Answer: I had to look this one up because it was something I had never heard before when I was emailed this question back in 2003. Since then, it's come up a lot.
PubMed apparently did some research on this theory and concluded that there are no conclusions and no proof to substantiate this theory.
BME quickly dismisses this as an urban legend, but one pervasive enough that even doctors have been known to believe it. Tattooz.net's medical expert says, "The needle would go through the epidermis, dermis and into the areas where the anesthesia is infiltrated without difficulty", but wisely advises that anyone in this situation get personal professional advice from their own anesthesiologist.
Does that mean that some doctors won't still refuse to administer an epidural if the patient has a lower back tattoo? Unfortunately, no. As stated above, the belief that the practice is somehow dangerous - despite research and evidence to the contrary - is strong enough that even anesthesiologists have been known to err on the side of caution and refuse to attempt it. Note the following experience submitted by a reader:
"On Tuesday I delivered a baby girl, without any drugs. This was NOT my choice. Since this is baby number 3, I had decided I would 'treat' myself to an epidural this time and take the 'easy' route.
I made my intentions known to my labor and delivery nurse and together we decided when we would begin preparations for the drugs. All together, it took over an hour of preparation before they finally brought the anesthesiologist in.
At this point, I was dilated to 8 and running out of time and stamina. The pain was so intense and since I had my heart set on drugs, I had not mentally prepared myself for it. When the Dr. opened the back of my gown, they discovered my back tattoo. Up until this point, during my entire pregnancy, NO ONE ever asked if I had a tattoo. There are only three vertebrae where an epidural can be administered. They are L5, L4 and L3. This is also the exact location of the all popular 'back tat.' The Dr. explained to me that he would NOT be able to administer an epidural because the pigment could contain bacteria and he could not pierce the ink with a needle that could ultimately push the bacteria directly into my spinal fluid. Ultimately, this could introduce an infection that would jeopardize my mobility.
So, I had to deliver the baby on my own. It was a terrible experience, so I decided to research its validity which is how I came across your post. You may want to amend you post so women know the whole story before making the decision to get a lumbar tattoo. Had I known it would impact my delivery I would have made many different decisions. Obviously, it's too late when you are in the throws of labor." -Kimberly T.
I should mention a couple of points about the above email. First, most doctors won't administer an epidural this late in labor anyway. Once a woman has dilated to 8, it's usually too late. Second, what doctor decides to proceed with something like this without a full consultation to determine if the patient is, in fact, a good candidate for an epidural? The presence of the tattoo should have been established early on. And last but not least, I can say from experience that an epidural is no "treat" and is not always the "easy" way out. The one I got was a horrible experience and I will never opt for an epidural again.
My conclusion? As a mother of two, I can assure you that there are so many variables when having children that it is impossible to consider and prevent any possible difficulty. I also know that doctors have a knack for finding ways to provide for their patients, despite obstacles. They're not usually going to refuse pain relief to a woman in labor just because she has a lumbar tattoo, even if they believe in the above theory. And an epidural is not the only source of pain relief - there are other drugs that can ease the pain of childbirth. If you are unfortunate enough to end up with a doctor like the woman quoted above, I hope you have time to demand that someone else take over. A woman in labor deserves the utmost care, not a paranoid and superstitious doctor.
If a lower back tattoo is something you really want and this is the only thing standing in your way, you can always talk to your doctor about your concerns and see what they have to say on the matter. However, it appears to me that the chances of a lumbar tattoo actually interfering with an epidural or other pain relief is very, very minimal if not nil.
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