Cesarean delivery rates at the National Hospital Juan Jose Ortega in Coatepeque, Guatemala have risen from 45% to 62% in recent years, largely driven by patients who elect to have repeat Cesarean deliveries because of a lack of pain management options for labor. While Casarean deliveries can save lives, unnecessary procedures increase short- and long-term health risks for women and newborns.

This project introduces a single-dose intrathecal spinal analgesia for patients who are attempting to have a vaginal birth after a prior C-section. By offering pain relief during labor, the goal is to reduce elective repeat C-sections, promote safer deliveries, and support long-term improvements in maternal care in a resource-limited hospital setting.

“I am most excited about the ability to provide analgesia for patients who are undergoing labor in hopes of reducing the rate of cesarean delivery,” says Kimberly Mendoza, MD, PhD, MPH, a principal investigator and incoming Stanford OB fellow.

Principal Investigators:

Kimberly Mendoza, MD, PhD, MPH – Chief Resident; Future OB Fellow (Stanford August 2025), University of Colorado Anesthesiology Team

Cristina Wood, MD, MS – Assistant Professor, Director, Medical Director Obstetric Anesthesia Maternal Fetal Care Unit, University of Colorado Anesthesiology Team

Colby Simmons, DO, MBA – Assistant Professor, Director of Global Health, University of Colorado Anesthesiology Team

Sara Strowd, MD – Clinical Assistant Professor, Co-Director of Division of Global Health Equity, Stanford University

Roberto Cifuentes, MD – Director, Department of Anesthesia, National Hospital Juan Jose Ortega Coatepegue, Guatemala Anesthesiology Team

Funders:

Stanford Department of Anesthesia, Perioperative, and Pain Medicine