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All women who have received an anaesthetic intervention for labour and/or delivery should be reviewed postnatally. Locally agreed discharge criteria should be met before they go home and written information should be provided.^25,138

There should be local guidelines on preoperative, intraoperative and postoperative care for those cases where an enhanced recovery process is appropriate.¹³⁹

Units with high numbers of caesarean births should have specific lists to minimise disruption due to emergency work.¹⁴⁰ Any elective caesarean delivery list should have dedicated obstetric, anaesthetic and theatre staff and should take place in a separate theatre to where emergency cases are undertaken.¹⁴¹

All pregnant women must be assumed to have capacity unless there is evidence to the contrary, as per the Mental Capacity Act.^137,142,143

There should be documentation of any discussions involving informed consent for any procedures undertaken by the anaesthetist.^137,142

Those with potential issues with their capacity to consent should be identified early in the antenatal period. Arrangements should be made to both to maximise their capacity and to ensure that they are adequately represented and advocated for, in keeping with current legislation.^137,142,143

Obstetric units should be able to provide regional analgesia on request. Smaller units may be unable to provide a 24-hour service; those booking at such units should be made aware that regional analgesia may not always be available.⁵⁹

Midwifery care of a pregnant woman receiving regional analgesia in labour should comply with local guidelines that have been agreed with the anaesthetic department. Local guidelines should include required competencies, maintenance of those competencies and frequency of training. If the level of midwifery staffing is considered inadequate, regional analgesia should not be provided.¹⁶⁵

Units should have local guidelines on the recognition and management of complications of regional analgesia that include training on the recognition of complications and access to appropriate imaging facilities when neurological injury is suspected. The patient’s general practitioner should be informed in the event of any of these complications.^15,136

Units should provide low-dose regional analgesia.^144,145