Pregnant, on subutex, but want a homebirth - Page 2

[JoyfulMama2be]

Originally Posted by Lynann 

The laws in any particular State do not necessarily reflect evidence based practice. The laws are generally written to protect the care provider rather than what is best for the birthing mama and her baby.

EXACTLY thank you. Its not unsafe, its just some legal nonsense.

And suboxone can actually be taken for the rest of your life. It totally depends on the individual and their circumstances. It can be used short-term for withdrawal or long-term (months, years, forever) for maintenance, meaning to help you stay clean. I have chronic serious back pain, I need to address that after the baby is born and once I am able to find another way to deal with the pain or if my back issue is resolved (I pray it is!) then I will try to get off again. Addiction is not a simple thing and I am thankful that suboxone has worked so very well for me. Opiate addiction is physical and mental, mentally I feel wonderful with no desire to use and the suboxone/subutex deals with my brain!

[JoyfulMama2be]

Originally Posted by my5loves 

How long do you plan on taking Subutex? Congrats on 5 years of being clean but the idea of methadone or Subutex is to wean you off drugs completely. I am very happy your first baby didn't have any problems. Good luck with your UC and your second baby!! Where I am from Social Services is called for all drug use, including Methadone and Subutex. : (  

also, I am not using drugs. I am taking medication given to me by my doctor, they aren't calling CPS. Its totally not the same thing, at all.

[mamaharrison]

In all love and respect, is there any consideration for you to discontinue {weaning safely} the drug? 

I, too, and an ex-heroine addict as is my husband. I have not had the experience of using any drugs to get or stay 'clean', so, I don't know exactly how that typically works--how long do you need to stay on the pharmaceutical? Can't you safely get off of it now? 

[JoyfulMama2be]

Originally Posted by mamaharrison 

In all love and respect, is there any consideration for you to discontinue {weaning safely} the drug? 

I, too, and an ex-heroine addict as is my husband. I have not had the experience of using any drugs to get or stay 'clean', so, I don't know exactly how that typically works--how long do you need to stay on the pharmaceutical? Can't you safely get off of it now? 

Actually while pregnant that would put the babies life in danger, or course pre-term labor. They NEVER recommend that, even if using heroin, never just stop and its not recommened to wean, they put mothers on methadone or subutex.

I am not using drugs to stay "clean". I am clean not "clean". And its a medication. 

Like I said, how long one stays on it is a personal decision based on how well your doing and if you desire to get off. There isnt any reason to get off if you dont want to.

Here is a link to a website that explains how suboxone works. It actually works to prevent opiate abuse, if one were to use heroin for example while taking it you would not get high. It reduces or eliminates physical cravings as well.

www.subutex.info

It explains the difference between an agnoist (like heroin), a partial agonist (like subutex), and an antagonist (suboxone), it also explains the difference between addiction and physical dependence.

The only reason why I want to get off suboxone is because it is very hard to get and I also really hate having to endure the stigma of being "an addict" in recovery from medical staff. I also really want a homebirth next time we have a baby and thats not possible unless its a UC, and I would prefer a midwife.

I cant get off the suboxone until my chronic back pain is address though, like I said in my previous post. Thats my biggest obstacle. I was almost off of it before I got pregnant (I was down to half a mg which is basiclly nothing) but the pain was so overwhelming that I was comepletly unable to move. I cant handle that pain. There is obviously something very wrong with my back but I need xrays...so thats my next journey after this baby is born.

But I wish that no one was ever asked when they will stop taking suboxone, as if its a bad thing. If I had something else, say diabietes, would people say "when are you going to stop your insulin?". Addiction is a physical issues that can be address with a very effective medication, suboxone and no one should be ashamed to take it. But sadly, they are. People are just uneducated about addiction in general, and addiction treatment in particular. I find that many addicts in recovery, esp. who attend NA judge people who take suboxone as if its just another drug without knowing much about how it works.

I understand that you are more than likely not trying to be offensive in any way, and maybe your even trying to help, but I really want people to be more educated about it because lives are saved with this medication. I know an 18 yr old girl who couldnt stop using heroin even though she wanted to very badly. She was plauged with cravings, because her brain is screaming for opiates. Once she started suboxone she felt normal again and shes going back to college, and not putting her life at risk anymore. I was homeless, I was a skid row addict. Now I am a normal wife and Mother and happy. Its a truly amazing treatment and should be available to every addict who needs it.

[Katie8681]

I second everything you posted, JoyfulMama! People can, and frequently are, safely maintained on suboxone or methadone indefinitely. I add that if someone asked for a social work consult while you were in the hospital, it would probably amount to the SW coming into your room, chatting with you for a bit to establish that all the good stuff in your chart is accurate, then congratulating you on turning your life around and on your beautiful baby.

[JoyfulMama2be]

Originally Posted by Katie8681 

I second everything you posted, JoyfulMama! People can, and frequently are, safely maintained on suboxone or methadone indefinitely. I add that if someone asked for a social work consult while you were in the hospital, it would probably amount to the SW coming into your room, chatting with you for a bit to establish that all the good stuff in your chart is accurate, then congratulating you on turning your life around and on your beautiful baby.

Thank you!

[my5loves]

Diabetes and addiction are actually very different and you are taking a drug. Just because it is prescribed doesn't mean it isn't a drug.  Tylenol is a drug. I am very educated and have studied and worked with mothers with addictions and their babies. Getting off heroin was a huge accomplishment and you should be VERY proud of yourself but methadone and subutex are not meant to be taken for life. Good luck with your birth. I wish you nothing but the best. I will leave this discussion for good now as it seems my comments are bothering you. I did not mean to seem as if I was attacking or belittling you.

[JoyfulMama2be]

Originally Posted by my5loves 

Diabetes and addiction are actually very different and you are taking a drug. Just because it is prescribed doesn't mean it isn't a drug.  Tylenol is a drug. I am very educated and have studied and worked with mothers with addictions and their babies. Getting off heroin was a huge accomplishment and you should be VERY proud of yourself but methadone and subutex are not meant to be taken for life. Good luck with your birth. I wish you nothing but the best. I will leave this discussion for good now as it seems my comments are bothering you. I did not mean to seem as if I was attacking or belittling you.

Yes, its a "drug" but its not the same and it doesnt work the same way. Anyway, yes it seems we can just agree to disagree. Many people do in fact use suboxone for life and there is nothing wrong with that,

[newsolarmomma2]

Please, please, please be very careful. I also wanted a UC badly, but didn't get one, so I understand the desire. Both my kids were born on Methadone (pain management), and I personally know others that have had their babies on MMT or Subutex.

You are right that the worry isnt the LnD- that drug wont effect the labor, and even if the baby gets NAS (mine did in 4-5 hours!) its easily treated. Subutex isn't as hard of a withdrawal as methadone, but many babies still need treatment. It's true that BF helps, but sometimes they are too disorganized to properly suck without further treatment.

The worry is afterwards.
If anything- labor transfer, baby goes into withdrawal, baby needs to see doc, or god forbid a bad outcome happens- you will be blamed, and will have your child removed immediately. With your history, they will take your nursing baby before you blink an eye. It is horrible, but sadly, I have seen this happen with SOBER moms on methadone and Subutex. All it takes is ONE person who thinks you are irresponsible, and you will be dealing with an ugly fight instead of a baby moon. I am not the type to worry over CPS, but in is case, I have seen it up close, and it is worth the worry. After seeing the worst happen to a mom at my clinic, I opted not to try a UC this last birth, it just wasn't worth it. I had a fantastic, problem free, painless VBAC in a good hospital instead.

Please protect yourself. Follow every single treatment rule, no matter how dumb, and ensure documentation. Make sure you are drug tested monthly- it is for YOUR protection. Go to every single OB appointment. and do all the normal prenatal care. You *can* find a good doc (I had 2 excellent ones, even with Mediciad for one birth) or even a CNM, and build a good relationship with them. They will be your greatest ally in an "oops" or transfer situation. (I also had an MFM for baby #2 and he was the best.).

Most important, find a pedi for is new baby and get to know them now. Confide in them about your fears, and let them help you. And older doc is always better IMO, they seem to know who is a good parent much faster, and will be easier to deal with. My son was detoxed AT HOME, by his pediatritian, after a NICU stay to get him stable (and treat a few unrelated issues). It is possible to do this, although I didn't know it until it happened. I had no CPS issues, though I had to meet with a social worker. FYI, hospitals usually have a LSW on staff, and they can opt not to call CPS, so its not inevitable.

Anyhow, best luck to you. I hope this birth is much better than your last one, and that your baby is healthy, and you all are happy.

[Katie8681]

PP is right- I forgot which board I was on when I said what I did about a SW response in the hospital. That's typically the response to a mom who has been regularly attending prenatal care and given birth in the hospital. A mom with your history who shows up with a sick baby the day after he was born at home UC would send up major red flags.

[JoyfulMama2be]

Originally Posted by newsolarmomma2 

Please, please, please be very careful. I also wanted a UC badly, but didn't get one, so I understand the desire. Both my kids were born on Methadone (pain management), and I personally know others that have had their babies on MMT or Subutex.
You are right that the worry isnt the LnD- that drug wont effect the labor, and even if the baby gets NAS (mine did in 4-5 hours!) its easily treated. Subutex isn't as hard of a withdrawal as methadone, but many babies still need treatment. It's true that BF helps, but sometimes they are too disorganized to properly suck without further treatment.
The worry is afterwards.
If anything- labor transfer, baby goes into withdrawal, baby needs to see doc, or god forbid a bad outcome happens- you will be blamed, and will have your child removed immediately. With your history, they will take your nursing baby before you blink an eye. It is horrible, but sadly, I have seen this happen with SOBER moms on methadone and Subutex. All it takes is ONE person who thinks you are irresponsible, and you will be dealing with an ugly fight instead of a baby moon. I am not the type to worry over CPS, but in is case, I have seen it up close, and it is worth the worry. After seeing the worst happen to a mom at my clinic, I opted not to try a UC this last birth, it just wasn't worth it. I had a fantastic, problem free, painless VBAC in a good hospital instead.
Please protect yourself. Follow every single treatment rule, no matter how dumb, and ensure documentation. Make sure you are drug tested monthly- it is for YOUR protection. Go to every single OB appointment. and do all the normal prenatal care. You *can* find a good doc (I had 2 excellent ones, even with Mediciad for one birth) or even a CNM, and build a good relationship with them. They will be your greatest ally in an "oops" or transfer situation. (I also had an MFM for baby #2 and he was the best.).
Most important, find a pedi for is new baby and get to know them now. Confide in them about your fears, and let them help you. And older doc is always better IMO, they seem to know who is a good parent much faster, and will be easier to deal with. My son was detoxed AT HOME, by his pediatritian, after a NICU stay to get him stable (and treat a few unrelated issues). It is possible to do this, although I didn't know it until it happened. I had no CPS issues, though I had to meet with a social worker. FYI, hospitals usually have a LSW on staff, and they can opt not to call CPS, so its not inevitable.
Anyhow, best luck to you. I hope this birth is much better than your last one, and that your baby is healthy, and you all are happy.

I hear you about CPS. I would not wait a day btw, if I did a UC I would call my midwives and tell them the baby came and go within two hours after birth. But I know what you mean about being careful. I am drug tested every month, I have been for almost three years and your right that it works in my MY favor so I am always sure that its done. That way I can say, "check the medical records, I am clean and I have been" they can drug test me all day, every day for all I care. I know the documentation matters. I am sorry that you know people who had such horrible experiences that is def scary. I had CPS come to our home once but it was unrelated to me (it was about my husband and unfounded) but thankfully we had a really nice worker and he was obivously impressed with us. But of course, with my history I DO worry that things could go badly if we had someone who is not so understanding. The pedi we have has been good so far and knows that my daughter was born with me on subutex, they didnt seem to be bothered by it and I have been treated well there thankfully. I also am involved in a voluntary program in my town for moms and children 0-3 years. I have a really awesome, kind, social worker come every two weeks (it was every week) and she just tells me about how I can help my daughter in her development and whatnot. Anyway, she is a good ally for me too because she knows us so well and she is someone they would respect. I wish so badly that I could just delete my history and have everyone focus on me now, but I know that often with addicts in recovery it is assumed that your lieing. So its like you have to prove yourself innocent before your trusted. Thanks for wishing us well, and I do think that things will go better this time around.

[mamaharrison]

Originally Posted by my5loves 

Diabetes and addiction are actually very different and you are taking a drug. Just because it is prescribed doesn't mean it isn't a drug.  Tylenol is a drug. I am very educated and have studied and worked with mothers with addictions and their babies. Getting off heroin was a huge accomplishment and you should be VERY proud of yourself but methadone and subutex are not meant to be taken for life. Good luck with your birth. I wish you nothing but the best. I will leave this discussion for good now as it seems my comments are bothering you. I did not mean to seem as if I was attacking or belittling you.

I agree with this. I am educated also and the dug you have chosen to take is affecting your child and you, whether you want to believe that or not. I congratulate you on turning your life around, but you are still using a drug that has side effects emotionally and physiologically. Also diabetes can be managed quite effectively and cured without drugs--through nutrition therapy--I know many who have opted to come off those drugs, too. Think about how wonderful it would be to not continue to identify and label yourself as an addict and to actually walk away {safely} from all the drugs. The pain you speak of is a symptom of the addiction, too--it is your body speaking its truth--until you address the emotional components to your addiction vs. the physical aspect of it you will always be in danger of relapse and thus dependant on 'medical management' with drugs.

good luck and congrats!  all will work out as it is intended to.

 

[Katie8681]

Originally Posted by mamaharrison 

I agree with this. I am educated also and the dug you have chosen to take is affecting your child and you, whether you want to believe that or not. I congratulate you on turning your life around, but you are still using a drug that has side effects emotionally and physiologically. Also diabetes can be managed quite effectively and cured without drugs--through nutrition therapy--I know many who have opted to come off those drugs, too. Think about how wonderful it would be to not continue to identify and label yourself as an addict and to actually walk away {safely} from all the drugs. The pain you speak of is a symptom of the addiction, too--it is your body speaking its truth--until you address the emotional components to your addiction vs. the physical aspect of it you will always be in danger of relapse and thus dependant on 'medical management' with drugs.

good luck and congrats!  all will work out as it is intended to.

 

mamaharrison, I don't know how to say this without sounding harsh. What you are saying here is a personal judgment. It is not rooted in the state of the science on treatment of addiction and maintenance in pregnancy. You say you are educated. What exactly is that education? In other threads, you call yourself a "body worker", and in one thread you said you were working towards an associate degree in nursing. None of that training gives your moral judgment additional weight. The bolded in particular, frankly, you have no business judging, and would not even if you were a physician, because you have not even seen this woman, examined her, or seen her medical records.

[JoyfulMama2be]

Originally Posted by Katie8681 

mamaharrison, I don't know how to say this without sounding harsh. What you are saying here is a personal judgment. It is not rooted in the state of the science on treatment of addiction and maintenance in pregnancy. You say you are educated. What exactly is that education? In other threads, you call yourself a "body worker", and in one thread you said you were working towards an associate degree in nursing. None of that training gives your moral judgment additional weight. The bolded in particular, frankly, you have no business judging, and would not even if you were a physician, because you have not even seen this woman, examined her, or seen her medical records.

Thank you, I was going to respond saying the same thing. Many people really do think they understand addiction when they don't, and also assume many things about me and my recovery without every having met me. But I try not to let it bother me too much, I know what I'm doing is right for me and my baby but its nice to hear from someone who understands. Thanks again :-)

[LessTraveledBy]

Originally Posted by JoyfulMama2be 

And symptoms will not show up weeks later. It shows up within 24 hours and is gone in a few days or a week maximum IF anything happens (praying that my baby wont get sick of course).

Respectfully, the hospital I worked with disagrees with you on this. 

[JoyfulMama2be]

Originally Posted by LessTraveledBy 

Respectfully, the hospital I worked with disagrees with you on this. 

Buprenorphine in Pregnancy - Statistically Speaking...

• 55-94% of babies born to opioid dependent mothers will exhibit symptoms of NAS.
• There have only been 21 published reports of the use of Buprenorphine in pegnancy.
• These reports involved the study of 309 infants who had been exposed to Buprenorphine (Subutex and Suboxone) in utero.
• Of these 309 babies, 62% exhiited NAS
• Of these 309 babies, 48% exhibited NAS and required treatment (though nearly half of this group was also exposed to illicit drugs too).
• Buprenorphine babies begin to present with symptoms of NAS within 12-48hrs of birth
• Withdrawals peak at approx 72-96 hrs.

In short, 96% of babies born to opioid dependent mothers experience NAS and only 62% of Buprenorphine babies experience NAS. This is one of the benefits of Subutex over Methadone during pregnancy. This is the reason that doctors favour Subutex over Methadone - the withdrawals are milder, shorter and require less medical intervention.

Notice that out of the group that required treatment nearly half was also exposed to illicit drugs. I will take the medical opinion of my doctor, my pedi, and the studies that I have read over the opinion of "your hospital".

Anyway, I really didnt want this to digress into a debate about subutex during pregnancy. I have made the best choice for me and my baby, some people disagree. That isnt why I posted here. I wanted to info about UC. Thank you for those of you who stayed on topic and refrained from making judgements. 

[Skelly2011]

Hi joyful,

I totally understand if you are no longer following this thread, what with the selection of unsupportive comments mixed in with the awesome ones. On the off chance you do see this, I just registered with the site specifically to get in touch with you.

I'm in pretty much exactly the same situation. I'm a mom, I have a two year old daughter and am 12 weeks pregnant. I'm now working in social services, harm reduction specifically, and overall I'm quite a normal boring middle class mom. Unfortunately, in my teens I was forced on the streets and ended up in a nightmare physically abusive relationship with a heroin addict boyfriend. And is usually the case, trying to save an addict makes it awfully easy to become one yourself. I've been clean for years, passing my monthly drug tests and active in NA. I'm also currently on 2 Mgs daily of subutex. I was taking subutex during my daughters pregnancy as well, and she was born perfectly healthy with no withdrawal symptoms, despite the nightmare hospital birth I had which was pretty much identical to yours.

This time I'm working with a midwife. I'll still be having a hospital birth, but the standard practice is to be discharged after 6 hours providing no hemorrhage or neonatal issues occur, then spend a week of recovery time at home with daily visits from the midwife to monitor mom and baby. I'm slightly concerned about the at home recovery in the event of subutex complications for the baby. I know I'm at a low dose which I plan on lowering once I'm out of the first trimester and the risk goes down, plus I've already had a healthy baby and plan on breast feeding, but as you know all the stress and stigma can really freak a mama out.

You are literally the first person I've found in my three years of pregnancy and parenting that is going though the same thing. I'd really love to chat if you get the chance. Let me know if you'd be interested in talking sometime. It's such a unique circumstance, with so much stigma against otherwise perfectly typical moms and pregnancies, it would really be awesome to know someone else going through it.

Ps: you sound like an awesome mom working a great recovery. Just do what keeps you and your children happy and healthy and tune out the naysayers.