To the Editor
I found it extremely disheartening to read Dr. Parker’s comments regarding the “privilege” of receiving a labor epidural. Since when is an epidural a privilege?
If a laboring patient is in need of an epidural, she should not be denied this service because Dr. Parker needs his rest because he has to work the next day, or because she is a Medicaid patient, and it is not financially worth his while to get up out of bed.
Patients who present at night should receive the same quality of safe anesthesia care as patients who present during daylight.
Linda E Ferro, CRNA
Virginia Beach, VA
Both Dr. Parker and Ms. Ferro raise important and difficult issues. Labor epidural analgesia has evolved from a procedure prescribed for selected medical indications to the current on-demand, widely available preferred method of labor analgesia. The resources necessary for 24/7 universally available labor epidural analgesia are significant and not always in place. Undeniably, reimbursement and financial support often fall short of covering the cost. Staffing and fatigue must be considered as safety issues as providers struggle with efforts to provide this important service to our laboring obstetric patients.