New Brunswick gets ready for epidural shortage to spread east

New Brunswick isn't refusing patients an epidural, but one doctor says health-care workers are starting to use them more carefully.

Shortages of the epidural catheter kits, used to manage pain during childbirth and cesarean sections, have been confirmed in Saskatchewan, Alberta, Manitoba, and British Columbia.

The shortage is due to supply chain issues, though not much more is known about why.

The Canadian Anesthesiologist Society told CBC Saskatchewan it's not just an issue in North America, and the shortage could turn into a global supply chain problem. 

Dr. Christa Mullaly is an obstetrician and gynecologist, as well as the section representative for obstetrics and gynecology for the New Brunswik Medical Society.

She said the Dr. Everett Chalmers Regional Hospital in Fredericton heard about the supply chain issue last week and started creating contingency plans early this week.

"We're just trying to use them carefully, only for women who are really needing them during labour because either they have a medical condition or they're not coping with some of the other things that we have available," she said.

Mullaly said that as of right now, New Brunswick is in an "OK situation," and supplies are expected to last until a resupply in about a month.

While Mullaly initially believed there would be a full restocking, she said later on Friday that she's been told this is no longer guaranteed, and the hospital may have to start rationing epidural supplies sooner than expected.

That concerns her for two reasons.

First, there are situations where an epidural is necessary, like if the patient is birthing twins or has uncontrollable high blood pressure.

"We always want to make sure that we have epidural access for those patients," Mullaly said, adding she's comfortable with the current inventory for those situations. 

The second reason is more philosophical, Mullaly said: all people giving birth should have the right to use the pain relief they want.

"So it's challenging to sort of face having to potentially balance that against having to ration or [having] supply issues in the coming weeks," she said.

Most patients understanding, Mullaly says

While Mullaly couldn't say how many pregnant people are in the area now, she said the hospital does about 1,500 deliveries a year. The numbers so far this year are stable and even rising a little bit, she said, leaving the hospital with about 120 deliveries per month. 

So far, most women have been "extremely understanding," she said.

"I think everybody knows we've been through a really difficult couple of years for lots of supply things," she said.

"I think a lot of women say, 'Okay, well, you know, I had my last baby with an epidural, but I was hoping to not have an epidural this time anyway'."

Mullaly wants to reassure pregnant people across the province that health-care workers are ready to provide the best labour support possible. She said her team of nurses have made it through staffing shortages and all the challenges that came with the pandemic.

"They keep coming to work because they're dedicated to supporting all of our moms and babies in our community."

Aside from the supply of epidurals the hospital still has, Mullaly said lots of other pain management techniques will be available.

"But if epidurals aren't available, we are still prepared to try to make sure everyone has definitely a safe birthing experience and a well-supported birthing experience."