October 01, 2003

Addiction links to obstetric medications

I receive a steady stream of emails from readers of my book Preparing for Birth: Mothers asking about the statements it contains regarding the link between exposure of the baby during labour to nitrous oxide and the increased risk it may become addicted to amphetamines in later life. The book also includes the comment that there is a similar link between in utero exposure to opiate drugs (e.g. pethidine/Demerol,) and later addiction to opiate drugs. This information worries caregivers who are usually ignorant of this research (the first papers on this subject began appearing almost 15 years ago) and who are concerned about the impact of their practice habits, especially if they have been encouraging the use of nitrous oxide (e.g. Entonox) as a “safer” alternative to pethidine and epidurals.

The references used as a basis for these comments are on the web site, and if you click here, you will get the full list.

Parents sometimes worry too, because they believe that some drugs will be necessary and they are keen to avoid any that might have an adverse impact on their baby. My answer to their concerns is to remind them that there are many ways of easing pain in labour without using drugs as our grandmothers and great grandmothers well knew. These days it is even easier, given the availability of hot water in various forms (baths, showers, hot wet towels), the encouragement of upright postures and freedom of movement and equipment such as birth balls, birth stools, floor mats and bean bags. If a woman tries all of these during her labour who will find she can manage nicely, at least until the transition phase when nothing (including drugs) will do much to help her through the turbulence of this short period. Once this phase passes, the medication free woman will be fully conscious and able to actively participate in giving birth to her baby, which brings its own huge rewards.

Drugs are not the answer for relieving labour pain. They are risky, unpredictable and carry consequences that can have huger implications for the health of the baby and mother. For the doubting caregivers who use drugs as a substitute for care during labour, the evidence is clear that dosing women and unborn babies with anaesthetics and other medication is not only exposing the baby to potential hard, but themselves to a charge of inappropriate professional behaviour. I would think that this alone would be sufficient incentive for midwives and doctors to learn more about non-pharmacological forms of easing pain in labour. The references I have cited on the web site certainly make salutary reading.....

Posted by andrea at October 01, 2003 08:48 PM

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