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Pregnancy: It is reasonable to assume that a large number of pregnant women and women of child-bearing age have been given bupivacaine. No specific disturbances to the reproductive process have so far been reported, e.g. no increased incidence of malformations.
Foetal adverse effects due to local anaesthetics, such as foetal bradycardia, seem to be most apparent in paracervical block anaesthesia. Such effects may be due to high concentrations of anaesthetic reaching the foetus.
The addition of adrenaline may potentially decrease uterine blood flow and contractility, especially after inadvertent injection into maternal blood vessels.
Breast-feeding: Like other local anaesthetics bupivacaine may enter the mother's milk, but in such small amounts that there is generally no risk of this affecting the neonate. It is not known whether adrenaline enters breast milk or not, but it is unlikely to affect the breast-fed child.
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