Anesthetic complications require immediate recognition and intervention. With the many options and high anesthesia rates among laboring women, today's perinatal nurses need education not only in the choices of anesthesia but also in the complications that can result from these choices. Most orientation programs briefly discuss the subject, leaving the amount of information and training insufficient for the nurses to feel confident in their understanding of the complications and competent to respond. This educational need could also extend to experienced staff who lack current knowledge and appropriate competence in responding to obstetric anesthesia emergencies. The purpose of this article is to address the major complications of obstetric anesthesia and how nurses need to respond, with the goal of improving patient safety in these rare but high-risk situations. Recommendations in didactic content are presented to assist hospital educators in achieving this goal.