Columbia University’s Chief of Obstetric Anesthesia On Helping Women Navigate Their Journey through Pregnancy, Delivery, and Postpartum

Disclaimer: The opinions represented here are those of the individual and do not necessarily represent those of their employer.

Content Warning: The video in this article contains a reference to infant death.

Dr. Ruthi Landau has never viewed anesthesiology as a narrow specialty, and certainly not as a background role in women’s experience during pregnancy, labor and delivery, and postpartum. As a leading obstetric anesthesiologist, professor at Columbia University, and the recently appointed Editor-in-Chief of the International Journal of Obstetric Anesthesia, she has spent her career redefining what it means to care for pregnant women before, during, and after delivery. For her, excellence lies not only in clinical precision but in building systems that are smarter, faster, and more human-centered.

C8 Health CMO Ariella Shoham sat down with Dr. Landau to discuss how technology is reshaping everything from patient communication to evidence implementation, why standardization must replace outdated practices, and how anesthesiologists can play a central role in guiding women through one of life’s greatest journeys.

Watch the full interview below, or read on for a selection of key takeaways.

Key Takeaways

• Recognize & prepare for technical evolution opportunities. As the number of medical professionals with technology skepticism and low digital interest retire from clinical practice, there will be fewer obstacles to digital integration.

• Embrace mobile-friendly solutions that streamline clinical admin. The next generation of anesthesiologists is comfortable using mobile devices in robust ways.
• Leverage AI to adopt new procedures faster. Use knowledge management platforms to ensure newly disseminated information is being acted on quickly.
• Trust patient experiences to highlight opportunities for operational improvements. Physicians have a responsibility to create as positive an experience as possible, and the patient journey leads the way.

1. Recognize & prepare for technical evolution opportunities

Progress in medicine is not limited to the adoption of new tools or treatments, it’s also about letting go of outdated mindsets. For Dr. Landau, one of the most significant changes in clinical practice is not just technological, it is cultural. Her reflections on the profession’s evolution reveal a deep belief in the power of evidence and shared clinical standards to improve care.

"I remember the days when anesthesiologists would say: “This is how I've done it for 30 years, this is my practice.’ So I would always joke and say, “My mind is made up, don't confuse me with facts”… it doesn't matter that there have been [new] publications or that an institution decides to integrate a protocol that could be viewed on a clipboard somewhere, or perhaps sent out via email, they would simply not follow it.

I think we have seen much progress and paradigm shifts. I want to believe… that by developing algorithms and clinical decision trees, and implementing standardized protocols which might not have been available in the past, we are seeing a true culture shift."

As fewer technologically progressive professionals leave the medical practice, there will be fewer barriers to implementing advanced new technology. Healthcare organizations will have the opportunity to strengthen their technological foundations and avoid being left in the lurch. Integrate digital tool sets that help clinicians, administrators, and other staff access information, treat patients, and streamline administrative work. 

Ensure that your hospital is capable of supporting such integrations at the IT level, so be sure to survey all possible stakeholders to identify needs that could cause disruptions if they were to go unmet.

2. Embrace mobile-friendly solutions that streamline clinical admin

Part of the transition is coming from a new generation of clinicians, many with new arrows in their quiver. In the past, communication in hospitals hinged on overhead pagers and shared workstations. Today, mobile devices have stepped in as the connective tissue of care teams, streamlining everything from patient updates to administrative tasks.

"I think having communication tools that this generation of clinicians is facile with is great… In our daily clinical practice, we no longer use paper and pen to obtain patients’ written consents for clinical procedures; everything happens now on secure mobile platforms (on tablets and our work phones). We also conduct patient surveys on mobile research platforms that are highly secure and validated. So the switch to digital mobile platforms is happening whether it is for education, clinical care, or research. I think we are really ready."

Hospital systems are rapidly transitioning to mobile-friendly tools to match the pace of modern clinicians. To be a cutting-edge facility, hospitals should provide staff with personal hospital phones designed to replace legacy systems. Doing so allows clinicians to engage with apps that simplify everything from patient monitoring to digital documentation in real-time.

This readiness is a critical point. It’s not just about introducing new tech, but also aligning that tech with a workforce that already operates with smartphones as their default interface. Mobile tools are no longer disruptive innovations; they are expected infrastructure. 

C8 can seamlessly deliver information on that infrastructure. Watch the video below to learn more:

3. Leverage AI to adopt new procedures faster

Artificial intelligence is no longer a hypothetical for healthcare. It’s a partner in progress. Dr. Landau expresses genuine optimism about how AI is transforming clinical decision-making, especially through conversational AI tools and natural language processing.

“In general, it has always been my goal to shorten the time from content creation to not just dissemination, but actual implementation. This has been a real barrier in clinical medicine, with too many steps between the emergence of evidence and its impact on clinical outcomes. We can shorten these steps [with AI] so that when a groundbreaking paper is published, it does not take 30 years for new findings to actually reach patients and improve their experience and outcomes.”

AI tools like virtual assistants help doctors validate clinical pathways, access new research, and even challenge their assumptions. Physicians can access databases, research summaries, and guidelines without toggling between systems or combing through PDFs. It helps prevent burnout and supports better decision-making under pressure.

However, none of that matters if the information is being accessed but not implemented. Once new information is introduced from a credible source, hospitals need to strengthen and streamline their workflows to implement that information faster. For example, if a higher dose of an antibiotic is found to improve recovery results in peer-reviewed clinical studies, hospitals need to have mechanisms in place to ensure that information can be distributed electronically, and procedures to ensure that information is acted on.

4. Trust patient experiences to highlight opportunities for operational improvements

Obstetric anesthesiologists are often misunderstood as playing a narrow, procedural role, primarily placing epidurals. But Dr. Landau says the reality is far more comprehensive and impactful. Obstetric anesthesia is not just about (labor) pain relief; the experience of childbirth should be paved with joyous moments.  However, patients sometimes come with a set of complex medical conditions (comorbidities), and require extensive planning to ensure a safe labor and delivery. Sometimes, it is during labor and delivery that complications arise, and obstetric anesthesiologists need to be prepared, be able to anticipate emergencies, and intervene skilfully when things do not go as planned.

“I tell everyone we have a huge responsibility to deliver what will be the best experience…. And that's what we do. Most people think of the obstetric anesthesiologist as the person placing the epidural and it sort of seems like a very small niche, but there's a lot that goes into the provision of the epidural, not just its placement, but how it's managed, along with managing medical conditions and possible complications at the time of delivery (postpartum hemorrhage as an example).

More than 30% of pregnant women worldwide end up with a cesarean delivery. So we must do the best we can to accompany women through this journey… ”

The goal is not just technical precision, but a commitment to long-term well-being. This is not a brief clinical encounter, it’s a partnership that starts before the birth and continues long after. To ensure obstetric patient needs are being met, hospitals should evaluate both peripartum and postpartum care efforts. Running patient and physician surveys can shed light on what’s working and what isn’t, making it easier to identify where changes need to be made.

Obstetric anesthesiology is evolving

Dr. Landau’s perspective challenges the traditional boundaries of anesthesiology, placing her at the forefront of a field in transformation. Her insights emphasize that technical skill alone is no longer enough. Anesthesiologists today must be skilled communicators, educators, technologists, and patient advocates. From embracing mobile-first tools to leveraging AI for real-time decision support, Dr. Landau highlights how innovation and empathy must move in tandem.

But perhaps most powerful is her belief that the culture of medicine is changing for the better. As outdated practices give way to standardized, evidence-based protocols, a new generation of clinicians is stepping forward — one equipped with both the tools and the mindset to deliver care that is smarter, faster, and more humane. To see more of her work, read the International Journal of Obstetric Anesthesia.

Contact C8 Health today to explore how our cutting-edge platform can streamline knowledge sharing, optimize workflows, and support your organization in delivering exceptional care.