Obstetric Anesthesia

Obstetric Anesthesia continues to provide high-quality clinical care to patients delivering at the UCSF Birth Center, alongside strong educational programs for anesthesia residents and obstetric anesthesia fellows, and a growing portfolio of clinically relevant research.

The Birth Center continues to experience increasing delivery volume. In FY2025, there were 2,633 deliveries at UCSF, representing an increase of 228 compared to FY2024. The overall cesarean delivery rate was 30.1%. The nulliparous, term, singleton, vertex (NTSV) cesarean rate—a key obstetric quality metric—was 22.6%, below the statewide target of 23.6%. Delivery volume is expected to continue to rise in FY2026, reinforcing the need for consistent, high-quality obstetric anesthesia coverage.

Our faculty regularly care for medically and obstetrically complex patients, including those with placenta accreta spectrum disorder. We remain a strong training environment, with the ACGME-accredited obstetric anesthesia fellowship continuing to attract a highly competitive applicant pool. In addition, the Labor and Delivery units at Mission Bay and Zuckerberg San Francisco General Hospital are recognized as Centers of Excellence by the Society for Obstetric Anesthesia and Perinatology.

Faculty in Obstetric Anesthesia achieved several notable accomplishments this year across education, research, and quality improvement. Dr. Won Lee was selected as a recipient of the 2025 UCSF Society of Hellman Fellows Award, supporting early-career faculty with strong potential for academic distinction. Drs. Sherry Liou and Pamela Huang contributed a chapter on neuraxial techniques to Atlas of Ultrasound-Guided Regional Anesthesia (4th edition, October 2025). Dr. Jeremy Juang received the 2025 UCSF School of Medicine Short-Term Mentor Award.

We also had a strong presence at the 2025 Annual Meeting of the Society for Obstetric Anesthesia and Perinatology in Portland, Oregon, with faculty, fellows, and residents presenting 11 abstracts (4 research abstracts and 7 case reports). Work from Dr. Alexander Butwick on the epidemiology of severe perioperative morbidity in cesarean delivery was selected for the Best Paper session and received the SOAP/APSF Patient Safety Award, with subsequent press coverage.

Additional scholarly contributions included a chapter on obstetric hemorrhage in Chestnut’s Obstetric Anesthesia: Principles and Practice (7th edition, October 2025), as well as a Department of Anesthesia Clinical Seed Grant (2025–2026) supporting development of a machine learning model to predict post-cesarean hemoglobin levels.

Drs. Stephanie Lim and Jenny Woodbury are leading efforts to strengthen the specialty’s quality improvement data infrastructure, with the goal of improving measurement and feedback on key clinical outcomes.

We look forward to continued progress in clinical care, education, and research in the coming year, with a focus on advancing outcomes for patients delivering at the UCSF Birth Center.

Alexander Butwick, MBBS, FRCA, MS
Chief, Obstetric Anesthesia