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Related Experiment Videos

Obstetric anesthesia work force survey, 1981 versus 1992

J L Hawkins1, C P Gibbs, M Orleans

  • 1Department of Anesthesiology, University of Colorado Health Sciences Center, Denver, USA. jlhawkins@ski.uhcolorado.edu

Anesthesiology
|July 1, 1997
PubMed
Summary
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Obstetric anesthesia has evolved, with increased labor analgesia and reduced general anesthesia for cesarean sections. However, smaller hospitals still face challenges in providing regional analgesia, and anesthesiologist involvement in neonatal resuscitation has decreased.

Area of Science:

  • Anesthesiology
  • Obstetrics
  • Healthcare Management

Background:

  • A 1981 survey established baseline data on obstetric anesthesia practices in the U.S.
  • The survey was repeated in 1992 to track changes and identify trends.
  • Supported by the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists.

Purpose of the Study:

  • To compare obstetric anesthesia personnel and methods used in 1981 versus 1992.
  • To identify changes in the provision of labor analgesia and anesthesia for cesarean section.
  • To assess variations in practice based on hospital size and U.S. region.

Main Methods:

  • A stratified random sample of U.S. hospitals was selected based on annual birth volume and census region.

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  • Surveys were sent to hospital administrators, chiefs of obstetrics, and chiefs of anesthesiology.
  • The 1992 survey incorporated new issues while maintaining comparability with 1981 data.

    • Main Results:

    • A decrease in the number of hospitals providing obstetric care, particularly smaller facilities.
    • Significant increase in labor analgesia use, with a 100% rise in epidural analgesia.
    • Reduced use of general anesthesia for cesarean sections, with increased regional anesthesia utilization.
    • Decreased involvement of anesthesia personnel in neonatal resuscitation.

    Conclusions:

    • Labor analgesia is more common, and general anesthesia for cesarean sections is less frequent compared to 1981.
    • Regional analgesia remains limited in smaller hospitals; nurse anesthetists provide a majority of cesarean anesthetics in these settings without anesthesiologist direction.
    • Obstetricians' direct provision of epidural analgesia has declined, as has anesthesia personnel's role in neonatal resuscitation.