All women will be instructed in the use of a patient controlled analgesia (PCA) remifentanil infusion which they can use during the cesarean section if they experience any discomfort. If this is not adequate, 60-70% nitrous oxide will be attempted. If adequate pain control cannot be established and the cesarean section is not near completion, conversion to a general anesthetic will be the next step. All women will receive rectal naproxen at the conclusion of the surgery unless there is a contraindication or bleeding is a concern. All women will receive prophylactic ondansetron intraoperatively unless there is a contraindication.