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Evidence Library · Being heard

Three organizations have now said the same thing

This is no longer a difference of opinion between reasonable clinicians.

For most of the history of this problem there was nothing written down, so a woman who reported pain was arguing against a room. That has changed. Statements from three international organizations now set out how pain during a cesarean should be prevented, assessed and treated.

They agree on the substance. The patient's report is the measurement. It should be acknowledged first and assessed, not reclassified. It should be treated promptly, with the options explained. It should be documented. And the woman should be followed up afterwards rather than left to reconstruct what happened alone.

The obstetric anesthesiologists who drove this work have been explicit that the field was slow, and that the delay was itself the harm. You are not asking for a favor when you cite it. You are asking for what the specialty has already agreed is ordinary care.

Where this comes from:
65. Gonzalez-Fiol A, Fardelmann KL, Landau R. Shedding more light on the management of intraoperative pain during cesarean delivery: a review of the American Society of Anesthesiologists statements. Int J Obstet Anesth. 2025;62:104360. doi:10.1016/j.ijoa.2025.104360
66. Sultan P, Carvalho B, Landau R. Intraoperative pain during cesarean delivery: reflections and next steps. Int J Obstet Anesth. 2026;65:104828. doi:10.1016/j.ijoa.2025.104828
67. Landau R, Janvier AS. Are we finally tackling the issue of pain during cesarean section? Anaesth Crit Care Pain Med. 2021;40(5):100938. doi:10.1016/j.accpm.2021.100938
42. American Society of Anesthesiologists, Committee on Obstetric Anesthesia. Statement on pain during cesarean delivery. Approved October 18, 2023.
44. Plaat F, Stanford SER, Lucas DN, Andrade J, Careless J, Russell R, et al. Prevention and management of intra-operative pain during caesarean section under neuraxial anaesthesia: a technical and interpersonal approach. Anaesthesia. 2022;77(5):588-597.

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