However, according to Health Canada, epidural catheters are on the list of medical devices facing a shortage – something that medical professionals are concerned about. Supply chain restrictions are currently affecting Manitoba, Saskatchewan, Alberta and British Columbia to varying degrees, and while patients have not yet been affected, it could only be a matter of weeks for some areas. Doctors are concerned about the impact this will have on pregnant women if provinces run out of supplies to provide epidurals. Epidural not only helps in pain management but also in high risk births. “It’s going to have a big impact on working women,” Dr. Lucie Filteau told CTV News. Filteau is vice-president of the Canadian Anesthesiologist Society. She says that in general, between 50 and 60 percent of deliveries use an epidural. Epidurals are also sometimes used for pain management in patients outside of the maternity ward, and a shortage would limit options for these patients as well. And the shortage problem isn’t getting any smaller, Filteau said. “What we thought affected the shortage in Canada [nearly] all provinces actually affect our colleagues in Australia and the United States,” he said. A statement from Alberta Health Services (AHS) on Tuesday added that “supply chain issues are leading to a global shortage of epidural catheters and tubing required for CADD pumps used for epidural infusions.” Some Ontario Health Networks have begun preparing to share supplies if needed. Last week, the Saskatchewan Health Authority released a statement “asking families to review pain management options with their care providers in response to the shortage of epidural catheter kits across North America.” Jamie Fiddler’s first child was born by C-section with an epidural, and now the Saskatchewan woman is expecting again. She told CTV News Saskatoon last week that the prospect of not having an epidural is scary, especially since she expects to need another C-section due to a medical condition. “I can’t imagine having a C-section without an epidural,” she said. According to the AHS statement, Alberta currently has “more than two weeks’ worth of supply and there is no immediate impact on patients.” But not everyone is reassured. As she prepares to give birth to her first child, Arianna Fierling worries about the prospect of giving birth without the option of an epidural. “I think that’s what every woman wants in the back of her head, knowing that an epidural is going to be available,” she told CTV News. “You don’t know until you’re in it, so for me, I just think if I can’t do it naturally, I’m definitely going to get an epidural.” An epidural works by injecting an anesthetic into a specific space in the layers of tissue surrounding the spinal cord. This placement close to the spine is key, as it prevents pain signals from traveling from the spine to the brain, with the anesthetic almost forming a cushion around the spine. But that can’t happen without the epidural catheter, a thin plastic tube inserted into the lower back with a needle to allow technicians to continue delivering pain medication to the spinal area during labor. With an epidural, pain relief occurs in minutes. Filteau says there are other options, such as nitrous oxide, opioids and local anesthetics to help with labor pain. “Unfortunately, none of them have the same sense of pain relief that you get with an epidural,” he said. And these are conversations Fierling is already having. “Well, we talked about some options, my doctor did a good job of reassuring me that he would be there every step of the way and there would be some options for me either way,” Fierling said. Health Canada says if the shortage reaches a national level, it will step in to alleviate the shortage for patients, even seeking access to international supplies if possible.
