Patient Information

Labor and Delivery

The placement of epidural catheters for the management of labor pain is the most well-known aspect of our obstetrical anesthesia practice. In fact, your anesthesiologist has a much larger role during your labor and delivery experience, ensuring the comfort and safety for both you and your baby.

NCAP anesthesiologists who specialize in obstetrical anesthesia are highly skilled and experienced.  The NCAP Obstetrical Anesthesia team is on site at CPMC 24/7, ready to collaborate with the rest of your medical team. Because childbirth can be unpredictable, we’re on the spot to provide elective and emergency care when needed.

Know your pain relief options

There are many pain relief choices during labor, both pharmacological and non-pharmacological. At CPMC, many  laboring moms opt for regional analgesia. These techniques include epidural anesthesia, spinal anesthesia, or a combination of the two.

There will be several opportunities to discuss your options and preferences for labor pain relief -- your pre-labor hospital tour, a phone consultation, or at the time of your labor. We’ll help you decide what’s right for you.

Advantages of regional anesthesia

In the first and second stages of labor, regional anesthesia offers superior pain relief to other options. You’ll still be able to actively participate in the labor process while avoiding the unwanted effects of large doses of narcotics that can cause nausea, sedation and respiratory depression in you and your baby.

Regional anesthesia also provides comfort and pain control should you have an episiotomy or instrument-assisted delivery. If you require a cesarean section, your epidural can be used for surgical anesthesia.

In addition, regional analgesia may facilitate normal vaginal delivery of twins, as well as pre-term and breech babies. It also can make labor safer and more predictable for women with obstetrical risk factors such as preeclampsia.

What to expect

Before receiving the epidural, you will meet your anesthesiologist who will perform a thorough pre-anesthetic evaluation. Once you've had your questions and concerns answered, and agreed to a plan, your anesthesiologist will begin the procedure.

While you sit or lie on your side, your back will be prepped with disinfectant and numbed with local anesthetic so the epidural can be placed without discomfort. Once the catheter is placed and secured and a test dose is performed successfully, you should become comfortable within a few minutes.

After an epidural infusion is initiated, you will be able to give yourself additional doses of medication as needed through a patient-controlled pump. This can be continued until your baby is born. Of course, your anesthesiologist will be on hand to make any modifications necessary.

In case of a cesarean...

Should you need a cesarean delivery, your anesthesiologist will help ensure a safe and pain-free experience. If an epidural is in place, often it can be used as the primary source of anesthesia. If not, your anesthesiologist will inform you of your options. After you have delivered, your anesthesiologist will stay by your side until you’re safe, stable and comfortable.

CPMC, San Francisco's renowned obstetric center

With over 6,000 births a year, California Pacific Medical Center has the busiest obstetrics center in San Francisco and is known for its excellent neonatal intensive care team. Doctors and staff at CPMC provide top quality care for both high and low risk pregnancies. As the hospital’s exclusive anesthesiologists for OB patient care, your NCAP anesthesiologist will be an integral part of your care team.

Your NCAP anesthesiologist will be your advocate and look forward to making your delivery a safe and satisfying experience.