How One CRNA is Holding Ground on Maternal Health

In a labor and delivery unit, joy can shift quickly, and safety depends on teams who are prepared to hold steady when it does. As a Certified Registered Nurse Anesthetist (CRNA) in New York City, Samantha Smith, DNAP, CRNA, has centered her career in that space where trust, vigilance, and human connection matter as much as clinical skill. 

One night, Smith was the CRNA caring for a patient delivering twin girls. By nature, twins are high risk and danger can still unfold even after a delivery appears to go well. As her patient’s condition began to deteriorate, the atmosphere in the room quickly shifted. The patient recalls being awake, aware, and terrified that she might not survive the night. 

What the patient remembers most wasn’t the alarms or the rush of activity, but Smith’s voice—calm and steady—cutting through the chaos. She remembers hearing Smith advocating for her, taking control of the situation, and ensuring the team was working cohesively as she was moved back to the operating room. In a DAISY Award nomination written nearly four years later, the patient recalled believing that Smith saved her life. 

The patient writes that when she looks at her daughters, she is reminded that she is here because of Smith’s knowledge, skill, and presence as a CRNA. “I believe I’m still here on this earth because of her,” she shared. “Thank you, Sam, for keeping me here… to be the best mother I can to my two girls.”

For Smith, that night reflected the heart of what it means to provide maternal health care. Obstetric patients are not asleep through their most critical moments: they are listening and can sense urgency, confidence, and whether teams are aligned. Obstetric anesthesia, she believes, carries a different kind of responsibility—one rooted not only in physiology, but also in presence. “How we talk to each other matters,” she explained. “How we communicate in those moments becomes part of the patient’s experience.” 

Her work is deeply personal. As a mother herself, Smith understands how vulnerable the patient experience is. “I try to ask open-ended questions,” she said. “I want patients to tell me what they’re feeling before I assume I know.” Every patient’s experience, she believes, deserves to be met with respect and attention. 

That deep respect did not begin in anesthesia. As an undergraduate student, she was drawn early to women’s health and began her career as a labor and delivery nurse. “I loved being a part of that journey,” she reflected. “You get to be there for one of the biggest days of someone’s life. It’s an honor.” 

She later carried that commitment globally, participating in medical mission trips abroad and witnessing how preparation and access to anesthesia could profoundly determine outcomes. “You realize very quickly what a difference it makes,” she said. “Safety isn’t abstract. It’s everything.” 

Over time, Smith found herself drawn to the urgency of critical moments. That curiosity led her to become a CRNA, but her interest in obstetric care never left. It remained central to her practice, shaping how she approaches care in every setting. 

Today, Smith practices at the NewYork-Presbyterian/Weill Cornell campus and is a core member of the obstetric anesthesia team. When the institution opened a freestanding women’s hospital, she helped prepare for it in a way that reflects her broader philosophy. “The strongest teams prepare before a crisis ever occurs,” she said. “That’s how you hold ground for maternal safety.” 

She became deeply involved in designing and leading interdisciplinary simulation training, helping nurses, obstetricians, anesthesiologists, and CRNAs practice together in psychologically safe environments so that, when real emergencies arise, trust and communication are already in place. 

Beyond the bedside, Smith serves on several maternal morbidity review committees, examining cases to understand where systems succeed, where communication breaks down, and how teams can strengthen preparation before the next patient is at risk. She sees CRNAs as uniquely positioned connectors across care teams, noting that they’re “often the bridge between nurses, physicians, and everyone else in the room.”  

Reflecting on Maternal Health Day, Smith emphasized her dedication to her patients and their families. She knows that pregnancy and birth can be joyful and scary all at once, and she wants to spotlight the tireless preparation care teams undertake behind the scenes. “Your concerns are real, and we see them,” she wants all patients to know. “You are not alone. Your interdisciplinary care team, including CRNAs, is ready.” 

To her fellow care team members, her message is a reminder of responsibility and purpose. Maternal safety, in her view, is built in the small moments and holding ground begins long before a crisis ever unfolds. “Our routine day represents one of the most important moments in a patient’s life,” she said. “We should never take that responsibility lightly.” 

The DAISY Award Smith received honors a single moment, but she is quick to highlight the collective effort behind it. That night reflected a team that trusted one another and was prepared to act. Still, she carried the patient’s words with her as a reminder of what is ultimately at stake. 

For Smith, holding ground on maternal health means showing up steadily when circumstances shift. It means advocating clearly, preparing relentlessly, and honoring both the clinical precision and the human weight of the moment.

On Maternal Health Day, and every day, her work reflects her central belief: when care teams hold ground together, patients are able to return home to their families—and that outcome is worth protecting, every single day.