<![CDATA[Background: Currently, the global maternal mortality rate stands at 152 deaths per 100,000 live births, with many low to middle-income countries (LMICs) not on track to meet this goal. Inadequate obstetric anesthesia is a significant contributor to preventable maternal and newborn deaths. The inability of district hospitals to provide safe anesthesia may lead to poor outcomes. This paper reviews existing data to assess the safety of obstetric anesthesia in district hospitals in LMICs and identify challenges. Methods: A scoping review of grey and peer-reviewed literature was conducted using terms such as “obstetrics,” “anesthesia,” “low to middle-income countries,” and “first-level hospitals.” Of the 3780 citations screened, 22 studies met the inclusion criteria. Result: A narrative synthesis was employed to report the findings, with quality assessed using the Mixed Methods Appraisal Tool. Common issues in LMICs included a shortage of skilled anesthetic providers, lack of funding, poor infrastructure, and limited access to essential equipment, drugs, and blood products. Conclusion: Obstetric anesthesia provision in LMICs, especially at district hospitals, is inadequate. None of the hospitals assessed could provide safe anesthesia. Investments in basic infrastructure, including reliable water and electricity, are needed. Promoting anesthesia appointments and training programs in district hospitals can have a significant, lasting impact on mothers, infants, and the community, helping achieve the Sustainable Development Goals (SDGs).]]>
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