Let's talk about this global issue and the impact on birthing families.
There are a few factors leading to this shortage.
1) The actual Epidural Kit itself, the Epidural Catheter and the IV Contrast are in short supply in some locations globally as supply chain issues impact their availability. Read more on that here: Is There an Epidural Shortage? Pain Management in Short Supply (marketrealist.com)
2) Bupivacaine usually paired with Fentanyl to create the epidural "cocktail" used heavily in labor and delivery also had some supply issues dating back to 2018. Manufacturing delays, the pandemic and the war in Russia served to make alternative access more difficult. Pharmaceutical discussion here:
Drug Shortage Detail: Bupivacaine Injection (ashp.org)
This is currently a global concern with Canada and Australia being hit the hardest, presently. The USA is a mecca for pharmaceuticals and may be called upon to provide kits and/or medicine to other countries. Although the kit shortage is mostly due to a manufacturing facility in China that closed, this may also impact the US at some point as well.
What does this mean to the laboring person who would have opted for an epidural in the US?
1) As of 7/25/2022, no US Hospitals are publicly announcing a shortage on epidurals like our Canadian counterparts. Again, we may be asked to come to their aid and the impact of that is not readily known.
Expectant mothers stressed as Sask. Health Authority braces for epidural shortages | CBC News
2) As with most things, access in the US relies on Capitalism. Knowing that there is a global shortage could spark price increases and the question remains how will insurance companies adjust? Some birthing persons may find they will be asked to pay more "out of pocket" for an epidural, while others may be denied access altogether based on systemic racism. How Much Does an Epidural Cost? | HowMuchIsIt.org
The alternatives are obvious but not necessarily available to all! The cost or availability of an epidural does not affect the person who planned to labor without one. But this isn't a panacea as no or low access could increase the need for surgical births.
HOW DO WE PREPARE FOR WORSE CASE SCENARIOS?
We must have open conversations with our providers, understand our options in ALL cases and look for support in those options!
Below is another great article of epidural alternatives noting that hiring a doula and taking childbirth education classes are high on the list. We at Baby Please Birth Services Agency LLC, are happy to explore your options with you for the best comfortable and empowered birth experience possible.
6 Alternatives to Epidurals During Labor (parents.com)
Michelle Gabriel-Caldwell; CD, CPD, LE, CBE and EBB Instructor
Owner of Baby, Please Birth Services Agency LLC
Owner of Baby, Please Doula/Childbirth Educator/Doula Trainer