Expectant mothers stressed as Sask. Health Authority braces for epidural shortages

Hospitals across Saskatchewan are preparing for a shortage of epidurals. Health care officials say the shortage is due to supply chain issues.

The Saskatchewan Health Authority is asking expectant families to review pain management plans with their care providers as a shortage of epidural catheter kits continues.

The kits are used primarily by anesthesiologists to manage pain during childbirth and cesarian sections, but are also used before and after some other surgeries. There have been confirmed shortages in Alberta, Saskatchewan, Manitoba and British Columbia. 

Kristin Walker is a Regina mother of one who is expecting another addition to her family in October. She said when she got the news that there may not be an epidural available to her when that time comes, she became anxious and concerned. 

This is especially stressful for Walker because during her first birth, she was in labour for 10 hours, experiencing tearing and other complications. If not for an epidural, Walker would have needed an emergency cesarian section. 

"There was a lot of tearing and cutting that I would have all otherwise had to experience and feel. I was really hoping to count on getting [an epidural] again. I am a little stressed out about that option possibly going away."

Walker said the child she is currently pregnant with is well over the average size, according to her most recent ultrasound. She said she expects to experience significant pain when the time to give birth comes. Walker said she's aware of pain management alternatives, but believes they are not as trustworthy as epidurals. 

"I don't have a lot of faith in what my mom used back in the eighties. And there's a reason that's not the gold standard anymore and that we've developed other options."

Meanwhile, Walker said she has confidence that the SHA is doing everything in its power to get more supply.

Indeed, the SHA said it is working to secure further supplies and ensure care teams are using existing supplies optimally. The authority said alternative pain control methods include medications through spinal, inhaled, intravenous or intramuscular injection. 

"There are risks with every procedure, including the alternatives for the epidurals. But we are well prepared for those risks and we are collaborating across the system, keeping our colleagues who may be dealing with those risks well informed so that everybody is prepared and well practiced in order to deal with them," said Dr. Mateen Raazi, SHA provincial department head of anesthesiology.

Pain can also be reduced through local anesthetic nerve blocks, therapeutic touch, breathing and positioning techniques.

Aimee Munroe, a Regina doula, said many mothers are feeling anxious and worried by the shortage news. 

"I'm sure there are many expectant mothers right now who are feeling very scared. And that's valid, especially if you're a first-time mom," Munroe said.

She said there are ways to adjust their birth plan so that they're prepared if epidurals aren't available to them. 

"A big one would be hypnotherapy. If you're expecting right now and you have time to take a hypnotherapy class, there are some offered in our city and I think that would be a fantastic alternative method. There are some other options that you can use for pain management and medically at the hospital, like the nitrous oxide gas. Sometimes you can use morphine," Munroe said. 

Not much is known about exactly why epidurals are in short supply. The SHA could not provide information about just how many epidurals the province has left. The president of the Canadian Anesthesiologist Society said it's not just an issue in North America. 

"We're suspicious that it is going to be a global supply chain issue," said Dr. Dolores McKeen. 

Munroe has had an epidural before herself, but not with her second child. She's encouraging expectant mothers not to panic.

"Try not to go into it with fear. Your body was made to have babies. Of course, there are things that happen that require these medical services or sometimes medical interventions. But birth is not inherently a medical event. So you can do it. You're strong."