Drugs in Labor

Epidurals may affect a woman's ability to breast feed.

Women in this cohort who had epidurals were less likely to fully breast feed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support. http://www.internationalbreastfeedingjournal.com/content/1/1/24

Read more about the effects of epidurals here: http://www.icpa4kids.org/research/pregnancy/drugs_labor.htm

More side effects from epidurals: A new study gives us another reason to avoid epidurals at birth.
http://www.healthfinder.gov/news/newsstory.asp?docID=536503

Read more about the negative effects of epidurals here: http://www.icpa4kids.org/research/pregnancy/drugs_labor.htm

Epidurals may affect baby's abilty to breastfeed. Researchers found that 93 percent of the women in the study breast-fed their baby in the first week after birth. However, women who had an epidural were significantly more likely to have difficulty breast-feeding during the first few days after delivery and to breast-feed less often than other women. In an accompanying commentary, Sue Jordan, senior lecturer in applied therapeutics at Swansea University, said that the effect of opioids and epidurals on breast-feeding should be regarded as an "adverse drug reaction." She called for "extra support to be offered to the most vulnerable women, to ensure that their infants are not disadvantaged by this hidden, but far-reaching, adverse drug reaction."
http://www.healthfinder.gov/news/newsstory.asp?docID=536503

Epidurals may increase pain to baby during birth.Women who receive epidurals to ease labor pains may be increasing discomfort for their newborns, according to a study published in Pediatrics. The study says that epidural's can cause fevers in mothers during childbirth, which, in turn, causes doctors to test newborns for blood and tissue infections (sepsis), and to treat the newborns with antibiotics. Of babies born to 1,047 women, 34 % needed an evaluation for sepsis, as compared to less than 10 % of babies born to mothers who had no epidural. Newborns whose mothers had received an epidural were four times as likely to be treated with antibiotics because doctors were concerned about the possibility of sepsis. However, babies of women who received an epidural were not more likely to actually have infections, which was very rare in both groups.
Lieberman E, Lang JM, Frigoletto F Jr, Richardson DK, Ringer SA, Cohen A, Epidural analgesia, intrapartum fever, and neonatal sepsis evaluation., Pediatrics 1997; 99(3): 415-9 / Medline ID: 97193713


Epidurals lead to additional interventions. From the archives of Gynecology and Obstetrics, comes this study on epidurals. It shows that women undergoing epidural analgesia demonstrated a prolonged second stage of labour, a higher rate of episiotomy and an increased use of oxytocin to augment labour. These results are not so new, they have been shown in numerous studies previously and this study is just another confirmation of the intervening effects of using epidurals. The conclusion of this study, however is where I become most perplexed. Because it does not compromise integrity to the woman's woman's birth canal, it's ok!! Will they ever get it!?
http://www.pediatriclinx.com/thearts.cfm?artid=455912&specid=6&ok=yes


The effect of epidural analgesia on the occurrence of obstetric lacerations and on the neonatal outcome during spontaneous vaginal delivery
Women undergoing epidural analgesia demonstrated a prolonged second stage of labour, a higher rate of episiotomy and an increased use of oxytocin to augment labour. Some of these adverse effects might be caused by the higher rate of primiparous women using epidural analgesia.
Archives of Gynecology and Obstetrics. Abstract Volume 267 Issue 2 (2002) pp 81-84 DOI 10.1007/s00404-001-0280-5

Epidurals lead to greater intervention in vaginal deliveries.
Infants born to mothers after a trial of labor are twice as likely to undergo diagnostic tests and therapeutic interventions than infants born after an elective repeat cesarean section, but the increase occurred only in the subgroup of infants whose mothers received epidural analgesia for pain relief during labor. The higher rate of intervention could relate to the well-documented increase in intrapartum fever that occurs with epidural use.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12752164&query_hl=6&itool=pubmed_docsum

Drug-Free Childbirth Prevents Repeat C-Section
While inducing labor with medication poses dangers for all deliveries, it's especially hazardous for women who have had previous Caesarean sections, researchers report. The study enrolled 179 women with a history of C-section. Of the 57 who had their labor induced, 57.9% had successful vaginal deliveries, compared with 77.1% of those who did not use labor-inducing drugs. Among women who went into labor spontaneously, those who used oxytocin had a 64.5% chance of avoiding C-section, compared with 87.5% of mothers who did not use oxytocin. For mothers who delivered via C-section in the past, inducing labor not only ups the risk of repeat C-section but also multiplies the odds of uterine rupture.
Sims EJ, Newman RB, Hulsey TC Vaginal birth after cesarean: to induce or not to induce. Am J Obstet Gynecol. 2001; 184(6):1122-4.


Effect of Labor Epidural Anesthesia on Breast-Feeding
from Journal of the American Board of Family Practice
This study concluded that there was a significant relationship between epidurals in labor and a decrease for breasfeeding success.
http://www.medscape.com/viewarticle/449424_4

Is there risk of pressure damage after epidural anaesthesia?
This study examines the increased risk of pressure ulcers to the mother following epidural administartion for labor.
http://www.worldwidewounds.com/2001/september/Hughes/Obstetric-Care-and-Pressure-Damage.html#aetiology-pressure-damage

Drugs During Labor Make Future Addicts

Scientists have discovered that women who take pain medication during labor may be upping their children's odds of future drug dependency.

The study compared 69 drug-abusing subjects with 33 of their siblings who did not abuse drugs. Subjects whose mothers took three or more doses of opiates or barbiturates during childbirth were 4.7 times more likely to develop drug abuse problems than were subjects whose mothers did not rely on pain medication during their birth.

Nyber K, Buka SL, Lipsitt LP Perinatal medication as a potential risk factor for adult drug abuse in a North American cohort Epidemiology 2000 (Nov);11(6):715-716

Side effects of Epidurals:
http://www.childbirth.org/articles/sideeppi.html
http://www.transitiontoparenthood.com/ttp/foreducators/ceinfo/Side%20Effects%202.htm
http://www.transitiontoparenthood.com/ttp/parented/pain/epiduralfx.htm
http://www.findarticles.com/p/articles/mi_m0838/is_2000_March-April/ai_60072813
http://parenting.ivillage.com/pregnancy/plabor/0,,midwife_47nx,00.html
http://www.lalecheleague.org/ba/Nov99.html


Read more about the effects of drugs in labor:

The Epidural Epidemic

Just Say No to Drugs

Search Midwifery Today Archives: Epidurals

http://news.bbc.co.uk/1/hi/health/2276595.stm