The Retrievals · Serial Productions & The New York Times

S02 Episode 3: The Guidelines

July 10, 2025·55 min·2 clips

Susanna Stanford explains that doctors need to "test the block not your block."

Susanna has been carrying the results of her research and the women’s accounts for a long time. She keeps putting off the moment when she has to face the hospital again. Her son Tristan’s surgery, her guilt, and the passing of birthdays and Christmases all weigh on her decision. Eventually she decides she has a duty to act. She opens the drawer, takes out the surveys, and starts drafting a formal letter. The letter uses the data to show how the cold spray test could fail as a meaningful check. One figure stands out: 33.8 percent of women were confused by that test. She explains that a test relying on a question many respondents struggle to answer is likely to let procedures continue when they should not. She is careful to say that she is not writing out of revenge. Her concern is patient outcomes. She wants anesthetists to understand what happened and to make a difference. On the last Sunday before Christmas break, she pastes the letter into an email and sends it. The response comes quickly. The president of the Royal College of Anesthetists asks to meet. The episode then closes by noting that the Obstetric Anesthetist Association guidelines were published in the May 2022 issue of Anesthesia. It also points to the U.S. statements on pain during cesarean from the American Society of Anesthesiologists. The story places those documents in a chain of evidence, testimony, and institutional response. It makes clear that the work was not abstract. It came from women describing pain and mental health consequences that were severe and long lasting. The episode keeps returning to the gap between clinical procedure and lived experience. It shows how expert language can either obscure or correct that gap. It also shows how slowly institutions can move until someone forces the issue. The result is a story about policy, but it is also about persistence. A single voice, backed by data and memory, becomes hard for the system to ignore. The episode closes in production credits and acknowledgments.

As heard by us

A careful account of how patient pain became formal guidance around cesarean delivery.

The episode follows how a stack of patient surveys and Susanna's persistence turned into formal guidance on pain during cesarean delivery. It works because it stays close to the human side of the reporting: pain, memory, and the frustration of being too easily brushed aside.

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Why you'd press play

Follow one patient's account of cesarean pain as it turns into research, advocacy, and updated anesthesia guidance.

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