Recommendations
– Comprehensive education for obstetric care providers, including nurses, midwives, physicians, and anesthesia and emergency personnel, is essential for preventing, recognizing, and managing lower extremity nerve injury (LENI, pronounced “LEN-EYE”) in childbirth. To reduce the risk of LENI during childbirth, especially in patients receiving neuraxial anesthesia, include the patient in the decision-making process, implement proactive repositioning strategies, and educate patients regarding self-repositioning and neurological signs and symptoms of LENI to report.
– During the postpartum period, health care teams should monitor neurological symptoms such as numbness, weakness, and altered gait and should respond promptly to minimize fall risk and protect physical function, safety, and emotional well-being. Symptoms should be treated with the same urgency and thoroughness as nonobstetric nerve injuries, including timely imaging, specialist referral, physical rehabilitation, and discharge follow-up. Providers must recognize and address the psychological impact of LENI. Mental health screening, emotional support, and access to counseling and therapy should be prioritized to support recovery and well-being.