Pain during the operation
The single most under-disclosed fact in cesarean consent.
Women are told they will feel pressure and pulling but not pain. That is not what the data show.
A 2025 systematic review of 34 studies and 11,351 patients found intraoperative pain in a pooled 17% of cesareans under regional anesthesia. Broken down by technique: 14% with a spinal, and 33% when a labor epidural was topped up for surgery.
17%
Pooled rate of pain during cesarean under regional anesthesia
34 studies, 11,351 patients
14%
With spinal anesthesia
Same review
33%
With a labor epidural topped up for surgery
Same review
Read the 33% againIf your cesarean follows a labor epidural, roughly one woman in three reports pain during the operation. This is exactly the scenario most women are in when they have an unplanned cesarean, and it is almost never mentioned beforehand.
Where this comes from:
293. Charles EA, Carter H, Stanford S, Blake L, Eley V, Carvalho B, et al. Intraoperative pain during cesarean delivery under neuraxial anesthesia: a systematic review and meta-analysis. Anesthesiology. 2025;143(1):156-167.
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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. If you are worried about a symptom now, see urgent warning signs.