Most anesthetic medications readily cross the placenta (Badve & Vallejo, 2015; Barash, Cullen, Stoelting, Calahan, & Stock, 2009). Opioids can produce neonatal respiratory depression after delivery. Fentanyl does not produce severe depression. Ketamine also produces analgesia without depression of the neonate. To minimize risk to the fetus, delay any nonurgent surgery until after first trimester or after delivery. Fetal heart tones should be monitored interoperatively and in the PACU after the 16th week.