Download Epidural Cocktail - San Diego Hypnobirth

Epidural-- What's in your epidural cocktail?
Information on drugs routinely given to laboring and breastfeeding women. [i] This information
can be easily found on the web either from the FDA sites or directly from the drug’s
manufacturers
Drugs that are offered during labor
Many women receive narcotic drugs during delivery, and sometimes in combination with an
epidural. This is done as early as a woman walks into the hospital in mild discomfort at 1 to 2 cm
dilation; or as late as when she is at 9 cm dilation, and nearly ready to deliver. Usually the
following information is not disclosed to the laboring woman, for we wouldn't want to worry her
little head about the medical mumbo jumbo.
Drugs such as nalbuphine (Nubain), butorphanol (Stadol), and sublimaze (Fentanyl) effectively
block pain throughout the entire body. The drugs are generally injected or delivered through an
IV in early labor. Though Fentanyl is often included in the epidural cocktail. According to the
FDA, all these drugs may: slow the baby's breathing at birth, especially if he or she is born soon
after the drug is delivered. Nubain has also been associated with severely slowing fetal heart rate
and causing permanent neurological damage. Butorphanol is said to be a better choice, but you
decide.
Fentanyl is a narcotic (opioid) pain medicine. FDA pregnancy category C. This
medication may be harmful to an unborn baby, and could cause addiction or withdrawal
symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant
during treatment. Fentanyl may also cause addiction and withdrawal symptoms in a
nursing infant. Do not use fentanyl buccal without telling your doctor if you are breastfeeding a baby. Fentanyl is always part of the epidural cocktail.
Nubain, (nalbuphine hydrochloride) is a synthetic opioid agonist-antagonist analgesic
of the phenanthrene series. Nubain may produce the same degree of respiratory
depression as equianalgesic doses of morphine. Severe fetal bradycardia has been
reported when Nubain is administered during labor. The placental transfer of nalbuphine
is high, rapid, and variable with a maternal to fetal ratio ranging from 1:0.37 to 1:6. Fetal
and neonatal adverse effects that have been reported following the administration of
nalbuphine to the mother during labor include fetal bradycardia, respiratory depression at
birth, apnea, cyanosis, and hypotonia. Some of these events have been life-threatening.
Permanent neurological damage attributed to fetal bradycardia has occurred. Caution
should be exercised when Nubain is administered to a nursing woman.
Stadol NS is not recommended during labor or delivery because there is no clinical
experience with its use in this setting. Butorphanol (Stadol) has been detected in milk
following administration of Stadol Injection to nursing mothers. Although there is no
clinical experience with the use of Stadol NS in nursing mothers, it should be assumed
that butorphanol will appear in the milk in similar amounts following the nasal route of
administration. (verbatim from the FDA site)
Butorphanol is sometimes used during early labor, but using it just before childbirth
can cause breathing problems in a newborn. Butorphanol passes into breast milk and may
harm a nursing baby. Do not use butorphanol without telling your doctor if you are
breast-feeding a baby.
At times I suggest to my clients to drink a glass of wine during early labor to relax and try to go
back to sleep. In fact I propose they have an intimate toast with their partner celebrating the
coming into this world of their wonderful child. Cin cin, as they say in my country… good bye
twosome, hello threesome. I can’t tell you how many times I see the look of horror at such a
suggestion. After all we all have been told by our doctors, the labels in wine bottles, and the signs
at bars, how harmful drinking can be. Yet it seems that as soon as a laboring woman enters the
hospital she is offered a free fall of extremely harmful drugs to manage the medical condition
called “labor,” and without much information on the potential harm she can do to herself and to
the child. Now please, don’t get me wrong it is your birth and your choice, I am simply fighting
for our right to informed consent, and full disclosure. You certainly cannot have a cesarean birth
without an epidural, and at times an epidural is a very effective solution, all at its right time,
under the right circumstances. The drugs administered via I.V. are very harmful and an epidural is
the better choice, if and when we must take that road. Yet, I wonder… If women were given more
credit in their ability to labor and birth their child by the professionals that welcome them into
their facilities, if more encouragement and confidence was given to them that they can do it, as
millions of women have done for centuries, then maybe things would be very different. Certainly,
we would not sell so many drugs, babies and moms could enjoy each other soberly after birth, we
might even have less intervention, and who knows we might even leave first place as the western
country with most fetal and maternal fatalities. Purely from an economical stand point, the prices
for a delivery would not sky rocket. In fact a natural birth needs only compassionate ushers (one
nurse, one midwife or doctor, one doula) standing by to support us, or just in case, usually, our
bodies, and our babies know what to do… It’s imbedded in our DNA.