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Anesthesia
Evidence LibraryPain during the operationBeing heard
Evidence Library · Being heard

What the team should be telling you as it goes

You cannot notice a silence nobody told you to expect.

The rest of this module tells you what to say if you feel pain. This is about what you should be hearing before you have to say anything.

Care that is going well sounds like a running commentary. "You will feel a lot of pressure now." "The baby will be out in about a minute." "That pulling is the placenta." "Nothing is wrong, this is the noisy part."

And when you report pain, it begins with acknowledgment, not correction: "I believe you. Tell me where, and what it feels like." The American Society of Anesthesiologists statement asks the team to acknowledge your experience and assess the pain before anything else. The joint Anaesthesia guideline, written with a woman who lived through this, treats communication as a duty of the same rank as the technique.

Silence is not proof that something is wrong. Teams concentrate hardest at the moments that matter most. But you can ask for narration in advance, when everyone still has time to hear you.

Ask for it before the operation starts"Please tell me what is happening as you go." One sentence, said while you are still being prepared, changes what the next forty minutes sound like.
Where this comes from:
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.
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

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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you.