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Saturday
Nov142009

Epidurals and Lower Back Tattoos

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Robin Elise Weiss posted an article on About.com: Pregnancy & Childbirth about some anesthesiologists’ fears of administering epidural anesthesia to women with lumbar tattoos.

Some anesthesiologists have speculated that placing an epidural during labor through this tattoo may be dangerous. The theory is that if you place the epidural needle through the ink, the dye in the skin may enter the epidural space and cause infection or damage. Other doctors offer the advice that if the tattoo is healed and the ink is dry there is no cause for concern.

The truth is we really don’t know, as very few women have been studied. One recent study involved three women. You may still opt for epidural anesthesia if you are pregnant, you can even request that they avoid placing the needle through your tattoo. If you are at the planning stages for a tattoo, consider a different location if you feel this decision is one you’d prefer to avoid.

Mayo Clinic obstetrician Roger W. Harms wrote in his July 2008 Q&A article that “the exception would be if the tattoo covers a large area and is still “fresh” — meaning the involved skin is still healing” and added that “very few studies have looked at the risks of epidurals in women with lower back tattoos.”

Snopes.com lists the claim that women with lower back tattoos should not receive epidural anesthesia as “undetermined” in a February 6, 2006, post entitled Suffer to be Beautiful. Post author Barbara Mikkelson offered her theory on why medical professionals are playing God when it comes to women with lumbar tats.

Whatever the medical world ultimately determines as the truth about potential risk regarding the combination of sacral tattoos and epidurals, I can’t help but be struck by the parallels between the modern rumor about inked vixens having to give birth unbuffered by pain medications and the penalty visited upon Eve for leading Adam astray. Eve, the original bad woman, the vamp, was punished for her part in the “Have an apple, sweetheart” fiasco by being cursed by God on high with the pain of childbirth, with the whammy laid upon her passed down to all her descendents (that is, all womanhood). Lumbar region tattoos on women are seen as communicating hinted-at promises of sexual favors. The consequence visited upon both classes of temptress is the same: they shall each know the physical pain of birthing children.

On Our Bodies, Our Blog, Rachel noted that the widespread coverage of the topic of lumbar tattoos and epidurals following an article in the Wall Street Times in September 2007 “distract[ed] from ongoing conversations about the state of birth today, and how women can best receive safe, effective, and satisfying maternity care” and noted that the odds of ever getting any decent research on lumbar tattoos and epidurals is slim.

Ultimately, there is not enough information to suggest that women should not get lower back tattoos if they plan to eventually give birth with administration of an epidural, nor is there enough to suggest that women who have such tattoos cannot receive epidural injections. There is likely very little incentive to study the issue, given that there are few reports of complications and no obvious money-making drug or procedure to be developed, short of the already available tattoo removal.

 

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Reader Comments (13)

Oh wow. I am a very tattooed midwife, including my lower and upper back. I like the point you make about Eve, as the original bad girl. The term 'trampstamp', which refers to lumbar back region tattoos, falls right into line with the concept of Eve, women with tattoos are naughty girls, therefor they must be punished...ugh! I don't see this as being about epidural safety - seems to smack more of gender and culture bias.

November 15, 2009 | Unregistered CommenterTiffany

My friend had this problem last year when she gave birth. They refused to give her an epidural during her 40+ hours of labor due to being heavily tattooed. Her back is basically covered. She ended up with a spinal and an elective c-section because she couldn't take it anymore. We had the same midwife and were delivering at the same hospital and I also have a lower back tattoo, although mine is not even close to being as big as hers and our midwife kept checking my back each appt after that to make sure there was a space to put an epidural in, should i want one (which i didn't)...

I think this is ridiculous, especially since her tattoos are all older...much older than 5 years, which I have heard is the cutoff of what some anesthesiologists use....

November 15, 2009 | Unregistered CommenterKristen

Five years?!

How would this not fall into the informed consent category? "We have no research to validate this but we need to inform you that there might be a very smal chance that ________ could happen if you get an epidural." Patients signs off.

Here’s the Wall Street Journal article that sparked the controversy in 2007.

November 15, 2009 | Registered CommenterJill

Yeah... maybe it's just a complex of mine, but as a Christian I have to sigh whenever my worldview gets blamed for sadistic doctors wanting to punish women. I dunno. Maybe it's that the medical community is largely not "Christian" in any real sense. Or that the whole Eve thing is being misrepresented and misinterpreted... Anyway, *sigh*

November 15, 2009 | Unregistered CommenterLaura Grace

Why would a woman who was in labor have a healing tattoo? Traditionally tattoos are not done on pregnant women.

November 15, 2009 | Unregistered CommenterStephanie

<<They refused to give her an epidural during her 40+ hours of labor due to being heavily tattooed. Her back is basically covered. She ended up with a spinal and an elective c-section because she couldn't take it anymore. >>

Interesting. Epidural...too unsafe. But spinal...oh that's ok. Anyone else befuddled?

<<Yeah... maybe it's just a complex of mine, but as a Christian I have to sigh whenever my worldview gets blamed for sadistic doctors wanting to punish women. I dunno. Maybe it's that the medical community is largely not "Christian" in any real sense. Or that the whole Eve thing is being misrepresented and misinterpreted... Anyway, *sigh*>>

Me too Laura. I actually don't think even most Christians understand the passage. I am *no* authority, but I am a Christian (although a bit unorthodox)...but I interpret the passage to refer less to the pain of labor (which actually has a physiological purpose) and more to the other pain ~ mortality brings on the possibility now that children can die ~ in labor, in childhood, otherwise before one's parent...that is a pain and sorrow of childbearing. Really, it's mortality that was the punishment (although there is reconciliation), and the pain is merely a result of the punishment of mortality. Also (secondarily), children often disappoint their parents, which is another pain of being a parent. THAT is what I think the passage refers to, moreso. The passage should *not* be used by anyone to refuse comfort to a woman in the throes of labor...that is a punitive, culturally-and gender-biased interpretation of it, IMO.

I'm with you, I think it's easy for anyone to use any religion to justify their own prejudices and resulting sadistic actions. As humans, we have an amazing ability to justify ourselves (including myself in this statement...as mom says when you point a finger three point back at you).

That being said, I'm not a huge fan of epidurals...but hey, it's not my birth...as long as the woman has been given informed consent (not usual, IMO...my first OB/Gyn told me epidurals didn't affect the baby...yeah right)...it's up to her to choose it or not. If not given informed consent, then shame on the physician!

Just my $0.02.

PS ~ Jill, not directed at you...thanks as always for a thoughtful post. I understood the post to mean that doctors have traditionally used this passage to deny women assistance of one kind or another, and that this cultural bias is still evident today in various forms...not that you believe such behavior is truly justified by Christians! ;-)

November 15, 2009 | Unregistered CommenterAnne

Anne,

Even if it were directed at me, that would be okay. :) Thanks for your interesting comment. I wouldn't have posted about epidurals and lumbar tattoos unless I had stumbled across that passage on Snopes and I hadn't thought of it as being offensive to judeo-christian believers. I appreciate the insight.

November 16, 2009 | Registered CommenterJill

Anne, thanks! I'm glad it's not just me... ;) I would agree that most Christians don't read that passage carefully enough. And I completely agree that anyone who claims to be a Christian and uses the Eve thing to deny comfort or pain relief to a woman in labor is... pretty confused, to say the least.

I really do think that this has to do with a perception of trashiness and a desire to punish that, but I hope people realize that while that might reflect institutional abuse and twisting/misinterpretation/misapplication of certain culturally "Christian" principles, such behavior is not truly Christian in any real way, any more than bombing buildings is Muslim in any real way.

November 16, 2009 | Unregistered CommenterLaura Grace

No matter what the bias about tattoos are the only question should be whether or not the epidural is safe for mommy and baby. I would imagine unless the ink is fresh it would be safe. Thank you for bringing up a topic I would never have thought about unless I came across this problem personally.

November 18, 2009 | Unregistered CommenterBobby

Thanks for your interesting comment. I wouldn't have posted about epidurals and lumbar tattoos unless I had stumbled across that passage on Snopes and I hadn't thought of it as being offensive to judeo-christian believers. I appreciate the insight.

January 12, 2010 | Unregistered Commenterlower back pain
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