Obstetrician distress levels

When facing a Caesarean section, obstetric anaesthetists have to deal with many types of ‘distress’ such as foetal, maternal, midwife and obstetrician related.

Here is a lighthearted way of describing the severity of ” obstetrician distress ” :


While this description is lighthearted, it does have safety implications. It is important to be cautious of ‘Obstetrician distress’ level 2, where an unnecessary rush to establish anaesthesia may cause harm to the patient.

Here is a text version of the image for those who want to cut and paste the text.

Level 1 :The obstetrician is distressed enough to be scrubbed up and ready in theatre when the regional anaesthetic is ready. Often, at this level of distress, the obstetrician would have also helped to wheel the mother to theatre.

Level 2 : The obstetrician is distressed enough to rush everyone to theatre, but isn’t distressed enough to be there when the patient is ready for surgery. Valuable time is wasted while someone fetches the obstetrician.

Level 3 : The obstetrician shows no distress. This typically occurs with elective caesarean sections which often only get done because of the tenacity of a distressed anaesthetist.

Reference : Tilakaratna P. Obstetrician distress levels. RCOA Bulletin January 2007; (Bulletin 41) : 2161