Birth is a natural process that can occur without interventions in most cases. In the Western world, however, the medicalization of labor and delivery has made the use of drugs to start labor, control labor and manage pain commonplace. These are not without their health effects to both mother and baby.
Heart Problems, Jaundice, Nervous System Damage
The most common drug used to start, augment or speed up labor is Pitocin. This medication is a synthetic form of a naturally occurring labor hormone, oxytocin. Health effects to the baby can include bradycardia (slow heart rate), irregular heart beats, low Apgar scores, neonatal jaundice and nervous system damage from lack of oxygen because of the absence of recover periods between contractions.
The contractions caused by Pitocin are very different from the contractions caused by oxytocin. They are longer, stronger, closer together with less chance for recovery by the fetus, and have multiple peaks. It is the unnatural nature of these contractions that causes most of the drug's side effects for the baby.
Other medications are often used in conjunction with Pitocin such as Cervidil, Prepadil and Cytotec. These can have the same implications as Pitocin when they cause abnormal uterine contractions.
Drowsiness, Irritability, Jitteriness
Epidural rates vary from hospital to hospital, but according to birth expert Sheila Kitzinger, an estimated 70 percent of women in the United States receive epidural pain relief during labor. Observable medication levels in the unborn baby are seen in as little as 10 minutes. For some infants, this medication leaves them drowsy and sleepy after birth, for others they seem jittery and irritable. Both of these conditions are different from the calm, alert state that unmedicated newborns experience. Sleepy or irritable babies also have trouble sucking and nursing immediately after birth, and this has the potential to cause difficulty in establishing a nursing relationship in the weeks following birth.
The medications used in epidurals are local anesthetics such as bupivacaine that are injected into the space around the spinal column to create a regional anesthesia. The medication travels from the mother's spinal column into her blood stream, then crosses the placenta to the baby.
Labor Complications
The most severe side effects of the epidural, however, are caused by the lengthening of the labor process, especially the second stage of labor, or the pushing stage. Epidural anesthesia has the potential to slow labor and diminish contractions. To counter this effect, mothers are often given Pitocin and the babies are subjected to its side effects as well. Then the amount of medication in the epidural is increased to counter the effects of the Pitocin. This chain reaction can lead to a host of other interventions such as a vacuum- or forceps-assisted delivery, continuous fetal monitoring, and cesarean section.
Newborn Distress
Occasionally narcotic drugs or sedatives are given for pain control or anxiety during labor. Nubain, Stadol and Demerol are a few examples. These medications have the potential to depress respiration in a newborn, causing low blood oxygen and newborn distress they can also slow the heart rate of an unborn baby. Often, they are not given when it is anticipated that delivery could happen within 4 hours to minimize risk to the newborn.
References
- American Pregnancy Association: Epidural Anesthesia
- National Institutes of Health: Epidural Anesthesia in Labor
- The Complete Book of Pregnancy and Childbirth; Kitzinger, Sheila; 1996
- FDA Approved Obstetrics Drugs: Their Effects on Mother and Baby
- "The Business of Being Born", Epstein, Abby and Lake, Ricki, 2007
