I have been clean from Heroin/other various substances and opiods my entire pregnancy (I was clean before I got pregnant, which I'm very grateful for). However, as I'm getting closer to my due date (June 14th) I have been researching child birth and found out that they use fentanyl (a very strong opiate, I used to frequently use) in the epidural. I have also read that, since it's injected in your spine, not IV, that very little, if any, reaches your central nervous system. My questions are, would it be safe for me to get an epidural? Would it cause me to get bad cravings afterwards? Do I have other options? I did a lot of things I'm not proud of when I was actively addicted, I just want to make sure I am the very best mother I can be to this baby girl. That includes not being exposed to things that will trigger my addiction to rear it's ugly head once again. Thank you!!
As you suspect, mere exposure to opiates - with your history - could be ife-threatening since the disease of addiction is fatal.
I encourage you to speak immediately with your obstetrician and anesthesiologist, discussing your history in honest, vivid detail so that safe anesthesia options are selected. There are options that will put you at much less risk than exposure to opiates, and these need to be well-planned long before delivery.
Thank you so much! I had NO idea who to even bring it up to (the nurses at my OB office, a psychiatrist, substance abuse counselor...) I have let the nurses (haven't seen a doctor) at my OB office know about my addiction (in detail). I'm glad I have other options and I'll be sure to put in my birth plan a note about restricting opiates because of prior dependence on them. Thank you!
Thanks for your Reply!
I would suggest taking a Lamaze class and considering hiring a doula if you can afford one. Lamaze teaches you ways to cope with pregnancy pains with out meds and doulas are birthing coaches who typically are more into natural births and are well trained on alternative pain relief options such using counter pressure. Also, if they have showers at the hospital your delivering at or if they allow water births then it's something you should check into. Some hospitals allow water births now and you just have to rent the tub (again something you wold want a doula for). Anyway warm water on your contraction areas helps relieve the pain. I spent the 1st half of my labor with my 1st born in the shower and hardly felt the pain. It was amazingly helpful and relaxing which is one of the reasons women are choosing water births more often now. Both my daughters were head down, but they faced my stomach when they should have been facing my back. This caused me to have all back labor (the most painful contractions you can get) and the water really helped. Another thing is not to let the hospital refine you to a bed unless absolutely necessary (always choose safety 1st obviously), but being able to walk around and find other things to keep you physically occupied and mentally occupied can distract your mind from the pain. This is why they say to stay home until your contractions are close enough together to show that they baby will be there with in the hour. Also, birthing balls are helpful and knowing your different birthing position options (laying flat on your back during birth causes the post pain). Honestly, if you used excessively than there is a chance that an epidural wouldn't phase you enough to give you proper pain relief anyway and I would really recommend that you take the time you have to look at alternative contraction pain management. I wish you luck and congratulations and hope the info helps.
In case anyone else has this same issue, I talked with a doc (my mom knows who works in the L&D) and the doc said to discuss it with an anestheisiologist (sp?) The doctor said there's a way for them to mix an epidural without the use of fentanyl- although you HAVE to be firm with them when you're in delivery because, since they don't mix it that way very often, it takes longer for them to mix it. Also, if I have a c-section, I'm pretty much doomed to having to take opiates to relieve the pain, although the doctor also said that, since I'd be in so much pain to start with and probably have a residual tolerance to opiates, it more then likely won't get me high. She also suggested having someone else moderate my dosage if I do get a script of opiates for post-c-section pain. On my own note, I think it would be wise for me to see a counselor/psychiatrist/substance abuse expert while on any opiate medication to help avoid abuse and later relapse. Sometimes it helps to have a 3rd party, who KNOWS addiction and who isn't biased (parents and loved ones who could be moderating your dosage, may give in to giving you more if they see you in pain because they care too much about you to see you in any level of pain). I think hearing from an outside source that you're doing well or getting out of hand will greatly increase the chances of continued recovery. It's also been noted (in advance) on ALL my medical charts that I am a former opiate addict and that should be enough to make MOST docs reconsider introducing them into my system in an emergency where other drugs and therapies are available.
I'm happy for you that you made sure to do your research & set a plan for any situation to avoid any relapses for yourself & the sake of your child. It sounds like a very well thought out & reasonable plan.
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