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PostPosted: Sat Jul 19, 2014 8:54 am 
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Hi everyone. I haven't had much of a chance to post the last few months, it's been a bit of a whirlwind. I'm currently 37w4d pregnant. It was quite an unexpected pregnancy thanks to a failed IUD. I've been in treatment with subs for over four years, for the dual treatment of opiate dependence and pain management. I have had a relatively uncomplicated pregnancy and have continued my treatment with my addiction/pain management doc as well as my OB and occasional check ins with a high-risk OB. All have been pleased with how the pregnancy is progressing and so far I have not really received any overt criticism from any of the medical practioners I have seen regarding my treatment with sub. I, of course, have all the guilt and worry that goes along with being pregnant and on sub therapy, and it has been very stressful worrying about how my baby will fare after birth and how we will be treated while in the hospital. As a nurse myself, I see how some (unfortunately, many) in the medical field treat patients they view as addicts, and it is thoroughly disheartening. To prepare myself for what to expect, I requested a tour of the NICU at the hospital where I will be delivering. I live in a small-ish city, we have two hospitals. The hospital where I work does not have a NICU, nor does my OB group have privileges there, so it wasn't really a choice for me as to where I would be delivering. I spent a good amount of time compiling a list of questions for the NICU. My OB has delivered some other moms on subs, but seemed to have only the most general information on what to expect for baby after delivery. So I had plenty of questions to ask.
I have to say that I am extremely disappointed and more anxious than ever after my "tour". I met with the charge nurse, who took about two whole minutes to briefly show me the actual unit. We then sat down to talk and she asked me if I knew what to expect. I explained that I only had a basic idea of how they treat babies with NAS and would like to know exactly what I can expect from the time I deliver and on. It was obvious to me at this point that she had already formed an opinion of "what" I am, and was rather making it a point to let me know that. She informed me that all babies born to mothers "on something" are directly admitted to the NICU regardless of what their condition is following birth. I may or may not have the opportunity to nurse and do skin-to-skin contact with my baby immediately following delivery, depending on how they feel the baby is doing. I asked about when they start scoring the babies for signs of NAS and how often the babies are scored. She informed me that "all babies whose mothers are 'on something' experience withdrawal". At this point, I am already upset but this statement truly raised not only my hackles but a whole bunch of red flags. If this is truly the expectation of the staff then there is no chance that my, or any other baby born to a mom in a maintenance program, is going to be scored fairly on objective signs of withdrawal. They have already decided that ALL babies withdrawal and I have no doubt that they will then score them accordingly. I was able to hold myself together enough to ask what percentage of babies being observed for NAS end up being treated with morphine for withdrawal. She said at least 85% at their facility...and if babies are started on morphine, they frequently put them on phenobarbital as well, and the babies stay in the NICU for the duration of their treatment, which is frequently 10 weeks or more. I was devastated to hear how high their numbers for medicating are, and between this, the nurse's attitude- and she was clearly in a hurry to be done with me, my hormones and the fact that I was exhausted from having just come from finishing my third 12-hour night shift, I totally broke down. I suppose she at least attempted to make me feel better... she did after all tell me to "try not to feel too guilty with yourself". At this point I couldn't have asked any more questions even if she would have had the inclination to answer them. She handed me a pack of papers and said that they should be able to answer any other questions I might have and escorted me out- the back door lol, I guess so no one else there would have to see me blubbering. All in all it was a total disaster. I'm two weeks (hopefully) from delivering and now I am scared to death to give birth in this hospital. I don't even know what to do. I'm doing this on my own, as my then-significant other checked out very early in the pregnancy, so it is only me to advocate for my baby's care and while I will absolutely do whatever I can to make sure she gets the best care, it is going to be really difficult especially in the hours following giving birth to recover and make sure that she is getting what she needs- and no more than that.
I did call a few of the other hospitals in neighboring cities, as well as talked to the charge nurse of the maternity/nursery unit at the hospital where I work. All of the other hospitals have at least a somewhat lower percentage of treatment with medication for NAS, and all seemed to be at least slightly more respectful. But as my OB (and her entire group) only has privileges at this one hospital I am either stuck delivering there, or stuck trying to change providers at 38 weeks pregnant...which I think will be nearly impossible. I really do not want to deliver somewhere where they don't at least have my records and an idea of who I am and what my treatment and pregnancy have been like...I think that would end up resulting in being treated poorly, and potentially having an even worse outcome then delivering at the current hospital... I am at a loss of what to do, praying I don't go into labor in the next few days.


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PostPosted: Sat Jul 19, 2014 3:29 pm 
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I'm a nurse, too. You and I both know those numbers are too high. We both know how the medical profession treats us is uniformed (first do no harm, sure, lol), prejudiced and harmful. We both know it's unacceptable. We both know we are doing the only thing we can do under the circumstances. And..........we both know it's not going to change. And I think it's amazing, that, knowing what you know, you are still doing everything you can do for your child. Especially in the face of that much prejudice. The next few weeks aren't going to be easy, especially with all those hormones! But remember, your baby isn't going to REMEMBER them. You will. So don't give the jerks that much power over the rest of your child's life. Because if you manage to let it all roll off of your back, so will your child as they grow up. Head up, one foot in front of the other and all that, blah blah blah. But it really does work, so head up, one foot in front of the other and walk out the door with your healthy baby in however long that takes. And let them live in that dark place they call their "knowledge". Good luck, CC


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PostPosted: Tue Jul 22, 2014 10:32 am 
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Not all babies have NAS.
Mine did not. After a 6 day stay at the hospital, i was cleared. It wasnt even in my childs system.
I handled my pregnancy differently. I had lots of guilt and nightmares. I know what u r going through.
I know they say to be honest with the medical staff about ur medication, but i knew exactly how they would react and treat me..i didnt wana tell anyone about my sub therapy. So heres what i did.
I took sub till 5 months in when i stopped. It was hell. It really was. After a month, i was still sick. I broke, and took the tiniest little crumb off a pill. A little crumb. I felt sooooo much better tho. So from then on, when i felt really bad i took a crumb. 3 weeks before labor, i stopped the crumbs. 3 weeks later, at 41 weeks, i started contractions, lost my plug and my water leaked all in one morning. I got to the hospital and requested pain meds right away. I also had an epidural. The started pitocin...didnt work n it lead to a c section. Baby girl came out healthy as can be. Full weight, great color. She was overdue as she had a bowel movement inside of me. I watched her like a hawk the whole 6 days in the hospital. Happy as can be she was.

I know most mothers do not stop treatment like i did, but they also report no wirhdrawl in their stories as well. Thats all i did during pregnancy was read birth stories woth women on sub. I tried to prepare myself.

My advice is, just listen to ur body and do the best u can. If ur doctors are supportive then even better. And the babies dont remember going through NAS. Once it is over, its over. Just prepare yourself. Its about a 60-40% chance. 60% of babies do not have NAS. This is what i have read.


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Dr. Jeffrey Junig, M.D., Ph.D.

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