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Pain during caesarean delivery under neuraxial anesthesia is common and historically has not been openly discussed within our specialty. This session will explore the incidence, risk factors, and challenges of recognizing and responding to inadequate neuraxial anesthesia, as well as its psychological impact on patients and the associated medicolegal implications for providers. Emphasis will be placed on evidence-based strategies to prevent, identify, and manage intraoperative pain. By highlighting gaps in communication and responsiveness, this session underscores critical opportunities to enhance patient-centered care, improve maternal outcomes, and strengthen overall quality and safety in obstetric anesthesia.

At the end of this session, attendees will be able to:

1. Describe the incidence and risk factors associated with pain during caesarean delivery under neuraxial anesthesia.
2. Explain patient, provider, and system-level contributors to inadequate anesthesia during caesarean section, including physician perception and recognition of pain.
3. Summarize the clinical, psychological, and medicolegal consequences of intraoperative pain during caesarean delivery.
4. Evaluate current strategies for preventing inadequate neuraxial anesthesia and identify early warning signs of block failure.
5. Apply evidence-based approaches to the management of intraoperative pain during caesarean delivery, including effective communication strategies.