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More on Tattoos and Epidurals

September 26, 2007

I had a bit of information I couldn’t quite fit into my recent post at OBOS on recent discussion of whether women with lower back tattoos can safely get epidurals during childbirth:

A case report of three women receiving such an epidural was published in 2002. In two of the cases, the tattoo was avoided entirely – the epidural injection was done through the tattooed area in the third case, but no complications were reported. Another case, mentioned in a letter to the editor of a medical journal in 2004, describes “the first report of a minor anesthesia complication resulting from epidural needle insertion through tattoos.” In that case, tenderness and burning was experienced at the injection site, but it resolved within twenty-four hours.

So what do we actually have on the topic, despite recent media coverage? No big studies. No conclusive evidence. Case reports of three women, only one of whom had any complications, which were thought but not proven to be possibly related to the epidural. Tenderness and burning at the site where a needle has gone into the spinal space? I’ll hold out for more solid and serious complications before worrying about this one. Insert your own “The Sound and the Fury” reference here.

In the comments of my previous post on the topic, Cyndi and Labor Nurse that they’ve never experienced lower back tattoos as a problem in any of the births they’ve attended. So where does that leave us? I’ll reiterate from OBOS:

“…it makes way for the supposedly sexually available woman with a “tramp stamp” (a common term for such tattoos) to be punished with the pain of childbirth. Meanwhile, it distracts from ongoing conversations about the state of birth today, and how women can best receive safe, effective, and satisfying maternity care.”

The Chicago Sun-Times actually referred to it as “the revenge of the tramp stamp.” If that doesn’t suggest a mocking ha-ha about those slutty women having to endure pain because of their behavior, I don’t know what does.

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10 Comments leave one →
  1. September 26, 2007 5:17 pm

    It’s so amazing to me that there is such prejudice over tattoos in women. I know so many women who have tattoos, including my dad’s wife who is in her fifties. She got a cute little one on her ankle a few years ago to prove to herself that she was still cool (so funny)

    As far as the “study group” Everyone feels a little sting and tenderness after having an large metal catheter inserted into their spine! Give me a break!

    It’s really all about control. It’s always about control. It will always be about control until women decide to take it back.

    Cyndi

    http://www.mybirthteam.com

  2. September 26, 2007 5:50 pm

    People make assumptions about other people based on their appearance. Men and women alike. I respectfully ask “why should things be different than human nature makes them?”

    Of course, everyone has the right to adorn their bodies as they wish, to dress as they wish and to speak as they wish. But they do not have the right to alter the world or people’s reactions.

  3. September 26, 2007 7:53 pm

    Zagrus, it’s not about “altering the world or people’s reactions” – it’s about the existing medical evidence.

  4. September 26, 2007 7:53 pm

    And Cyndi, exactly.

  5. September 26, 2007 10:46 pm

    I stumbled across a great letter to the editor once when I was researching something. I wish I could find it now. It was in response to a journal article about when to get psych consults when admitting people to the ER. The original authors stated that a tattoo or piercing (other than traditional ear piercing) should be considered “symptoms”, if you will, for a psych consult. The doctors who wrote the letter argued that both were so common that they in no way indicated any instability or special conclusions to be drawn from them, and used some epi numbers about how common they are. I have to say there are a lot of tattoos (including mine) and piercings among our med school class.

  6. October 2, 2007 2:09 pm

    As a nurse anesthetist, I insert epidurals into laboring women all the time. Many have back tattoos. I will usually try to avoid inserting any needles through them, but if it is unavoidable, then I go through them. I’ve literally put in thousands of epidurals; countless numbers of patients with lower back tattoos, and I can honestly say that I have not had one complaint or problem as a result of piercing the tattoo. Nor am I aware of any literature to the contrary. If a woman feels discomfort in her back at the site of injection post-epidural, that is normal and natural, with or without the tattoo.

  7. October 2, 2007 3:26 pm

    Thanks, Terry. I laughed out loud when I saw the letter leaping to the conclusion that discomfort after epidural was tattoo-related. Needle+spine=ow. LOL.

  8. Kerri permalink
    February 29, 2008 2:39 pm

    Im 5 months pregnant and was told by my doctor i wont be able to get one cause i have a lower back tattoo and its less then 3 years old, if it was atleast three years old it would be no problem, its not judging someone, its a health risk, they say if its less then 3 years old the ink isnt old enough and there is a chance that having the needle go through it can make the ink go in your blood, its a load of bull when your telling a pregnant women that is about to be pushing a 9 pound baby out of dime size whole, (we have a family history of large babies, and mine is already seeming bigger then usual) so here i am going to be having a large baby and being forced to go natural!!!

  9. February 29, 2008 2:58 pm

    Kerri, you might want to talk more with your doctor about this (or the anesthesiologists where you plan to give birth). The last time I checked, the evidence on this topic was really insufficient, and certainly didn’t suggest any hard and fast rules about “less than 3 years old.”

  10. Lindsay permalink
    March 6, 2009 5:39 pm

    I am a happily married woman turning 28 on March 29. I have never been sexually promiscuous, and am really offended by the term “Tramp Stamp”. I am planning on getting my first tattoo for my 28th birthday on my lower back. It is derogatory and wrong to put women who have one of these tattoo’s in a derogatory class of their own. I have many friends who have these tattoo’s and are not anything like what the term is suppose to mean. I also have several piercings, one being my tongue…does that mean I like to perform fellatio on random guys I don’t think so!! NO IT DOES NOT. I just wanted to have it done. As for the women/epidural, I agree that if you have any type of needle stuck into you, you end up having at least a small mark on your body for a few days afterwards, and if your main concern while giving birth is to have or not to have an epidural because of complications due to your tattoo then you need to not be having a baby! My only concern would be that somehow the ink could pass through the injection site and into your body…is that possible? I am also at the age where I would like to start having children and an epidural is a definite possibilty for me. Any comments on the last part?

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