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 Post subject: Pregnant on subs help
PostPosted: Mon Mar 20, 2017 10:52 pm 
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Hi I've been dealing with a lot through my pregnancy and I need some answers of what I should do!?!? I'm 38 weeks pregnant and I'm about to have a c section next week. Now my problem is I've been taking subutext my whole pregnancy unprescribed. I've been trying to get into a program my whole pregnancy and they keep telling me there's a six month waiting list. I've even got on lists way early in my pregnancy and never got a call or anything and obviously I'm still not in a program. Now I wanted to tell my doctor I was taking sub's but I've been afaird to until I got into a program then I was going to tell him. Because I don't want cps involved. I only take 1mg a day if that. Mainly I want to know is if the baby will with drawel after I have her and will cps be called on me? What should I do? Is there sub doctor's that will take u even if ur about to have ur baby?


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PostPosted: Mon Mar 20, 2017 11:59 pm 
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Hey Alexis,

Congrats on your baby! I'm out of my league on pregnancy but want to welcome you and at least get you some info tonight. For sure read the pregnancy section. Some great threads w excellent info. I'm sorry its so hard to get in w a bup Dr. or program. Too many restrictions on bup prescribers limits needed access. Some info I can touch on. Your OB and anesthesiologist will need to know you're on plain buprenorphine, for your pain management during the C section. And to understand how to best support your baby. For pain relief during your C section, Mom's on bup do well w C section delivery when the team knows you're on bup. Its possible maybe likely CPS will get involved w no script. Others will come along w better info on why and how CPS gets included. Even when CPS is involved, they want the mom and baby together, doing well. Your Dr never tested for bup? Sometimes hospitals do test for bup and other substances upon admittance. Does yours? NAS or neonatal abstinence syndrome does not seem to be related to the bup dose, per studies. So even tho you are on a low dose, it still might be possible that your baby will have NAS, but not necessarily likely or certain. What state/area do you live in? I ask bc sometimes folks here know of bup pregnancy help or info in your area. From all I've read on this forum site, its important to let your OB know and far worse when the Dr and hospital are surprised. It may be that your OB can get you in w a bup Dr, given your upcoming C section and need for a script. Like I said, others w better info will come along -- so hang on... Wishing you my best, P

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PostPosted: Tue Mar 21, 2017 3:23 pm 
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alexix, I don't know what state you live in, but many states prioritize pregnant women for treatment. You could look up the regulations in your state. Some programs keep emergency slots available for pregnant women. Best of luck with your c section and your new baby!


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PostPosted: Tue Mar 21, 2017 8:47 pm 
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I hope you are doing well. Congratulations! Pelican and jeandianne gave you some pretty good advice. I would also suggest being up front and honest with your OB. They will know how to treat you and the baby for the upcoming procedure, so put your fears aside-the doctor needs to know. CPS does not want to take your baby away from you. IF they do happen to get involved, be ready with a list and proof that you did call doctors, and that you are indeed on those lists. CPS just wants to make sure you are doing the right thing, which you are!! You are already a wonderful mom by taking care of yourself and being in recovery! You got this!


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PostPosted: Tue Mar 21, 2017 8:54 pm 
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I have little to add, and agree exactly with the other comments.

If you were having a vaginal delivery you could probably get through the process without problem, and without anyone noticing that you are taking buprenorphine. I don't mean to encourage keeping it a secret, because there would be some, low risks in doing that (although I honestly can't think of what the risk would be).

But after a c-section, you are going to need pain medication. That is the main risk. You could just see what happens; at some point you will be in pain, and they will be hesitant to give more narcotic, and they may or may not decide to drug-test you to see why you are not reacting to the opioid in a usual way.

There is a low risk of neonatal abstinence syndrome too. These days hospitals often hold babies for two weeks, waiting to see if they show any sign of withdrawal. That practice is nonsense in many cases, because 1. neonatal abstinency syndrome happens less than half the time with buprenorphine; 2. while studies didn't show a decrease at low doses, logic suggests those studies are wrong, and your dose of 1 mg is less likely to cause NAS (in a logical world anyway!!); 3. NAS is not fatal, and develops over a period of time-- so if you found that the baby was not feeding well, you could go to the hospital or pediatrician and deal with that. Why do they hold all babies for two weeks? Because NAS from buprenorphine occurs late-- after a week-- and they don't trust modern moms to do the right thing. Honestly-- they are worried that moms won't do the right thing if baby isn't feeding or sleeping... so they just take over, and avoid letting moms make that call.

I don't have a good solution at 38 weeks, and maybe I wouldn't have had one at 20 weeks either. In case a mom at 20 weeks reads this on 1 mg of buprenorphine, I would suggest completeling the taper off in the next few months.

I don't know what else to tell you-- but good luck, with all sincerity.


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PostPosted: Sun Apr 09, 2017 10:16 am 
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would the baby get bup through breast milk?
just wondering after I read that all.

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PostPosted: Sun Apr 09, 2017 4:27 pm 
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The baby gets a scant amount in breastmilk, and that is why we recommend that women on buprenorphine do breastfeed. They are less likely to go through withdrawal if they are getting some of the medication through mom's milk. And it truly is a very small amount. As baby grows and starts transitioning to solid foods, he will be weaning off very slowly. That's if he ever ends up with any in his system in the first place.

Alexis, I hope you have had your baby and are enjoying every minute of your time with him or her!

Amy

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