Saskatchewan Health Authority (SHA) is asking families and doctors to prepare for a shortage of epidural catheter kits that are mainly used for managing pain during childbirth and C-sections. They are also used to provide postoperative pain management for major abdominal and chest surgeries.
According to a SHA press release, world-wide supply chain issues are impacting the ability for care teams to provide the kits to pregnant women. In response to the shortage the SHA is asking expecting parents to review pain management options with their caregivers.
“The challenge that we’re facing right now is that the amount that we have currently existing and the amount that we are anticipating to get in in the near future remains unclear. So we are trying to gather information on what supplies we do have or can expect in the short term,” Dr. Joanne Sivertson, SHA Provincial Department Head, Obstetrics and Gynecology said.
Alternative pain control methods include medications through spinal, inhaled, intravenous, or intramuscular injection. Pain may also be reduced through local anesthetic nerve blocks, therapeutic touch, breathing, and positioning techniques.
Sivertson added that the nursing staff will be using non-pharmacologic methods, but they also have other medications that can be used.
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Marteen Razzi, a physician and anesthesiologist at SHA, said there are other options available. “Usually morphine or morphine-like drugs and the varieties that are safer for pregnant women and children or babies are utilized. Then the other options besides that include breathing in gases. The most common gas is a laughing gas – nitrous oxide in combination with oxygen that can serve just a mask on the face and the patient in labor,” he said.
Razzi said that epidural is likely considered to be the gold standard for pain control in labor because while some of the other options can provide just as intense pain relief, they may have the drawback of not being as sustained. Whereas epidural provides a very high level of comfort for the pregnant patient and sustains it as long as it is needed in a manner that is safe and reliable.
Sivertson said that SHA is trying to ensure that the supply they have is fairly distributed across the province and patients have equitable access regardless of where they deliver. “Ensuring that our highest risk patients are the ones that we meet up with early to have a safe labour during their labour to ensure that we can continue to have supplies for that purpose.”
We will absolutely look after the patients, our patients, the way that they deserve to be looked after and provide safe care and compassionate care and timely care,” Razzi said.
Sarah Beckel, coordinator at Regina Perinatal Health Network said that she feels this is a very unfortunate situation. “My initial reaction was just general sadness, birthing people and mothers are going to be paying the price for this one.”
She said that she thinks education about the birth process and the available options is important. “We just want to make sure that birthing people feel safe and comfortable as they move through their birth process. Currently about one in three people are experiencing a traumatic birth. And so uncontrolled pain management can certainly add to that, which comes with a whole host of other impacts.”
Beckel added that social support is also important, surrounding yourself with families and having a good support system. “A safe place to talk about what they’re experiencing, a trusted resource to find information and that’s something that we can help with in building a birth plan and helping people understand their options.”
Morgan Taylor who is due to give birth in three weeks said she felt pretty scared and worried when she heard the news. “As the days progressed, I became more accustomed to the thought that it’s nothing in my control and I need to just deal with it as it comes in the hospital. Give me some sort of painkiller. It doesn’t matter what it is, at this point, as long as I get something.”
“Growing a human is hard. It’s hard to describe to someone that’s never done it, but it’s not as glamorous as you would think. It is hard on the body and the mind every day and without a support system. I’m not sure how some people do it, but yeah, if you know anybody that is pregnant and getting ready to deliver it, definitely give them that extra support if they’re worried that they’re not going to get that epidural,” she said.
Taylor has given birth before and advised expecting mothers to ease in, go into it with positive thinking.
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