Births and operations | Epidurals threatened by a shortage

Supply difficulties are still creating problems, this time even in the delivery rooms. After Ontario, British Columbia, Alberta, Saskatchewan and Manitoba, it is Quebec’s turn to prepare for a shortage of epidural catheters, much to the dismay of pregnant women.

Alice Girard-Bosse
The Press

Currently, a worldwide shortage of epidural catheters affects several Canadian provinces. “In Quebec, a shortage situation is also to be expected for epidural catheters with three suppliers who supply establishments in the health and social services network”, indicated Tuesday to The Press the spokesperson for the Ministry of Health and Social Services (MSSS), Robert Maranda.

One manufacturer, Smiths Medical, expects its supply to return to normal levels by August 26, while another, Teleflex, has signaled the shortage will end on December 30.

The Department takes steps with institutions in the health network to draw up an inventory of available stocks. “The MSSS is also informing the various professional orders of the situation,” added Mr. Maranda.

Exceptional measures

An epidural, also called an epidural, is an analgesic technique frequently used during labor and delivery for pain management and high-risk births. It is also used for other surgical procedures.

This technique consists of inserting a catheter into the epidural space, along the spine, and continuously injecting a local anesthetic with or without an opioid. “It’s the best tool we have to relieve the pain of labor or surgery,” says Dr.^r Nikola Joly, president of the Association of Anesthesiologists of Quebec.

Other options exist, such as administering intravenous medications, but nothing is as effective as an epidural, says Dr.^r Pretty. “That’s why we want to make sure we don’t run out of catheters,” he says.

To resolve the situation, Canada is considering allowing the exceptional importation and sale of catheters that do not fully meet Canadian regulatory requirements, but are manufactured “to comparable quality standards in countries with similar regulatory requirements to those of Canada,” said Health Canada spokesperson Natalie Mohamed.

These new catheters will be tested shortly in two Quebec hospitals, says Dr.^r Pretty.

Limited resources

There are two main reasons for the shortage of foreign-made catheters, a lack of raw materials and a problem with certification of catheter sterilization in China, says Dr.^r Pretty.

Currently in Quebec, no hospital lacks epidural catheters, says the anesthesiologist. “Some facilities have enough catheters for more than a month, and others for a little less than a month,” he says.

In the coming weeks, there will certainly be a sharing of equipment between the establishments, he indicates. “We wouldn’t want people shopping around their facility based on catheter inventory,” he says.

Concerned pregnant women

The possibility of this shortage worries many pregnant women. “It worries me a lot. It’s my first pregnancy, I don’t know how it’s going to go. The epidural is the most popular anesthesia technique according to my doctor, so knowing that it will not be available is worrying,” says Chloé Lapointe, 38 weeks pregnant.

When she heard about the shortage on social networks, she hastened to contact the obstetrics department of the hospital where she is followed in Mont-Laurier.

Daphnée Marineau also learned of the existence of the shortage on social networks. “I looked on Google and it said the shortage was in Ontario and Saskatchewan. I said to myself that it was surely going to come to Quebec. It freaked me out a bit, because I wanted to use it,” said the 35-week pregnant woman.

According to Julie Pelletier, president of the Ordre des sages-femmes du Québec, a woman who is not prepared for a natural childbirth can experience anxiety if she does not have access to an epidural. “Most women who give birth [avec une sage-femme] want to do it without an epidural, so they are prepared. But a woman who is faced with the pain of childbirth without having wanted it, it can be quite anxiety-provoking. Anxiety can even increase the pain tenfold and be a hindrance to childbirth,” she concludes.