Global Issues in Obstetric Anesthesia: Perspectives From South Africa, Japan, China, Latin America, and North America

(Int J Obstet Anesth. 2023:54:103648) Anesthesia provision varies worldwide, and obstetric anesthesia in particular is highly variable. The first country discussed in this article is South Africa, which is classified as a low-income to middle-income country. South Africa has high patient mortality related to cesarean delivery. The epidural rates for labor in South Africa are <5%, which is considered extremely low. Approximately one-third of maternal deaths investigated occurred following the administration of spinal anesthesia. In South Africa, it is 3 times more likely for maternal mortality to occur following cesarean delivery than vaginal birth. The mortality rates following a cesarean delivery in South Africa are also 50 times higher than in other regions of the world. Training has been implemented to reduce these statistics, although the level of preparedness following this training has been questioned.