September 09, 2002

Drug addiction references

The discussion about doulas is still going on and I want to say some more about this on another day. However, let's change the subject for now!

Had a phone call from a staff person at the Drug and Alcohol Committee of the Royal Children's Hospital in Melbourne. She was chasing up some references she had been asked to track down ...... I immediately knew what she would be asking for next, and I was right.

In Preparing for Birth: Mothers in the section on Drugs in Labour (page 43) and also in The Midwife Companion, I list the potential risk that babies exposed to opiate drugs during birth may develop a lateraddiction to opiate drugs, or to amphetamines if exposed to nitrous oxide during labour. I regularly get requests for the references to back these statements and I am always happy to pass on the list of studies. In fact, I have now included them in an article in the Essential Parent pages of this web site to make them easier for everyone to access.

The interesting thing about this call was that this person was very defensive about this information and was adamant that I should reference these statements int he book itself. I pointed out that the book clearly says on the cover that it contains "Background notes for prenatal classes" and on the inside cover is suggests parents ask their educator if they want references or more information on any topic included in the publication. The book was designed like this to encourage parents to talk to their educator about issues that are concerning them and also to avoid the book becoming 'heavy' with a lot of technical references. I wanted it to be as "user friendly" and non-threateneing as possible, like a woman's magazine. My caller obviously didn't have a copy of the book to hand but my explanation didn't mollify her at all - she was clearly upset that I had included this information in the first place and that the Drug and Alcohol Committee didn't know about this research.

It is interesting how people react to this issue of drug addiction. I've been talking about it for 10 years now, at every class, workshop and training course I have presented, and it always raises anxieties. As a result, people often say that parents should be protected from this info because "we don't want to make them anxious, or guilty of they choose to use these drugs during labour".

I have found that parents often take a different view. If they have never had a baby they don't understand (yet) that the decisions they make in the heat of labour are often different from those they might choose in the calm of the pregnancy. As a result, when these thorny issues of predisposing their unborn baby to the potential for a later addiction to drugs (and it must be stressed that it is not cause and effect, just an increased risk) are raised during the pregnancy, parents are often glad to have the information. In fact, if it was withheld, there would be a risk that later they might get angry if it was discovered that they had been misled, or patronised by the educator.

It is a tricky one, and an issue I have written about elsewhere. In the meantime, I hope that the Drug and Alcohol Committee at the Royal Children's Hospital might investigate these links further. We need more research in these vital areas - I am convinced that one day the connection between exposure to drugs and medical procedures during labour and birth and the effect of their imprinted memories on the unborn baby will be shown to be a major factor in some teenagers developing life threatening behaviours later. It is a topic that health professionals find very threatening, especially if they have offered women drugs during labour, but one they must face squarely.

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