Health ministry reconsiders ban on epidural+PainBuster combo for C-sections amid public outcry

Last month, the Ministry of Health and Welfare (MOHW) issued a public notice stating that, starting July 1, pregnant women will be prohibited from using the combination of labor analgesia and PainBuster for C-sections, prompting outrage from expectant mothers.

As the rallying cry of protests intensified against the government’s policy to prohibit the simultaneous use of epidural analgesia and ON-Q PainBuster, thereby limiting mothers’ choices for anesthetics procedures, the health ministry expressed its willingness to reassess the policy.  

The health ministry's policy change plan was based on the National Evidence-based Healthcare Collaborating Agency (NECA)'s report in November of last year stating that there is “no significant difference in pain-reducing effects between using epidural alone and using epidural and PainBusters together.” NECA also expressed concerns about the increased risk of systemic toxicity when such anesthetics are used in combination. 

PainBuster, commonly used for C-sections, involves administering local anesthesia at a constant and preset rate through a device into the muscle near the surgical area. C-sections are the most preferred mode of delivery in Korea.

A controversy erupted among expected mothers when they were informed by hospitals that they would no longer have access to PainBuster. 

"Regardless of the severity of potential side effects or its efficacy in mitigating pain, our primary concern lies in the fundamental right to choose," said Lee Hye-seon, a mother working in the healthcare sector who had received both epidural and PainBuster during her recent childbirth, emphasizing the emotional aspect of the issue over the rational problem. 

"What exacerbates the situation is that the government is taking away something we already had, which feels different from simply not being offered the choice initially. We feel like something has been unfairly taken away from us."

Mothers also took to online mom communities platforms to speak out against the government’s policy, claiming that  "This restricts material autonomy," "It seems like the government doesn’t care about declining birth rates," and "Have you ever experienced a C-section? I barely survived my first birth with a PainBuster.” 

In response to public outrage, MOHW announced on Tuesday that they are considering allowing PainBuster and similar medications to be administered as non-insured services upon patient request. MOHW also raised the co-payment for PainBuster from 80 percent to 90 percent. 

“We will finalize the revision of the criteria for local infiltration and continuous infusion of the surgical wound with anesthetics, taking into account the opinions of mothers and doctors advocating for the right over their bodies for reproductive choices and personal autonomy,” MOHW said. 

NECA also stated that they received opinions from the Korean Society of Anesthesiologists saying that the simultaneous use of anesthetics options is only deemed necessary for patients experiencing severe pain or those who do not achieve adequate pain relief through conventional pain management methods.

The MOHW also refuted claims circulating the online mom communities, dismissing assertions that “labor analgesia or C-sections will no longer be covered services” and “labor analgesics and PainBusters are prohibited from combined treatments” as false. 

“Epidural is already included in insurance benefits, so any suggestions that they will become non-covered are baseless,” said an official at MOHW. “Also, there is no validity to assertions that C-sections will no longer be covered."