Dec 102012

“It’s really ok for you to keep using right up until your birth… but if you are still using the medication by the time you give birth let us know because we will have to treat your baby for withdrawal symptoms… but really it’s safe to use.” – OB to mother who had severe migraines but was concerned with the opiate medication she was taking to manage the pain.

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 December 10, 2012  informed consent, newborn, OB  Add comments

  27 Responses to ““…We Will Have To Treat Your Baby For Withdrawal Symptoms…””

  1. My guess, from people I know who had to take opiates throughout pregnancy, was that the OB meant to monitor for withdrawal symptoms. Not knowing what medication the mom was taking means I can’t know if this was a scare tactic (you’re going to have a crack baby born addicted if you continue to take the medication you need!!!) and not really a concern, or if it was the OB ignoring a real risk to the baby. Either way, OB could have handled it better. “I understand your concerns. You are taking x medication. This medication does/does not transfer to your baby. (assuming it does) When your baby is born, we’ll watch for any problems, and also tell you want to watch for. If the baby does seem to be going through withdrawal, we will follow this course of treatment with your child’s pediatrician. This medication does not appear to have any long term effects on the baby.” (Adapt as needed to match facts for the medication)

  2. My SIL has severe chronic pain/fibromyalgia. Her pregnancy was a surprise. She tried going off her meds, but the baby went into distress so her doctor told her she had to stay on them. When the baby was born, the hospital put the baby into a step-down program, weaning him off the narcotic she was on onto morphine and so on. Which is fine, it had to be done. The problem was the nurses. They treated her like she was a druggie (step-down is typically used for babies born addicted to crack or meth). They were absolutely horrible to her. They were so bad when it came time for my VBA2C, DH refused to let me go to that hospital.

    • Its really horrible the way some medical professionals treat women who take medication during pregnancy. A friend who had to take her chronic pain medication during pregnancy was told by a number of nurses that she should have aborted her newborn or gotten off the pain pills before she got pregnant- or at the latest when she found out she was pregnant. She was even reported to CPS by a nurse because she had been taking her prescribed medicine while pregnant. Its horrible, and another result of one size fits all medicine.

    • I also have fibro/chronic pain and just assumed I should never have kids because of the medications. It’s nice to know there are options in base of a ”mistake” for the health of a baby. Nice to know also the BS everyone treating you like a druggie never ends…sorry for the person who went thru this I totally get it. People who don’t live in chronic pain don’t get it that it’s either that or no quality of life.

  3. Ok, it’s not Thursday so obviously this was seen as bad from the mother, and doc could have been more understanding and explained more. But opiods taken in theraputic doses *are* safe during pregnancy as long as you were on them when you became pregnant. Most pain management doctors do prefer you remain on them as 1) only about half of babies show any addictive/withdrawl symptoms after birth and 2) it is easier to monitor baby after birth, if mom goes off medication during program they have to carefully monitor and do the step down very slowly, which is difficult for mom. I’ve done it twice because I was willing to take the extra precaution to avoid a possible NICU stay, but I am in the minority. But it’s horrible when chronic pain sufferer or women who develope high pain during pregnancy are told by illiterate doctors there isn’t anything but tylenol to take, it’s just not true and if you see a pain specialist, they’ll generally agree with this OB.

  4. I hd to take pain meds through my surprise pregnancy and I talked to the neonatal specialists about it. Addiction is not a garuntee or dose dependent. My son was born with 0 withdrawl. So sad moms are treated like this, it’s. agony..i know from experience.

  5. What is the problem? Those are reasonable concerns given the issue, it is better for the mother to be able to function and be healthy in pregnancy and that means use of opiates, but upon withdrawal (delivery) there might be issues with the neonate. Those are the risks in taking the med, I think crippling pain is worse then having a neonate in withdrawals and that is what the doctor was saying – the med won’t cause long term effects to the future child just withdrawals initially, worth the cost.

    • The problem is that it’s contradictory and suggests the mother doesn’t want what’s best for her baby.

      Oh sure, the medicine is safe, but if you take it you’re making your baby a drug addict who will have to go through extra treatment, all because you selfishly tried to manage your pain.

      • I didn’t read the doctor’s comment as suggesting selfishness at all, I saw the contradiction more like “Oh sure, it’s safe, but we’ll have to treat your baby for withdrawals, but don’t worry, it’s totally safe!” Like…even though it may cause withdrawal in a baby it’s still totally “safe”. What??

  6. Do we know what triggers/causes moms migraines? Mine disappeared during pregnancy because of increased bloodflow to the part of my brain that caused mine. Are there any alternative treatments available for her situation?

    • I’ve had migraines all my life, as did my father. He spent his entire adult life addicted to opiates to manage the pain. I’ve gone to the doctors a few times to explore my options but I’ve always been treated like it’s just a magical mystery (with no testing, no specialists, nothing to determine if maybe there is a solution). They come and go, I can go months without them and then have a string of them. They’ve gotten more prevalent with this pregnancy (the first doctor I complained to said that migraines usually disappear for pregnant women… as if to suggest I was either imagining that they had gotten worse or that I should just expect them to go away).

      The reason I had made the above appointment was to look into alternative therapies and none were offerred, just repeated insistence that what I am taking is fine.

      • sorry forgot to pink link the above comment.

      • I’m sorry if my questions seemed dismissive or judgmental, I did not intend that in the least. Have you charted what you’ve done or eaten prior to these migraines? They can be triggered by food intolerances (which could easily be inherited from your father). Have you seen a neurologist for care? Mine are caused by a damaged or underdeveloped (no way to tell without surgery) part of the brain. If meds arr truly your only treatment option, by all means take them, but i’d seek a second opinion first.

        • nope didn’t feel like you were being dismissive… interpreted it as a caring inquiry :)

          I do suspect food intolerances maybe to blame and have played recently with cutting wheat and dairy out of my system (its hard when you’re pregnant to start cutting a lot of stuff out!)

          I have never been referred to a neurologist and I am not sure a doctor will give me a referral as I am from BC Canada and our health care system is so back logged that even people needing immediate care wait 6 months – 2 years to see a specialist (as is the case with my friend who was in a severe car accident over 3 years ago and just recently got into a neurologist to deal with outstanding and debilitating issues pertaining to the accident).

          I’ll keep pushing my doctors and see what comes of it.

          • MSG is my trigger. Took me YEARS to figure it out. But that was before kids.

            My pain was pregnancy related. I saw a few specialists and had several ultrasounds trying to figure it out. Never did figure it out until they opened me up for the c-section. It would have really ticked me off if my OB had just prescribed the pain meds and ignored the root of the problem.

          • You hit the nail on the head… I am really feeling frustrated that because these narcotics cover the pain, that the problem is somehow solved in my doctor’s eyes. I am particularly nervous not only for my pregnancy but also due to the fact that my father ended up taking 5-10 times the recommended dose of codiene EVERYDAY to deal with his migraines until he died of unrelated issues in his mid-40s … I don’t want that fate for myself but apparently in my doctor’s eyes the problem is solved.

            what is it with doctors and their bandaid solutions.. if the pain is covered up, the problem is solved!

          • Nat, you might like to try the Feingold plan. Eliminating petrolium from your diet can clear up all kinds of hard to pinpoint health complaints.

  7. He could have said it better. But I know what s/he meant, and I’m sure s/he meant well. Much better than those who tell moms to treat pure agony with nothing more than Tylenol. Of course, the wrong tone could make it pretty awful.

    I was in a similar situation. I tried to come off of it at 7 months. I couldn’t. My doctor told me not to worry, my baby wouldn’t have permanent effects, we’d have to monitor for withdrawal but it was possible he wouldn’t even experience that. And he didn’t. Either way it would have been worth it. I hate to see my baby suffer as much as the next mother, but stress has an effect on a baby, too, and the stress of uncontrolled pain is pretty extreme.

  8. Hi Everyone

    This one is mine. The reason why it was a negative situation for me was because:

    a) The doctor said it exactly as above without any further explanation. I’m planing a home birth and by telling me my child WILL be born with withdrawal was alarming to me for a variety of reasons. Had it been explained as some people have posted above, I would have been much more comfortable and felt much more informed. All throughout the consultation she just continued to say “it’s safe, don’t worry”… opened the door to the examination room and as I left concluded with the above statement with no other explanation or detail.

    b) I also took issue with the fact that the OB was so nonchalant about it and wasn’t willing to look into, suggest or explore any alternatives (which is why I was there). My midwife suggested I consult with the OB because she had just heard about new safer migraine medication for pregnant patients that had just become available. The OB wouldn’t even look into it for me, because in her mind, there was no problem with taking the opiates, so why explore other options.

    • also want to add: I take no issue with people in chronic pain who have to make the choice between potential minor and correctable complications versus being in agony. I don’t judge those people as I am in that position and know that those decisions aren’t taken lightly. My beef is simply with the insensitivity of the comment without explaining the situation in better detail. “Withdrawal” to most people is associated with a lot of uncomfortable and / or downright painful symptoms and to be told your child WILL be born with them without any real further detail is not a pretty thing to hear… and because the lack of detail I was absolutely terrified to continue using my pain medication, spending three or four days straight in bed in utter agony. All around not a positive experience.

    • I get migraines as well, and find that keeping up with my chiropractic adjustments does wonders for them. You might consider checking in to that option if you haven’t already. Good luck!

    • I can relate to you! I have horrible chronic migraines. I’ve tried hypnosis, diet changes, acupuncture, chiropractic, Imitrex and medicines similar. The *ONLY* thing that helps is narcotic pain relief. <3

    • The OB wouldn’t even look into it for me,

      And just think — you or your insurance company paid for that office visit.

    • I understand the OP completely. I had withdrawal symptoms after taking a narcotic post-surgery and it was horrible and painful. I would never wish that on anyone, especially not my own newborn baby. I would not have been pleased with that comment AT ALL.

    • I can’t even imagine! My mother gets debilitating migraines. When they’re really bad she has to take narcotics heavy enough to knock her out to just sleep through it. I get them from time to time but they’re rarely that bad. I actually had MORE during pregnancy but was able to deal with it naturally.
      I hope that you got the answers you needed or told that jerk where to shove it…

    • Just another migraineur here, empathising. Mine were literally crippling me, and I was holed up in my room for days at a time. The only thing that helped me was changing my diet and medical marijuana if one struck without warning. I’m pleased to say that after 3 years of that, I’ve got my migraine incidence down 99%! In fact, if I can get to Jan 16th, 2013 (assuming the world doesn’t end in a few weeks, lol) then I won’t have had a migraine in a YEAR.

      Not bad for someone who had 2 per WEEK in 2008.

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