Ferne R. Braveman, MD, cares for patients at a life-changing moment in their lives: during labor and delivery. Her goal is to make the experience safe for mom and baby and as enjoyable as possible, by providing pain relief during labor or, if the patient requires a cesarean section, making it possible for her to be awake and involved with her baby right after childbirth. “Obstetrical anesthesia is fun because we can make such a difference to the patient’s experience,” she said.
Braveman provides epidural analgesia for vaginal deliveries, but because Yale attracts an increasing number of high-risk patients, 30 to 40 percent of deliveries are C-sections. As often as possible, she provides regional anesthesia in the form of an epidural or spinal. “If you have to have a surgical delivery it provides the best obstetrical experience possible,” she said, adding that general anesthesia is used only if the mother or baby is unstable. She usually recommends a spinal if a patient has not had an epidural during labor because it only takes a few minutes to provide anesthesia that’s adequate for surgery. If an epidural is already in place, however, a change in medication gets the job done.
In addition to her work in obstetrics, Braveman also handles pain management for other types of patients. More than 20 years ago, she established one of the first postoperative pain management services in the country with Raymond S. Sinatra, MD. She cares for patients who rely on such analgesic techniques as continuous catheter analgesia, as well as those who have complicated opioid or chronic pain issues. New ultrasound techniques have paved the way for an increase in the use of nerve catheters. By placing local anesthetic in the sheath surrounding nerves, Braveman can numb a specific area, such as a knee or a foot, without numbing the entire lower body.
She began her career in family medicine, but anesthesia soon fascinated her. The combination of obstetrical anesthesia and pain management brings her back to her roots in primary care, allowing her to interact with her patients and help them at important moments in their lives. In fact, it’s not uncommon for obstetrical anesthesiologists to move into post-op pain management. “We’re used to having patients who are awake and which allows us to talk with them, not unlike obstetrical anesthesia,” she said.
Name: Ferne Braveman, MD
Title: Professor of anesthesiology and of obstetrics, gynecology, and reproductive sciences; Chief, Section of Obstetrical Anesthesiology; vice chair for clinical affairs, Department of Anesthesiology
Area of expertise: Obstetrical anesthesiology, postoperative pain management
Place of birth: New Brunswick, NJ
College: University of Connecticut
Med School: McGill University Faculty of Medicine
Training: Residency in anesthesiology and fellowship in obstetrical anesthesiology and ICU/ recovery room management at Brigham and Women’s Hospital, Boston, Mass.
Family: Three children: Michael, 25; Nicholas, 23; Laura, 21
What is most challenging to you in academic medicine?
Finding the time to meet my clinical, administrative, and academic goals and responsibilities.
What is most rewarding? Teaching residents.
What do you like most about your practice? I enjoy spending much of my time caring for women and families.
Personal interests or pastimes: Over the last few years I have been involved with Kybele, a humanitarian
organization dedicated to improving childbirth conditions worldwide by bringing U.S., Canadian, Australian, and European health care professionals into host countries to work alongside doctors and nurses in their home environments.
Kybele has allowed me to combine the rewards of teaching, and improving the care of women and infants, with my interest in traveling and visiting new places. Other interests and pastimes include scuba diving, reading, and hiking.
Last book read: Master of the Senate, by Robert Caro
What would you do to improve our clinical environment
if you had a magic wand? Improve availability of patient information. Right now none of the systems interface, so, for example, if you need either old information (which is in storage in another state) or information from a hospitalization two days ago (which is being scanned and therefore not available), you’re out of luck.