Obstetrical (OB) Anesthesia

Obstetrical anesthesia in progress

The Department of Anesthesia provides an excellent clinical and educational experience encompassing all aspects of anesthesia for labor and delivery. Residents spend two months providing anesthesia in labor and delivery. Senior residents have the opportunity to do an OB elective.

Approximately 2,200 babies are delivered each year at the University of Iowa Hospitals & Clinics. We take care of most of eastern Iowa's high-risk obstetrical patients, including patients with congenital heart disease, diabetes, preeclampsia, multiple gestations, and premature labor. Our facilities include combined labor-delivery rooms, modern operating rooms, and an adjoining NICU (all close to the main OR). Because of this experience, our residents are familiar with the special needs of these challenging patients.

At UI Hospitals & Clinics, a high percentage of laboring patients request epidural anesthesia, and most non-emergent (and some emergent) cesarean deliveries are performed under spinal or epidural anesthesia. In addition to the regional anesthesia cases, a number of other procedures (both emergent and non-emergent) are performed under general anesthesia or conscious sedation. Residents also help with pain management for patients unable to receive regional anesthesia, use invasive hemodynamic monitoring in selected patients, and serve as consultants in the management of patients with complex medical conditions.

The resident Monday/Tuesday morning didactic curriculum covers the important topics related to OB anesthesia. In addition, there are computer-based lessons, simulations, lectures, conferences, and daily discussions during the rotation. The extensive use of regional anesthesia in labor and delivery provides ample opportunity for residents to become comfortable and proficient with spinal and epidural anesthesia. In addition, residents learn techniques such as combined spinal-epidural anesthesia, patient-controlled epidural anesthesia, "walking epidurals," and placement of epidural and intrathecal narcotics.