I just had a good discussion with my father in law who is chief of anesthesiology at a hospital in Hawaii and has worked as an anesthesiologist for almost 40 years. I discussed my concern about how many women are reporting inadequate pain management during c-sections. He was also very concerned at some of the stories that have been shared recently and suggested the following things:
1. If the c-section is not an emergency talk with the anesthesiologist prior to it. Ask him or her:
-If pain relief is inadequate during the birth what is the backup plan?
-How do you test to insure proper numbness or sensation block prior to the first incision?
Answers should be reassuring and include re-doing the epidural, placing a spinal block instead, local anesthetic (which he said wasn't hugely helpful), ketamine thru your iv or narcotics thru the iv. With something like ketamine you will still have discomfort but you won't remember it-I don't recommend this and neither does he if it's avoidable.
If he's dismissive or creepy talk to your ob privately and let them know you are uncomfortable and see what the ob says. If it's a non-emergency c-section then you can re-schedule. They might get pissy but it's your birth and ultimately your comfort is utmost.
If during the procedure a mom is feeling pain then she can insist on additional pain relief. If the ob or anesthesiologist is dismissive then dad or coach can help mom insist on additional pain relief "it's all in your head" or "no you don't feel anything" isn't an appropriate answer.
He acknowledged if it's an emergency and baby is in distress and the anesthesiologist is a boob that mom doesn't have many options.
So he PLEADED for all moms that have bad experiences-whether it's inadeequate anesthesia, abusive staff, or anything to write letters. He said a letter from one mom might not get somebody fired or their licensed yanked but multiple letters from various women might get something done.
I encourage moms to write letters to any or all of the following:
-Your treating doctor or midwife.
-The specific staff member that was abusive or inadeequate.
-The hospital's "risk management," ombudsman, or patient relations department. Essentially the "complaints" department.
-The state medical board.
If all else fails sites like www.ratemds.com can at least give other moms a warning. Also Yelp sometimes has doctors listed. I also encourage moms to tell other women about poor treatment by doctors, hospitals, or midwives. Word of mouth can be very very powerful.