Ontario monitoring epidural shortage in Western Canada, hospitals making plans

When Shaneeza Shaw planned for the birth of her first baby, she had hoped for an unmedicated delivery, but baby Jaylen had other plans.

“Initially labour went fine and then I started getting a lot more pain,” recalled the new mother.

“My initial plan was not to take the epidural, but I ended up getting the epidural because at that point I knew I couldn’t handle it anymore,” she said.

Shaw ended up having an emergency C-section Tuesday morning and gave birth to a healthy baby boy.

Dr. Lesley Hawkins, obstetrician and gynaecologist at Humber River Hospital, said an epidural is “one of the most popular choices for pain management in labour.”

There are concerns right now in Canada and around the world due to a worldwide shortage of epidural kits used to treat pain in childbirth, but also for pain relief during or after various surgical procedures.

“An epidural is part of really multi-modal options for pain management in labour and the discussion about an epidural happens throughout the entire pregnancy with the patient’s provider, whether that’s an OBGYN like me, a family physician or a midwife … and it is absolutely a patient’s choice,” said Hawkins.

The Ontario Ministry of Health is watching the situation unfold in other Canadian provinces where there are shortages in the availability of epidural catheters due to supply chain issues.

“Currently, Ontario has an adequate supply of epidural catheters and women are able to access epidurals for childbirth. The Ministry of Health and Ontario Health are actively engaging with Health Canada, suppliers, distributors and manufacturers across Ontario to understand the current situation and supply forecasts in order to mitigate any potential impact to patients,” a spokesperson for the ministry told Global News in a statement.

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The shortage is due to a supply chain issue from one component of the epidural catheter kit.

“An epidural is a great mode of analgesia, one of many different options for pain management in labour and it really helps with the discomfort and the pain that happen during labour and delivery,” explained Hawkins.

“It certainly is something that is on all of our minds and it is a concern,” she added.

From Seed to Sprout, a perinatal organization based in Saskatchewan, is hoping to inform expectant parents about other methods that can be used for pain management in labour.

“We like to talk about it in terms of tools in your toolbox. So an epidural is one of the tools in your toolbox, and it’s the most commonly thought of tool in your toolbox, but it’s just one of them. So the very first tool that every pregnant person should have in their toolbox is education and education about the labour process, about birthing, about the norms, the expectations,” explained registered nurse and co-owner of From Seed to Sprout, Loreli Palandri.

She listed a number of alternative options to an epidural that can help with pain management, like baths and showers during labour.

“You actually can decrease the sensations that contractions give you because the water kind of changes your buoyancy and the gravitational pull on you so it literally changes the sensations that you will feel. You can also enlist your support people … we know that having continuous support during labour and birth is also proven to make you feel better,” said Palandri.

In a statement, Health Canada told Global News that it “has engaged with provincial and territorial (PT) health authorities, hospitals and manufacturers to gather information regarding current supplies of epidural catheters in Canada and to determine whether there is a national shortage.”

Preliminary information indicates that “the provinces of Alberta, Manitoba, Saskatchewan and British Columbia are experiencing varying degrees of constrained supplies.”

“It is a concern but something that our team is working really hard on,” said Hawkins.

“Our team is working really hard from our leadership to the physicians and other health-care providers on our team for a shortage should it happen.”

Hawkins also pointed out there are other options to consider during labour.

“For example, nitrous oxide or other pain medications to help with labour pain management and then there is all the non-medication options as well that we’re employing, like using the birthing ball, a warm bathtub, different mobility exercise, all sorts of things that we use for pain management in labour.”