Obstetric Anesthesia Rotation

The provision of patient care and resident supervision 24/7 by subspecialty obstetric anesthesiologists on the main campus is only practiced at a handful of institutions and is a major strength of the Division of Obstetric Anesthesia. Most residents rotate through the Morgan Stanley Children’s Hospital labor suite three times (four-week rotations each) during their three years as clinical anesthesia (CA) residents, and there is a two-week rotation, usually in the CA-2 year, at the Allen Hospital to increase exposure to “community hospital obstetrics.” The residents care for all patients on the Labor and Delivery floor, including the most complex obstetric or medical cases, and perform consultations along with a fellow and/or attending. A typical distribution of cases for each resident during a four-week rotation is:

• Epidural analgesia for labor: 30–40 (~85 percent will be combined spinal-epidural procedures)
• Cesarean section: 20 (~15 spinal, 5 epidural (from labor), 0–1 GA)
• Assisted deliveries (forceps/vacuum) or other procedures: 1–3
• Cervical cerclage (spinal): 2–4
• Postpartum tubal ligation (spinal or epidural): 1–3
• External cephalic version (spinal or epidural): 1–2
• Fetal/placental procedures: 0–1