Pregnancy and Morphine: A Safety Overview
In recent years, the number of women using opioids at the time of delivery has significantly increased by 131 percent between 2010 and 2017. This trend has raised concerns about the potential risks associated with the use of opioids during pregnancy and breastfeeding.
Morphine, a common opioid, is sometimes used by healthcare professionals to treat severe pain during pregnancy. However, its use comes with potential risks. For instance, morphine can pass through the placenta to the baby, increasing the risk of congenital birth defects, such as cleft lip and cleft palate, which can lead to speech, feeding, or even breathing concerns in babies.
Research has shown that even common pain relievers like ibuprofen may cause birth defects. In contrast, the American College of Obstetricians and Gynecologists (ACOG) prefers alternative treatments like physical therapy and non-opioid medications for chronic pain during pregnancy.
The use of morphine during pregnancy may also lead to Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS) in newborns. These conditions can cause irritability, feeding difficulties, breathing trouble, seizures, mottling of the skin, fever, sweating, hyperactive reflexes, poor muscle tone, vomiting, diarrhea, sleep concerns, and low birth weight.
Long-term use of morphine during pregnancy comes with a greater risk of complications. It can cause concerns like growth delays, breathing difficulties, or drug dependency at birth. In the third trimester, morphine use could also lead to complications such as growth delays and breathing difficulties.
Babies exposed to morphine during pregnancy may also experience constipation. Treatment of newborn withdrawal from opioids and other substances can be difficult and may require the use of medications, including opioids.
Despite these risks, it's important to note that short-term use of medications like morphine to manage delivery pain in the first 2 to 3 days after birth is considered 'compatible' with breastfeeding or chestfeeding.
Close monitoring is required when morphine is used for long-term therapy or pain relief, especially in infants who were not exposed to these medications during pregnancy. For babies born without NAS or NOWS who are exposed to short-term doses of morphine during pregnancy, the outlook is generally good.
The CDC warns that taking morphine during pregnancy can put your baby at greater risk of having a birth defect than if you take non-opioid pain relievers like acetaminophen. Pregnant individuals who were already taking morphine or another opioid should consult their doctor before stopping the medication abruptly to avoid withdrawal.
The Food and Drug Administration (FDA) puts morphine into category C on its pregnancy category scale, meaning that pregnant people and their doctors should weigh the benefits of using this medication against the potential risk.
In conclusion, while morphine can be effective in treating severe pain that isn't relieved by other medications or therapies, its use during pregnancy and breastfeeding comes with potential risks. It's crucial for pregnant individuals to discuss their pain management options with their healthcare provider to make informed decisions about their care.
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