effects of drugs on babies.
The American Academy of Pediatrics Committee on Drugs has recommended that, during labor, drugs be used that have the least effect on the baby, as determined by neurobehavioral testing.¹ The committee advised avoiding medications that produce significant changes in infant behavior.
Their recommendation also concluded that physicians should discuss with patients the potential benefits and side effects of any drugs used for the relief of labor pain, including the effects those medications may have on both mother and baby.
In past years, the effects of labor medications on babies were measured primarily by the incidence of sickness or death. Today, physicians have a greater understanding of how drugs transfer from mother to baby through the placenta and how those drugs affect newborn behavior and physiology.
During labor, a mother metabolizes much of the medication administered to her. After birth, however, the baby must metabolize the drugs that have entered their system.
Physicians now acknowledge that medications given to a mother during labor can have adverse effects on her baby. Yet because many of these effects do not appear to extend beyond infancy, the use of drugs during labor continues to be widely accepted.
A Cultural Contradiction
Why, in a culture that so strongly encourages people to “just say no” to drugs, do women often feel that drugs are acceptable during labor?
As parents, many of us would be appalled if our children used recreational drugs or narcotics. Yet, in many cases, babies are first exposed to drugs while still in the womb.
Research² has suggested that when mothers in labor receive opiates, barbiturates, or nitrous oxide for longer than one hour within ten hours of delivery, their children may be more likely to become addicted to opiates if they experiment with drugs later in life.
Some researchers have proposed that drug addiction in adulthood could stem from imprinting during birth—particularly when certain medications are used during labor. The risk of drug abuse in children has been observed to increase as the number of doses of pain medication during labor increases.
Narcotics and Epidurals
Narcotics are often added to epidural medications to enhance pain relief. These narcotic pain relievers can cross the placenta and enter the baby’s bloodstream.
Because of this transfer, some experts argue that these medications should be used with caution. When drugs cross into the baby’s circulation, they can potentially produce effects that extend beyond the immediate moment of birth.
Possible Long-Term Effects
While this idea may seem far-fetched to some, at least one study has suggested a correlation between babies born under general anesthesia and a higher incidence of autism later in life.³
In one particular hospital where approximately 95 percent of births occurred under general anesthesia, babies were born to mothers who had been medicated with a combination of sedatives, anesthetics, and analgesics. Among those births, researchers documented:
23 cases of autism
14 developmental disorders
12 cases of intellectual disability
The depression of the central nervous system in these infants was believed to be linked to Diazepam, a drug frequently used during labor in the 1970s and 1980s.
Questions That Remain
The long-term effects of labor medications on babies have not always been thoroughly addressed.
While modern obstetrics has made many advances, questions remain about how medications administered during labor may influence newborn behavior, development, and long-term health.
Parents deserve clear and complete information about the potential risks and benefits of medications used during labor so they can make informed decisions about their birth experience.
Choosing a Drug-Free Birth
Some families choose to pursue a drug-free birth to minimize potential effects on their baby.
Short-term and long-term adverse effects of labor medications have been reported for years. For this reason, many advocates encourage parents to carefully consider the use of medications during labor and to discuss all available options with their care providers.
Allowing a baby a drug-free entrance into the world is a choice some families make in the belief that it supports the most natural transition from womb to birth.