The Saskatchewan Health Authority is asking expectant families to review their pain management plans with care providers as a shortage of epidural catheter kits continues across North America. The kits are primarily used by anesthesiologists for pain management during labor and caesarean sections, but are also used before and after some other surgical procedures. Kristin Walker is a Regina mother of one expecting another addition to her family in October. She said when she got the news that there might not be an epidural available when that time came, she became anxious and worried. Kristin Walker of Regina is shown here with her first child, a son, who was born with the help of an epidural. He is now four years old. (Submitted by Kristin Walker) This is especially stressful for Walker because during her first birth, she labored for 10 hours, with tearing and other complications. Had he not become epidural, Walker would have required an emergency C-section. “There was a lot of tearing and cutting that I would otherwise have to experience and feel. I was really hoping to rely on getting [an epidural] again. I’m a little worried about that option going away.” Walker said the child she is currently pregnant with is much larger than average size, according to her most recent ultrasound. She said she expects to experience significant pain when it’s time to give birth. Walker said she is aware of alternative pain management solutions, but believes they are not as reliable as epidurals. “I don’t have a lot of faith in what my mum used in the eighties. And there’s a reason it’s no longer the gold standard and we’ve developed other options.” In the meantime, Walker said she’s confident SHA is doing everything it can to get more supply. Indeed, SHA said it is working to secure further supplies and ensure care teams use existing supplies optimally. The authority said alternative methods of pain control include drugs via spinal, inhaled, intravenous or intramuscular injection. “There are risks with any procedure, including alternatives to epidurals. But we are well prepared for those risks and are working together across the system, keeping our colleagues who may face those risks well informed so that everyone is prepared and well practice to deal with them,” said Dr. Mateen Raazi, head of the anesthesiology department of the SHA province. Epidurals are often used for pain management during childbirth and C-sections, but they are also used before and after some other surgeries. (Callaghan O’Hare/Reuters) Pain can also be reduced through local anesthetic nerve blocks, therapeutic touch, breathing and positioning techniques. Aimee Munroe, a Regina doula, said many mothers feel stressed and worried by the news of the shortage. “I’m sure there are a lot of moms-to-be right now who are feeling very scared. And that’s true, especially if you’re a first-time mom,” Munroe said. She said there are ways to adjust their birth plan so they’re prepared if epidurals aren’t available. “A big one would be hypnotherapy. If you wait now and have the 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 a few other options that can be used for pain management and medical in the hospital, like nitrous oxide gas. Sometimes you can use morphine,” Munroe said. Aimee Munroe, a Regina doula and mother of two, says hypnotherapy is a pain management option for expectant mothers. (CBC News) Not much is known about why epidurals are in short supply. SHA was unable to provide information on the number of epidurals left by the province. The president of the Canadian Society of Anesthesiologists said it’s not just a North American issue. “We suspect it’s going to be a global supply chain issue,” said Dr. Dolores McKeen. Munroe had had an epidural before, but not with her second child. She encourages expectant mothers not to panic. “Try not to dwell on the fear. Your body was made to make babies. Of course, things happen that require these medical services or sometimes medical interventions. But birth is not inherently a medical event. So you can do it. You are strong”.
