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The effect of labour drugs on newborn babies

More meetings with midwives this weekend, this time a group that has representatives of 6 hospitals around Birmingham. The contrast in maternity services (that exists in every country) was very apparent, with some midwives telling excited stories of their new midwifery unit opened six weeks ago and others bemoaning the rigid obstetric policies being applied in another unit.

We talked about the usual topics including the effects of drugs given for pain on both mothers and babies. I am always surprised that many midwives have not considered the consequences of giving these drugs on the babies. Many consider that Entonox is “harmless” when it clearly has an anaesthetic effect on women and will therefore be having some impact on the unborn baby. Opiate drugs are still widely used even though they are not pain killers but sedatives and the depression on the baby’s respiratory system and sucking reflex should be well known.

We talked yesterday about the continuum between pregnancy, labour, birth and the immediate post natal period, which includes breastfeeding. Putting the baby to the breast is part of the birth process, triggering the flow of oxytocin that causes placental separation and birth. When babies are drugged and drowsy, or irritable and unsettled, these precious moments are likely to be disturbed and this first breastfeed unsuccessful. Fortunately, any stimulation of the nipple, such as licking, nuzzling or even touching, will initiate the release of oxytocin, an important safety mechanism provided by nature in case the baby is unable to nurse normally.

The effects of drugs on newborns is well set out in an important new book “Impact of Birthing Practices on Breastfeeding” which is the first to collect the evidence into one convenient reference. All of the obstetric practices and drugs offered to labouring women are included. This books should be required reading for midwives and doctors, so that they are clear about the implications and consequences of the treatments they offer women during labour and birth. In the UK, where much effort and money is being expended on attempts to boost breastfeeding rates, the link between labour ward practises and post natal problems is one area that needs close attention. Reviewing the evidence included in this book would be a good place to start.

Posted by andrea at March 28, 2004 04:39 PM

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