Elevating Anesthesia Choices for Cesarean Delivery: A Roadmap for Patient-Centered Research and Solutions With Key Findings and Recommendations From the ELEVATE Project

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esarean delivery is the most common surgery in the world and accounts for 32% of births in the United States. 1 Although neuraxial techniques are preferred, 2 many patients report intraoperative discomfort or emotional trauma.These experiences can contribute to known associations between birth experiences and risk for post-traumatic stress disorder (PTSD), anxiety, and depression postpartum.[3][4][5] Current clinical workflows often lack structured tools to support patient-centered decision-making, which can lead to inadequate or poorly timed counseling, miscommunication, mismatched expectations, and heightened perceptions of pain or discomfort when anesthesia plans do not align with patient understanding or preferences.The lack of consistent, patient-centered anesthesiology education and counseling underscores the need to develop effective communication tools as a core element of high-quality obstetric anesthesia care.This prioritization is not only to uphold high-quality clinical care, but also because positive childbirth experiences are beneficial to the health system for several non-clinically centered reasons.First, hospital reimbursement is increasingly tied to patient experience, which influences how the anesthesia care team is perceived within the institution.6 Also, hospitals desire to provide obstetric care services, because they serve as a gateway to future healthcare interactions, including pediatric care and subsequent surgical and women's health services.Finally, women make 80% of household health care spending decisions, 7 playing a central role in recommending hospitals and influencing healthcare utilization within their communities.For these reasons, anesthesia care professionals across all practice settings have a vested interest in ensuring that obstetric anesthesia care for cesarean delivery is patient-centered, evidence-based, and aligned with broader institutional goals for quality and patient satisfaction.The Elevating Anesthesia Choices for Cesarean Delivery (ELEVATE) Project aimed to identify barriers, facilitators, and evidence gaps in delivering patient-centered anesthesia care.Stakeholders included patients, clinicians, professional societies,

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