Anagesia Negatively Affect The Parent-Newborn Relationship

Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.

The use of controlled substances throughout pregnancy is a very prevalent issue among society today. Controlled substances have devastating effects on not only the mothers using the substances, but also infants while they are in utero and after they are born. Many infants born to mothers, who are abusing drugs, suffer from life threatening illnesses and are forever affected through adulthood. Specifically, heroin is a common drug form that is often used during pregnancy and results in the life threatening effects mentioned above.

Four years later, I got pregnant. I was nervous, scared and anxious. The doctor I saw said that I could have a VBAC(vaginal birth after c-section). I raided the library and read books on that subject. It was then I found out that the United States had the highest incidence of C-sections in the world. Research shows that epidurals increase the use of other interventions that themselves carry risks. These interventions include electronic fetal monitoring (which has shown to increase the likelihood of a cesarean without improving outcome), I. V oxytocin, and instrumental delivery. Epidurals also deprive women of a sense of mastery over labor. Goer, Henci. "Epidurals Myth Vs Reality." Childbirth Instructor Magazine Winter 1995: 17-22

Effects may vary depending on family structure, manifesting differently in individual family members; According to the National Center on Addiction and Substance Abuse both alcohol and drugs can have dramatic negative effects on a developing fetus. They have been linked with premature birth, decreased head circumference, brain functioning difficulties and low

It can cause substantial teratogenic effects early in gestation, during the embryonic stage. During the fetal period, abnormal growth and maturation, alterations in neurotransmitters and their receptors, and brain organization are direct effects caused by opioid abuse (Behnke & Smith, 2017). Continuous use of opioids throughout pregnancy increases the risk of prematurity and growth retardation, deficits in attention, cognition, and behavior, neonatal morbidity and mortality, and neonatal abstinence syndrome (NAS) (McQueen, Murphy-Oikonen, & Desaulniers, 2015).

The independent variables in this study were buprenorphine and methadone and the dependent variables were the number of neonates requiring treatment for NAS, the peak NAS score, the total amount of morphine needed to treat NAS, the length of the hospital stay for the neonates, and neonatal head circumference.

Children born to drug dependent mothers are susceptible to preterm delivery, decreased intrauterine growth, impaired neurological developments, as well as congenital abnormalities. Unfortunately, once the umbilical cord is cut, the withdrawal for the infants is initiated. The symptoms of withdrawal will be evident in 55% to 94% of infants within 2 to 7 days after delivery (Eichel & Johannemann, 2014).

The use of opioids during pregnancy has increased drastically over recent years, causing newborns to fall victim to the opioid crisis. It has now become an epidemic, affecting people in the United States and globally making it a major health concern. A vast percentage leading to the opioid crisis is due to women in their childbearing stages of life. Newborns born to women addicted to opioids suffer through a form of newborn drug withdrawal known as Neonatal abstinence syndrome (NAS), resulting in increased admission rates, prolonged length of stay in the hospital and infants often require medication to recover. NAS is a result of opioid exposure in utero characterized by “central nervous system hyperirritability and autonomic nervous system dysfunction” (Kraft et

(2010) explains that although methadone is used for opioid exposure especially during pregnancy, but also is linked to NAS when a fetus is exposed to methadone. With their focus of the effects of NAS on the central nervous system hyperirritability and autonomic nervous system dysfunction Jones et al. also focused on the different effects of methadone versus those of buprenorphine, which has less substantial research. The points of study included number of newborns requiring treatment for NAS, peak score on a NAS scale, amount of morphine given through out treatment, length of hospital stay and the head circumference. Overall they only found significant differences in outcomes for the total morphine required as well as the length of the neonates hospital stay. When exposed to buprenorphine prenatally the newborns required 89% less morphine during treatment and 43% less time in the hospital than those exposed to methadone (Jones et al.,

The study identifies several studies that focus on variables, but none that fulfil the whole sample criteria. Finding a gap in previous research is justification for the study (Polit & Tatano Beck, 2006). The literature review states studies that cite that operative delivery is associated with bonding difficulties (Rowe- Murray & Fisher, 2001), vaginally delivered women had more positive perceptions (Fawcett et al.,2007), women who had a high level of obstetric intervention were more likely to have trauma symptoms (Creedy et al., 2001), and birth experience affects postpartum development (Stadmayr et al., 2004). To summarise the cited literature, women that have a caesarean section or instrumental delivery are more likely to suffer from feelings of ill health and difficulty in parental transition. This is a limitation of the research. As these are proven factors, including them in the criteria for participant selection could discredit the study as they are already well known implications without the phenomena of prolonged labour. In addition to this, the same researchers had previously devised a case referent study investigating negative birth experiences following prolonged labour (Nysted et al., 2005). This is not disclosed or referred to within this study. A study should describe how it enhances existing knowledge (Holloway & Wheeler, 2002). As the findings of

They realize their addictive behavior has caused current birth problems or inherent long term effects on the baby after the birth. These feelings can exacerbate to depression, and anxiety. Without proper treatment these feelings will be unremitting and could lead to further excessive drug abuse.

Providing continuous physical and emotional support during labour can reducing maternal fear, stress, and anxiety and protect physiological birth (Steen, 2012). Research shows that fear and anxiety during labour and birth can be detrimental to physiological birth. An environment that women feel unsafe in may stimulate a surge of neuro-hormones that can influence both fetal and maternal physiology, causing irregularity of contractions, fetal distress and subsequent medical inteverntions (Fahy & Parratt, 2006). Conversly, maintaining an environment where women feel safe, protected and supported can facilitate favourable physiological performance (Fahy & Parratt, 2006). Midwives can do this by giving women one-on-one continuous support and placing her at the centre of care throughout childbirth (Steen, 2012). As observed in practice, by constantly reassuring the woman about her progress, her baby’s health and addressing any of her concerns, the midwife can provide a calm and relaxing environment that is conducive to the labouring woman (Buckley, 2015; Steen, 2012). The midwife worked with the woman, encouraging her throughout labour and birth by telling her that she was doing extremely well. The midwife also breathed in-tune with the woman while giving her a back massage, inducing a sense of comfort. The atmosphere was calm and this contributed to the woman garnering confidence in her ability to avoid medical pain relief. Downe (2008) noted that the positive impact of

Pharmacological comfort measures can provide partial or complete pain relief. The epidural is the most efficient way of reducing labor pain. Opioids can be given continuously or in intermittent doses at the patient 's request or through the patient controlled pump. There is the potential for these drugs to have some effect on the fetus, such as breathing difficulties that may require assistance through the use of Narcan. Providing pain relief during the labor process is solely the patient’s choice, and as the nurse only support and encouragement should be given for however she chooses to handle the pain. (Jansen, Gibson, Bowles, & Leach, 2013)

Childbirth is a beautiful thing. After the hours of labor, there is nothing more special than having the newly mother able to hold her child the minute after it’s born. It makes the pain that you had just experienced go away because all that matters in the world is that newborn child in your arms. During labor, every woman has her own experience but one common experience is the pain. According to Kitzinger (1978) “Labor pain can have negative or positive meaning, depending on whether the child is wanted, the interaction of the laboring woman with those attending her, her sense of ease or dis-ease in the environment provided for birth, her relationship with the father of her child and her attitude to her body throughout the reproductive

Central Idea: Pain management is an important aspect of childbirth that women need to educate themselves on so they can make an informed decision when choosing which method they will use.