Background: Perioperative catastrophes are sentinel events in anesthesiology with well-described emotional and professional consequences. A landmark national survey published in 2012 demonstrated substantial and prolonged distress among anesthesiologists after such events. Since 2012, anesthesiology practice has evolved within a healthcare environment characterized by persistent workforce strain, heightened attention to clinician well-being, and expansion of peer support programs. A contemporary reassessment is warranted. Methods: A voluntary, anonymous electronic survey was distributed in 2025 to U.S.-based members of the American Society of Anesthesiologists (Schaumburg, Illinois) who had opted to receive research surveys. The 44-item instrument was adapted from the 2012 questionnaire to preserve longitudinal comparability while incorporating contemporary support modalities. Domains included experience with perioperative catastrophes, characteristics of a memorable event, emotional and physical sequelae, impact on clinical performance, recovery trajectories, and perceptions of institutional support. Descriptive analyses were performed. Results: Of 1,725 respondents included in analysis (response rate, 7.1%), 94.2% reported involvement in at least one perioperative catastrophe during their careers. After a memorable event, 72.5% reported physical symptoms, and 91.6% reported psychosocial symptoms. Most respondents perceived impairment in ability to provide anesthesia care in the first 4 h (69.0%) and 24 h (61.5%) after the event. Nearly one fifth (19.7%) reported never fully recovering emotionally, closely mirroring rates reported in 2012. Although informal peer support was common, formal debriefing and institutionally supported time off were infrequently provided. Nearly one quarter of respondents reported considering leaving anesthesiology as a result of a perioperative catastrophe. Conclusion: Perioperative catastrophes remain a common experience in anesthesiology and continue to carry substantial and enduring consequences. Despite increased cultural awareness, there remains a gap between recognition of their impact and clinicians’ reported recovery experiences. Routine integration of peer support, nonpunitive debriefing, and flexible duty relief may represent critical opportunities to improve clinician well-being, patient safety, and workforce sustainability.
Background: Persistent pain can significantly affect maternal health outcomes. However, there is a lack of representative data after vaginal birth. This study used population-based data to estimate the prevalence and risk factors of persistent genito-pelvic pain 2 months after vaginal birth. Methods: Data from the 2021 National Perinatal Survey, a French nationwide, cross-sectional, population-based survey, were analyzed. The study population included women who delivered vaginally. The main outcome was persistent genito-pelvic pain at 2 months postpartum after vaginal birth. Prevalence with 95% CIs was estimated overall and by degree of perineal tear. Risk factors were identified on univariable and multivariable logistic regression. All analyses were weighted to account for 2-month attrition. Results: Among 5,802 vaginal births, the prevalence of persistent genito-pelvic pain at 2 months postpartum was 12.8% (95% CI, 11.8 to 13.8%), ranging from 5.9% (4.3 to 7.9%) for women with no tear to 38.9% (27.1 to 52.2%) for those with obstetric anal sphincter injury. On multivariable analyses, persistent pain was significantly associated with all degrees of perineal tear versus no tear (first/second-degree tears: adjusted odds ratio, 2.08 [95% CI, 1.51 to 2.87]; episiotomy: 3.37 [2.27 to 4.99] and obstetric anal sphincter injury 5.92 [3.03 to 11.55]). Other risk factors included being born in Africa (1.51 [1.06 to 2.16]), primiparity (1.50 [1.20 to 1.87]), poor maternal psychological status during pregnancy (2.05 [1.48 to 2.83]), and operative birth (1.43 [1.14 to 1.79]). Negative childbirth experience (2.03 [1.50 to 2.77]) and dissatisfaction with pain management during the maternity stay (somewhat satisfied: 1.59 [1.28 to 1.98]; and little/not at all satisfied: 3.11 [2.27 to 4.26]) were also associated with persistent pain. Conclusions: At 2 months postpartum, persistent genito-pelvic pain affected one in eight women after vaginal birth and increased with perineal injury severity. Further studies are warranted to explore the potential preventive effects of limiting perineal tears and instrumental births on persistent pain, optimizing maternal satisfaction with postpartum pain management, and improving childbirth experience.
