S02 Episode 1: The Case

Inside a Chicago Labor and Delivery Unit: One Birth That Changed A Hospital

This episode follows a single dramatic cesarean delivery at a city hospital to illuminate a larger problem: tens of thousands of patients nationwide report feeling major pain during C-sections. Through the eyes of a labor nurse, a nurse-patient, and two anesthesiologists, the story traces how routine practices, split-second decisions, and communication gaps can leave patients exposed to visceral pain while surgeons operate.

A patient who is also a caregiver: unique perspectives on cesarean pain

Clara, a labor-and-delivery nurse delivering her own twins, becomes the patient who experiences intraoperative pain despite tests suggesting she was numb. Mindy, a colleague and nurse-photographer, documents the birth, offering both witness and advocacy. Heather, the anesthesiologist who placed the epidural, and Corey, the anesthesiologist called in during the crisis, reveal the professional stakes and personal responsibility clinicians feel when anesthesia does not work as intended.

What visceral pain during C-section feels like and why it matters

The episode explains visceral pain in plain terms: it originates inside the abdomen, can feel burning or searing, and is distinct from the skin-level numbness commonly tested before incision. Listeners hear that exteriorized uterine manipulation, cautery, and organ handling can cause intense pain if regional anesthesia is incomplete. The narrative places the listener in the operating room to make clear how traumatic and disorienting interoperative pain can be.

Data and the path to system-level change

Reporting introduces a new study estimating roughly 8% of patients experience significant pain during cesarean delivery — a startling figure when extrapolated across the 1.2 million annual U.S. C-sections. The episode shifts from case reportage to problem-solving, profiling clinicians and patients pushing for better measurement, clearer protocols, and cultural changes that take patient reports seriously.

Practical responses and actionable steps from clinicians and patients

The story emphasizes both immediate and systemic solutions: improving anesthesia handoffs, documenting sensory testing more carefully, offering alternative anxiolytics, and creating transparent incident reviews. It also highlights patient-level actions: documenting preferences, asking about contingency plans, and requesting senior anesthesia involvement when desired.

• For clinicians: Treat patient reports of intraoperative pain as urgent signals, not anxiety.
• For hospitals: Standardize handoffs and require documented sensory testing before incision.
• For patients: Discuss anesthesia contingencies and advocate for known providers during delivery.

By centering human stories — the nurse-photographer who races in with a camera, the patient who endures and then demands change, and the anesthesiologists who feel guilt and resolve — the episode reframes a clinical statistic as a solvable problem that demands institutional attention and practical remedies.