Could a lower back tattoo keep me from having an epidural during labor?
Answer From Yvonne Butler Tobah, M.D.
A lower back tattoo won't necessarily prevent you from having an epidural, a common type of anesthesia, during labor. The exception would be if the tattoo is:
- Raised and scaly
- Red, swollen or oozing fluid — it appears infected
- Recent and the affected skin is still healing
Research on tattoos and epidurals is limited. Theoretical concerns — such as the development of skin cancer in the affected area years later — remain controversial. Actual reports of problems associated with epidurals and lower back tattoos are rare.
If you have a lower back tattoo and decide to have an epidural during labor, the doctor giving the epidural (anesthesiologist) will likely try to insert the needle through skin that isn't tattooed — such as an open area in the tattoo design. If possible, the anesthesiologist might choose a different space along your lower back.
If that isn't possible, the anesthesiologist might nick your skin before inserting the needle. This reduces any possible risk associated with trapping tattoo pigment inside the needle or depositing the pigment into deeper tissues.
Keep in mind that placing a needle through the tattoo might result in a small scar that could alter the appearance of the tattoo.
If you're concerned about the unknowns associated with tattoos and epidurals, you might ask your health care provider about other options for pain relief during labor — such as relaxation exercises, breathing techniques, nitrous oxide, or oral or injected medications.
Yvonne Butler Tobah, M.D.
Aug. 18, 2020
- Welliver D, et al. Lumbar epidural catheter placement in the presence of low back tattoos: A review of the safety concerns. AANA Journal. 2010;78:197.
- Pomeranz MK. Maternal adaptations to pregnancy: Skin, hair, nails and mucous membranes. https://www.uptodate.com/contents/search. Accessed June 13, 2018.