Fentanyl -- More about Fentanyl

Last year I posted about epidural and how babies are non-consenting research subjects. Today I received a comment on that post and wanted to share it here. Otherwise, you might miss it. It gives me the opportunity to revisit that information.

Link to the post:
http://hospitalbirthdebate.blogspot.com/2007/01/babies-are-non-consenting-research.html

And today's comment:

Anonymous said...

I am a terminal ovarian cancer patient and my doctor prescribed a fentanyl patch for the extreme pain I suffer. It has provided excellent relief and I don't believe that it has damaged my mental or physical health in any way. However, I have read that it is not short-term, acute pain, so I would agree that it doesn't belong in obstetrics. However, I think you're going overboard to classify it as a street drug. There are people who misuse just about anything in an attempt to get high. Should we ban house paint and spray cans so teens can't "huff" them? Same with fentanyl. There's more to life than giving birth. This drug has brought much comfort for people who suffer chronic pain.

11:26 AM

Thank you for your post, Anonymous. There are not words to express how sorry I am to know that you are terminally ill. I wish you the best. I am sure the fentanyl patch is most helpful to you. This is the appropriate use of fentanyl. Labor and birth is not.

I shared an article about a young man who died from a fentanyl and heroine overdose in my post last year. The article says that over a hundred people have died from that combination of drugs. Clearly, I am not the one to classify it as a street drug. Whether it is or not isn't the point. What is happening to babies who are born under the influence of narcotics and synthetic opiods is the point. In addition to it being known as a dangerous drug on the street, the US Defense Department classified fentanyl as a potential chemical warfare drug. They were considering it as a chemical to use to subdue crowds but decided against it after the tragic loss of many lives in the Chech Republic, I think it was., where fentanyl was responsible for many deaths when used to subdue crowds.

Why would anyone even consider administering this to a laboring woman and baby? For any reason? The reason it is used at all was to counter the effects of bupivicaine which was known to be dangerous.

Fentanyl is a synthetic opiod. The drugs -- a cocktail of drugs at the discretion of the individual anestheseologist -- are administered directly into the spine of a woman. It doesn't just numb her from the waist down -- it gets into her system. She is impaired. Her baby gets the drug and is impaired. This doesn't begin to compare with the valid use of the drug for pain for an adult, with a patch. The blood brain barrier of the newborn doesn't develop for weeks according to some research out of the University of Arizona. Unfortunately, I can't find it right now. Basically, the astrocytes that will eventually make the blood brain barrier don't develop for awhile.

Prior to the great marketing campaign in obstetrics that convinced women that epidural is safe, we knew that babies were affected by the drug that is still used in epidural -- bupivicaine. I can tell you, as can many women, we were not "numb from the waist down." We were drug impaired. Babies were limp, unresponsive, and hard to waken. My daughter could not be wakened. So, now, a decade later, thanks to fentanyl... thanks to fentanyl!?!??! ... those effects are minimized. All babies from the beginning of obstetrics have uninformed, non-consenting research subjects. Now epidural is promoted as so "safe" and so "normal" that women who want to NOT have epidural are now seen as the weirdos by women who are happy to go in, lay down, spread before strangers, and turn their bodies over to the medical conveyor belt. They are happy to be numb, unable to feel their bodies, their babies, or to even move to allow their baby more room to birth from their bodies. Pitiful. Talk about "peer pressure".

Bupvicaine and fentanyl, neither one, were ever shown to be safe before using in labor and birth. Never shown to be safe for the baby. Experimentation on women and babies in recent years in obstetrics has been to find the dosage of bupivicaine that does provides the best "maternal satisfaction." The harm to the baby during birth and for his life time is not anyone's consideration.

The research by the early 90's was clear about the detrimental effects for both. Rather than discontinue it's use, experimentation on women and babies continued. The main point of my posts is that fentanyl is used by obstetricians without ANY research to show that it was safe for the baby or mother before doing so. There is a huge difference between a fentanyl patch for a adult in pain, and a catheter in your spine allowing the drug directly into your nervous system. HUGE DIFFERENCE. An adult can choose to use it. A baby can not choose. They are dependent upon to ensure their safety and wellbeing during labor and birth. A woman who would never consider during sanctioned (prescription) or street drugs, and is admonished if she does, is given full permission to use harmful drug during this most important event. It is done without his consent and against his will. Does the human baby not have the right to labor and be born without drug? With a mother is not impaired.

bupivicaine and fentanyl to find the best amount of fentanyl to COUNTER the dangerous effects of bupivicaine. These effects have been known since late 80's and early 90's. Rather than ending the use of the bupivicaine researchers continue to study the effects on HUMANS ... human newborns.

I am sorry, I don't think we can compare the adult experience/need for pain relief with fentanyl with what is right and just for the human newborn. The "off-label" use of fentanyl in obstetrics, on laboring and birthing women and babies can not be justified. I am speaking out on behalf of the babies who cannot speak for themselves. I am outraged at the medical profession for such criminal violation of woman and babies and for violating the position they hold. They are to protect and "do no harm." I am sad that women are so incapable of trusting their own body to birth their baby and instead trust the propaganda that epidural is perfectly safe. I am outraged that they believe that the use of narcotics is dangerous and the potential for addiction applies to everyone else but them.

What kind of society is this that promotes that a woman laboring and giving birth "under the influence" is ok? Natural? Normal?

I was born by saddle block and have done intensive trauma therapy to heal it. I have given birth "under the influence" of drugs several times -- one against my will and permission, and one by choice as my ex-medical student, later to be obstetrician husband convinced me it was perfectly safe. I was thirty-seven, supposedly in the high risk category and "didn't need to go through all of that." Wasn't he sweet? That was in 1994. Ten years later I found the extensive research showing how dangerous it was for me and for my daughter. He didn't read the research. He had trusted his teachers who pass on their medical rituals.

I know how hard it is to process the violation of a birth where things were done to me, against my will. I know what is it like to feel violated and feel raped .... to not remember twenty hours and who did what to me. All because of drugs I never said yes to. I know how hard it is to have chosen to induce and use epidural and then to learn how lied to I was. In both cases I know how painful and how freeing it is to recognize and deal with the impact on myself and baby. I know the power to heal that comes from seeing that my baby experienced their birth, whether I was violated or made the decision that resulted in their wounding.

We can acknowledge that women and babies are affected by birth ... drugs, interventions, rough handling, strangers, invasions ... because now we have techniques to help us heal and integrate the early, traumatic experiences. We don't have to remain ignorant, in denial, continuing to harm babies.