intraoperative pain during cesarean birth is more common than previously recognized, particularly when measured using patient-reported outcomes rather than procedural proxies. Inadequate pain management has been associated with psychological distress, trauma symptoms, and dissatisfaction with care. Historical patterns that minimized women's pain and disparities related to race and language continue to influence clinical response. In this column, I synthesize the current evidence and clinical guidance to highlight opportunities for improved nursing assessment, communication, and escalation of care, with emphasis on the role of nurses in promoting patient safety and respectful maternity care.