Drugs in Labour: What Effects Do They Have 20 Years Hence?

by Beverley Lawrence Beech

© 1999 Midwifery Today, Inc. All Rights Reserved.

[Editor's note: This paper was presented at the Midwives of North America (MANA) Conference in November 1998, and appeared in Midwifery Today Issue 50, Summer 1999.]

You can go and find Midwifery Today on the web, it is free to join and their search facility is excellent, just tap in issue 50 and it should be easily recovered.

Address for correspondence: Suzan Kardong-Edgren, RNC, MS, University of Texas at Arlingtony School of Nursing, Box 19407, Arlington, TX 76019.

Abstract

Published research has suggested that infants whose mothers received opiates, barbiturates, or nitrous oxide gas during labor are significantly more likely to become addicted to opiates if they experiment with drugs in later life. Why has no one further investigated this hypothesis? What if these researchers are correct? In the future will there be class action lawsuits against the medical and nursing research communities for failure to follow up on this question? Is it time to change the research paradigm?

[This is a very valid question and one that has concerned me greatly. It may well be that a class action law suit may have to be started before any action will been taken. I am looking in to this. Until recently noone has even bothered to answer my letters etc., Except for Midwifery Today who have been most kind in printing my articles. Those unfortunately evoke little response. R. ]

Selected References

This list contains those references that cite another article in PMC or have a citation in PubMed. It may not include all the original references for this article.

* Jacobson B, Eklund G, Hamberger L, Linnarsson D, Sedvall G, Valverius M. Perinatal origin of adult self-destructive behavior. Acta Psychiatr Scand. 1987 Oct;76(4):364–371. [PubMed]

* Jacobson B, Nyberg K, Eklund G, Bygdeman M, Rydberg U. Obstetric pain medication and eventual adult amphetamine addiction in offspring. Acta Obstet Gynecol Scand. 1988;67(8):677–682. [PubMed]

* KOVACH JK. EFFECTS OF AUTONOMIC DRUGS ON IMPRINTING. J Comp Physiol Psychol. 1964 Apr;57:183–187. [PubMed]

* Brazelton TB. Effect of prenatal drugs on the behavior of the neonate. Am J Psychiatry. 1970 Mar;126(9):1261–1266. [PubMed]

For those not familiar with finding references I would take the Beach aricle in Midwifery Today which has a very extensive list of references. A very good, balanced article.

The second method for pain and stress free labouring experience came about with the birth of my eldest daughter. My wife beat pillows strenuously at our home birth and screamed with rage and fury. Then when she had discharged the adrenaline which she had put into her circulatory system as a result of having her fear, fight and flight syndrome from being stimulated by the appearance of the midwife, she gave birth without pain or distress. She described the sensations as muscles stretching.

The midwife was a very warm, and highly experienced. But she came from a different ethnic group to my wife who was partly Hawaiian. The Caucasians and the Hawaiians had always been at loggerheads and had been viewed as predators by the Hawaiians.

When she arrived my wife stopped labouring, went into fight or flight mode, quite unconsciously, and had to discharge the adrenaline while the midwife made tea.

When the adrenaline was discharged the midwife and two friends who also were having tea, came back into the birthing environment and witnessed the birth with no further re-stimulation. Since then, for over twenty five years I have been recommending labouring mothers use strenuous excercise to discharge the adrenaline once it has reached the uterus. This of course once they have been examined and no physical problems or pathology is present. To date no harmful or adverse reactions have been noted. Just an easy and quite speedy birth. In some instances a matter of ten or twenty minutes from the waters having broken.

If you should want to read more go to google.com and type in rayner garner labor labour [You will need both the American and British spellings of labor, labour to find the articles.]

I hope that this will clarify some aspects of birthing.

Rayner

Rayner, you may not realize it, but Midwifery Today is not a scientific publication. It is a trade journal for direct entry midwives.

Let's be very clear about this. There is NO scientific evidence that suggests that any type of medication in labor is associated with any type of addiction in ANYONE and ANY TIME. There are literally thousands of papers about medication in labor, and literally millions of doses of medication and millions of epidurals have been given in labor. Medication in labor has been studied extensively.

This is one of the primary problems with homebirth advocacy. Most of it is completely fabricated. Your claim is just another fabricated claim.

Let us be completely clear about something else very important. All the scientific evidence to date shows that homebirth has an excess of preventable neonatal death compared to hospital birth for women of comparable risk. This excess rate of neonatal death is in the range of 1-2/1000. There are NO studies that show homebirth to be as safe as hospital birth. There are studies that CLAIM to show that homebirth is as safe as hospital birth, but they always compare low risk women at homebirth to all risk women in the hospital (including premature babies, pregnancy complications, etc).

Unassisted homebirth has never been systematically studied, but the existing data shows that it has a very high rate of neonatal death as compared to midwife attended birth, and, of course, as compared to hospital birth.

People who want to have a homebirth should go right ahead and have one. Just don't tell the rest of us that it is as safe as hospital birth, because it is demonstrably not as safe. Homebirth is about the mother and her desires for a particular "experience". That experience is obtained at the cost of putting the baby's life at risk. The risk is small, but it is real, and women contemplating homebirth need to know about it.

I was planning on having a homebirth with a midwife, but the ones who were recommended to me retired, were out of town, or moved when I needed to see them. I researched freebirthing, and the more I read, the more sense it made.

When my daughter was conceived, no strangers were in the room peering at my naked body or sticking their fingers in my vagina to be sure things were going properly; and it occurred to me that childbirth should also be a private event, as sacred as conception.

During my pregnancy, I read many books, checked the protein in my urine, and my blood pressure. I also followed Dr. Brewer's diet to prevent preeclampsia. I wasn't scared to give birth at home, but it was nice to have the hospital a mere 10 blocks from my apartment.

I had contractions that kept me awake for four nights. On the fifth day, I had hard labor, but no baby. Against my better judgment I decided to go the hospital to get an ultrasound. Unfortunately, my daughter was born about 20 minutes after I got there.

The reason my labor took so long was because her foot was up by her face in utero. She was born face first, posterior; a rare presentation (10% or less if I remember correctly). I am positive that had I had a midwife or doctor attending me, I would've ended up with a c-section.

Despite being a wimp when it comes to pain, and having such a complicated birth, I was able to deliver my daughter without any meds or other interference other than an angry OB/Gyn between my legs, whom I almost kicked several times in the face.

Of course the doctor on call was extremely upset with me; I think it was mostly because my daughter was healthy and therefore she had no reason to upbraid me for doing something "unsafe." To this day, I totally regret every showing up at the hospital. If I ever get pregnant again, and want an ultrasound, I'll be sure to go to a clinic or some other place I can pay out-of-pocket.