Between Issues

Lower Extremity Nerve Damage During Childbirth: Patient Resources

June 23, 2022

Omar Farooq; Samia Sami, MBA, MHA; Cheryl Parker, DNP, CRNA, RNC-OB

To the Editor:

We would like to commend the authors of the article titled Postpartum Peripheral Nerve Injuries – What is Anesthesia’s Role?, printed in the June 2021 issue of the APSF Newsletter. There are a few factors that could provide supplemental information to the article.

We are aware that not all lower extremity nerve injuries (LENIs) are avoidable. However, physical therapy and the use of assistive devices such as leg braces, shower chairs etc. are not only a mode of treatment for peripheral nerve injuries, but these may also prove essential for the mother that has to care for her newborn. Other recommendations have been identified for patients that might help them to advocate for themselves for the prevention of LENI (Table 1).

Table 1: Recommendations to help prevent LENI during Labor

  • Reposition women’s legs every 10 to 15 minutes during the second stage of labor.
  • Reserve the use of stirrups for the birth only. Avoid placing women’s legs in stirrups for pushing. If stirrups must be used during pushing, remove women’s legs from stirrups between pushes.
  • Move hand placement frequently during the second stage of labor.
  • Avoid lengthy hand placement laterally, directly below women’s knees.
  • Both the laboring woman and anesthesia providers should strive for non-motor blocking epidurals.

For those women who have incurred a LENI, support groups can be a valuable resource. Unhindered Steps is a “not for profit” advocacy and awareness initiative that sends out awareness flyers to physicians and other healthcare providers. It also supports patients, especially those worried about repeat damage during subsequent births. Unhindered Steps is on Facebook, and Omar Farooq, the founder, can be reached at [email protected].

MICA (Maternal Nerve Injury from Childbirth Awareness) is a similar advocacy group and was founded in 2018 to educate patients about resources regarding lower extremity nerve injuries from childbirth. This website: contains multiple resources including a link to a Facebook support group: Moms with Femoral/ Peroneal/ Sciatic Nerve Damage from Labor/ Delivery.



Omar Farooq (undergraduate student)

Samia Sami (MBA, MHA)

Cheryl Parker (DNP, CRNA, RNC-OB)


  1. Duncan, A., & Patel, S. (2016). Neurological complications in obstetric regional anesthetic practice. Journal of Obstetric Anaesthesia and Critical Care, 6, 3–10.
  2. Richard, A., Vellieux, G., Abbou, S., Benifla, J., Lozeron, P., & Kubis, N. (2017). Good prognosis of postpartum lower limb sensorimotor deficit: A combined clinical, electrophysiological, and radiological follow-up. Journal of Neurology, 264(3), 529–540.
  3. Association of Women’s Health, Obstetric and Neonatal Nurses (2020). Lower Extremity Nerve Injury in Childbirth: AWHONN Practice Brief Number 11. Nursing for Women’s Health, 24(6), 470-472.
  4. Sleutel, M. R., and True, B. A. (2020). On Analgesia and Anesthesia in the Intrapartum Period: Evidence-Based Clinical Practice Guideline. Letter to the Editor. Journal of Obstetrics, Gynecology, & Neonatal Nursing, 49, 227–229.