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Anaesthetists with a job plan that includes obstetric anaesthesia must demonstrate ongoing continuing education in obstetric anaesthesia, and continuing professional development as needed for this aspect of their work.¹⁰⁴ Hospitals have a responsibility to enable this with local teaching where appropriate, and by facilitating access to other education and training.^96,105,106

Any non-trainee anaesthetist who undertakes anaesthetic duties in the labour ward should have been assessed as competent to perform these duties in accordance with OAA and RCoA guidelines.^31,55,89 Such a doctor should work regularly in the labour ward but should also regularly undertake non-obstetric anaesthetic work to ensure maintenance of a broad range of anaesthetic skills.

All staff working on the delivery suite should have annual resuscitation training, including the specific challenges of pregnant women.¹⁰⁷

Preoperative care requires careful co-ordination and communication with individual surgeons, general practitioners, medical records, outpatient clinics and specialist services such as diabetes. The anaesthetic lead for the preoperative preparation clinic should ensure adequate systems are in place, and be responsible for overseeing the adequacy of these processes.⁶

Anaesthetists should contribute to the education and updating of midwives, anaesthetic assistants and obstetricians.

Anaesthetists should help organise and participate in regular multidisciplinary courses and ‘skills drills’ for emergency situations.^{8,99,100,101,108}

A system should be in place to ensure that women requiring antenatal referral to an anaesthetist are seen and assessed by an anaesthetist, normally a consultant, within a suitable time frame. Ideally, this should be in the form of multidisciplinary team management of these high risk women. Where the workload is high consideration should be given to risk stratification so...

An anaesthetist should be included in the multidisciplinary team (MDT) antenatal planning of management for women with complex medical needs.⁴ Planning should include consideration of the woman’s wishes and preferences.

All women requiring caesarean section should, except in extreme emergency, be visited and assessed by an anaesthetist before arrival in the operating theatre. This should be timed to allow women sufficient time to weigh up the information they have been given, in order to give informed consent for anaesthesia.

There should be a local guideline on the monitoring of women after regional anaesthesia and the management of post anaesthetic neurological complications.¹¹⁰