Four hundred eight-five fetal monitor patterns were reviewed to correlate the incidence of postparacervical fetal bradycardia with the preceding fetal heart rate pattern. Three hundred and one patients received a total of 408 paracervical blocks, with an overall incidence of bradycardia of 11.3%. Patients with reassuring patterns had an incidence of 8.4%, those with concerning patterns 20%, and those with very concerning patterns 39.1%. Restricting the use of paracervical anesthesia to patients with reassuring fetal heart rate patterns should minimize this complication of obstetric anesthesia.