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How many studies have been done on Chamomile/passionflower/valerian in pregnancy?<br><br>
I can't honestly think of a time when I would have recommended Chamomile tea to a mom when I was considering an IM of Stadol (that's what we used). I'm sure anyone I would have suggested that to would have ripped my head off. Chamomile in early labor, maybe the first couple of times I have spoken with mama--absolutely, along with a bath, mineral salts, food, fluids, relaxation, massage, etc. But when mom is telling me that everything is not working, she is reconsidering her natural birth, I can tell she is exhausted from days and nights of prodromal labor--when it is at the point where we can give her an IM of 1 mg of stadol to help her sleep, relax her irritable uterus, and hopefully kick her either into a productive, regular pattern or out of a completely unproductive, irritable pattern--why would I not try Stadol/Morphine, etc? Why would I deny that to her, and instead let her head to the hospital for her epidural?<br><br>
At the birth center, we dont' use it every often--we never use the vial before it is expired, so we probably use less than 10 mg in 2 years--but every time we've used it it has been very judiciously used after much discussion between mw, nurse, client, and client's support people. And it has, every time, made the difference between birth center birth with few to no other interventions and a hospital birth with an epidural and everything that comes with it.<br><br>
I had narcotics used on me several times when I was in preterm labor. When everything else didn't work, my OB gave me an IM of demerol. Three different times this was the only thing that knocked out my contractions. Enabled me to get to 36 weeks before birthin--woot woot.
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10091463"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">And I am still wondering why more herbal options are not explored/researched. In general, it is because no one owns herbs, but it is painful to see Western Med's Pharmaceutical Profit motive at work even in Birth . . .<br><br>
How many mamas who are offered Benadryl/Ambien/Xananx/Morphine are first offered Chamomile/PassionFlower/Valerian? I'm not worshipping at the altar of herbs exactly, but just saying that for this 'client', there are choices that accomplish roughly the same goals that are much more in line with my normal health philosphy (the same one that causes me to choose midwifery care over obstetrical care in the first place). . . I just wonder why those more natural choices go out the window (or seem to) when labor starts?</div>
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My patients who are prodroming have, for the most part, gone the herbal route already. They've walked. They've taken baths. They've done relaxation techniques. They are at the end of their tethers by the time they ask for morphine.
 

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yes, I have a list of herbs and things to try--- but to stay on topic--- there is a reasonable explaination for the ability to access or have morphine or another sleeping med available
 

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So "powerful drugs" like morphine are bad. But wine is OK? And Ambien? I don't get it.<br><br>
FWIW did chamomile in early labor. And a bath. Didn't help me sleep one bit.
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I can't honestly think of a time when I would have recommended Chamomile tea to a mom when I was considering an IM of Stadol (that's what we used). I'm sure anyone I would have suggested that to would have ripped my head off.</td>
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So you don't think it's her right to decide for herself? You just make the choice for her?<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">So "powerful drugs" like morphine are bad. But wine is OK? And Ambien? I don't get it.<br><br>
FWIW did chamomile in early labor. And a bath. Didn't help me sleep one bit.</td>
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I wouldn't take Ambien either, myself, and I don't know a lot about it so I can't say how it compares to narcotics. I'm not sure how much it has been studied for use in pregnancy and is probably overused like every other drug. I don't see how anyone could compare a half glass, or even a whole glass, of wine to a narcotic injection. They're totally different, and one is far stronger than the other.<br><br>
Chamomile, baths, natural things are enough for some people. Some women can get by on less sleep than others, and the mental/emotional aspect can't be underrate either. The emotional cost to me, for example, of going to the hospital to get a drug to sleep was far higher than dealing even with the weeks of prodromal labor I had. I'm sure other women feel differently, which comes back to my main point: it should be her choice. I'm really glad I had a UC last time, so I wouldn't have to worry about some HCP deciding what was best for me without giving me all the information available and letting me make my own decision.
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">How many studies have been done on Chamomile/passionflower/valerian in pregnancy?</td>
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Umm, that's my point exactly. Find me a study that approves Ambien or Xanax or Benadryl for use in Labor (?!?) Many of the drugs that we use in labor are not even approved for use in labor. So how are they safer, just because they are made in a lab? I mean we have literature/written records on herbs from Jesus' time on . . . In a situation where Morphine was being considered, I wouldn't be still taking Chamomile, c'mon, but I know I did NOT exhaust my herbal alternatives, nor were any available to me in the hospital. It's conventional meds or the highway there, no?The herbs I mentioned most likely (even Valerian) would have been gentler on my body & my baby than IV Morphine! Just sayin' . . .
 

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<div>Originally Posted by <strong>SublimeBirthGirl</strong> <a href="/community/forum/post/10094599"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">So you don't think it's her right to decide for herself? You just make the choice for her?<br><br><br><br>
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I see by this quote that you are intent to only see things from your perspective, so I'm not sure any response I write will change that. Please, do not continue to do as many in the medicalized community do, twist and turn every phrase and every word to an accusation against the speaker as well as an illumination of the superiority and correctness of your own way of thinking and doing.<br><br>
Assuming that you do actually want a dialogue and not just to assert your moral authority and righteousness over the rest of us evil minions of the medical establishment, I will repost what was later in my post that you quoted:<br><br>
"every time we've used it it has been very judiciously used after much discussion between mw, nurse, client, and client's support people."<br><br>
Look, if you want to discuss the pros and cons of informed consent; of what you do include when you discuss the pros and cons of a treatment in what little time there is, that's great. I'm up for that, and would enjoy the give and take as well as the variety of perspectives. I have many times reevaluated my client teaching and practice based on discussions of this type, both from this discussion board as well as other places and means. If you merely want to insinuate accusations of maliciousness, mysogony and authoritarianism against the many good practitioners here who work their hearts out, who miss family celebrations, nights and sometimes days of a time of their family and home life to support the moms and families whom we all work with, who deal daily with attacks from a variety of practitioners who believe that natural childbirth, in hospital or out, is simply stupid, and that midwifery, home birth and UC are reckless and dangerous, then no, I am not up for that. I come here for a lively discussion, a fresh perspective, and support. Not for repeated assertions of the like you continue to put forth.<br><br>
Please, you seem to have a lot of experience and passion. Don't turn it against your fellow MDC birth attendants who are on your side. Don't continue to sit on a throne in absolute judgement of all who do and view things differently than you. You can certainly continue to assert that 100% complete informed consent must be obtained; you can continue to assert that a shot of liquor is better than a shot of stadol. But please try to be more respectful and welcoming of discussion. You only damage this board and all free dialogue with your current method.
 

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<div>Originally Posted by <strong>BugMacGee</strong> <a href="/community/forum/post/10094080"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">So "powerful drugs" like morphine are bad. But wine is OK? And Ambien? I don't get it.<br><br>
FWIW did chamomile in early labor. And a bath. Didn't help me sleep one bit.</div>
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I wonder about this too. Alcohol *is* a powerful drug in its own right, and opiates are just as "natural" as alcohol.<br><br>
The thing I always think about herbs is this; either they do work (and I believe many do), in which case they can be just as powerful and dangerous as non-herbal meds, and should be used with just as much caution - or they don't, and then the question is moot anyway.<br><br>
Would people feel differently about this if it were "Well, I offer the mother a glass of poppy tea?" or if the drug being offered was poppy heads steeped in alcohol by a homebirth midwife?
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10094821"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Umm, that's my point exactly. Find me a study that approves Ambien or Xanax or Benadryl for use in Labor (?!?) Many of the drugs that we use in labor are not even approved for use in labor. So how are they safer, just because they are made in a lab? I mean we have literature/written records on herbs from Jesus' time on . . . In a situation where Morphine was being considered, I wouldn't be still taking Chamomile, c'mon, but I know I did NOT exhaust my herbal alternatives, nor were any available to me in the hospital. It's conventional meds or the highway there, no?The herbs I mentioned most likely (even Valerian) would have been gentler on my body & my baby than IV Morphine! Just sayin' . . .</div>
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Most drugs aren't approved for use during labor--most drugs aren't used for their approved means exclusively, no matter who the patient or client is. Mostly that is valid, sometimes it isn't. Aspirin for prevention of heart attacks isn't FDA approved, but since in the experience and observation of physicians and practitioners it seems to work well, we use it that way, a lot.<br><br>
I would wager that most herbs are not approved for use during pregnancy and labor, either. When we say things like "We have input from Jesus' time on these herbs" well, we know that they were used. Were there studies done? What factors did these studies control for? What dosage, strength, and frequency was used? If it is justifiable to say, "In my experience and in the experience of other practitioners for years and years, this herb has proven beneficial in this situation," why is it not justifiable to say, "In my experience and in the experience of other practitioners for years and years, this medication has proven beneficial in this situation"?<br><br>
I'll not argue against the assertion that EVERYTHING is over prescribed. It's crazy. And it's often expected--for every mom who is grateful for the nonpharmacological recommendations, there is one who asks me, "But can't you just give me a pill? My sister/friend/coworker took Ambien..." Urgh. It's this entire societal fabric that I personally am not going to be able to rip apart and reweave. I'll do my best to keep my little thread going, but that's about all one can do, I think.<br><br>
I just view the "herb is better than medication" with as much skepticism as the "medicine is better than any thing else" argument. It seems counterintuitive to me. Unless you grew those herbs yourself and know exactly how strong the active chemicals are concentrated, then you really don't know much about them.<br><br>
I, too, see alcohol as pretty potent, and am not sure I think a glass of wine is better than a small dose of a narcotic. Probably tastes better, though.<br><br>
You come to a medical environment, you get medical advice. You engage a more holistic practitioner, you should get more of a spectrum. You cannot expect a hospital to dispense valerian to help you sleep, for the reasons mentions. You can't expect a massage therapist to write you a script for a muscle relaxer. However, I've given all sorts of nutritional supplements from "pt's home stock." And if you bring it to the hospital, they can't take it away from you.<br><br>
I'm not necessarily defending that situation--but I'm saying if you go to an OB or a medical doc, unless you do your homework and look around for the crunchy doc, you shouldn't be surprised to be prescribed an medication. And, whether you want it or not, it's what the majority of their patients want.<br><br>
I guess educating yourself as to what you want and what is best for you continues to remain primarily within the mother's responsibility. Whether that's right or wrong, it's how it is.
 

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<div>Originally Posted by <strong>SublimeBirthGirl</strong> <a href="/community/forum/post/10094599"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I'm not sure how much it has been studied for use in pregnancy and is probably overused like every other drug. I don't see how anyone could compare a half glass, or even a whole glass, of wine to a narcotic injection. They're totally different, and one is far stronger than the other.</div>
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I guess it all depends-- pick your poison -- alcohol even a few drops of tincture bother some alcoholics I know-- absolutely sets off a craving they could no more touch a 1/2 glass of wine than a full shot, so for anyone who has had an addiction problem just as bad --- not to mention the sulfates....<br>
look I had days of prodromal labor with my last 2 kids and I was fine no drugs.. no alcohol - no tinctures but I have also been with women who cannot and do not manage active labor after days of prodromal --- and that is what others are saying as well having an option of something to sleep rather than full on transport--<br>
so for you the answer is to not even be offered the option=<br>
having had a UC myself I don't recommend it -- and someone telling me what drugs are available to me doesn't even come into the picture of why or why not.
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I would wager that most herbs are not approved for use during pregnancy and labor, either. When we say things like "We have input from Jesus' time on these herbs" well, we know that they were used. Were there studies done? What factors did these studies control for? What dosage, strength, and frequency was used? If it is justifiable to say, "In my experience and in the experience of other practitioners for years and years, this herb has proven beneficial in this situation," why is it not justifiable to say, "In my experience and in the experience of other practitioners for years and years, this medication has proven beneficial in this situation"?</td>
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Right, but conventional meds tend to be MUCH newer, like by centuries. So we have less information on these substances, de facto. My personal faith belief is that herbs created by God are always preferable to synthetic chemicals created by Man, but that is really beside the point.<br><br>
These controlled studies (which are not even applicable here because the meds are being used 'off-label') are often WAY more biased than we think . . . (example: my BIL takes medications in "controlled double blind studies" FOR A LIVING! :shock: And everyone else in the studies with him is doing it for a living . . . Not so scientific, if you ask me. He gets paid VERY well for his time, too.)<br><br>
In any case, I personally don't get when Doctors, Hospitals, CNMidwives, etc married conventional pharmaceuticals. In any case, it's time to get a divorce. . . . Why can't I access herbs which I believe to be gentler, on which my practicioner has gathered all the available information on, while having great access to lifesaving medical equipment in the case of an emergency? Since all the meds are being used off label, I just feel that this bias is totally unacceptable to me as a woman. If I would prefer to trust in Mereck, that is one thing . . . But to force that upon me because I want to give birth in a Birthing Center or Hospital is unacceptable, IMO.<br><br>
And FTR, I would be pretty okay with a Poppy Tincture by mouth, if I was considering getting Morphine by IV! Of course I would want some information on the correct dose, but a few drops of a tincture by mouth of a plant is way safer than a synthetic opiate derivative by vein, sorry.
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10095774"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
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And FTR, I would be pretty okay with a Poppy Tincture by mouth, if I was considering getting Morphine by IV! Of course I would want some information on the correct dose, but a few drops of a tincture by mouth of a plant is way safer than a synthetic opiate derivative by vein, sorry.</div>
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If you're going to bother getting twitterpated about the morphine we're discussing, let's be clear:<br><br>
1) Morphine is not a synthetic narcotic<br>
2) It's not given IV for prodromal labor. Doesn't last long enough and is more potent than needed.<br><br>
I'm sure that were I to mix up herbs and their administration, someone would jump on me, so let's be clear about what we're talking about here.
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10095774"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Right, but conventional meds tend to be MUCH newer, like by centuries. So we have less information on these substances, de facto. My personal faith belief is that herbs created by God are always preferable to synthetic chemicals created by Man, but that is really beside the point.<br><br>
These controlled studies (which are not even applicable here because the meds are being used 'off-label') are often WAY more biased than we think . . . .</div>
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This is an honest comment, but morphine has actually been around for centuries, and would fall into the category of created by God (i.e. poppy plant) rather than a synthetic chemical. Why is it so different? Is it because the big pharmaceutical company is producing it rather than the local herbalist?<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10095774"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">In any case, I personally don't get when Doctors, Hospitals, CNMidwives, etc married conventional pharmaceuticals. In any case, it's time to get a divorce. . . . Why can't I access herbs which I believe to be gentler, on which my practicioner has gathered all the available information on, while having great access to lifesaving medical equipment in the case of an emergency? Since all the meds are being used off label, I just feel that this bias is totally unacceptable to me as a woman. If I would prefer to trust in Mereck, that is one thing . . . But to force that upon me because I want to give birth in a Birthing Center or Hospital is unacceptable, IMO.</div>
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Let's see....the last time I forced someone to take morphine as a condition to birthing in the hospital....um, never? I offer it to women, some turn it down, some take it. I don't offer it lightly. But when I have a primip showing up on Labor and Delivery four nights in a row because she can't sleep and just "wants to have the baby", by the third or fourth night I'm going to start offering morphine, because the other things we're suggesting, the warm baths and relaxation, aren't working for her, and I'd like her to get a good night of sleep before actual labor. And my teens aren't going to be offered wine, sorry.<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shy.gif" style="border:0px solid;" title="innocent"><br><br>
And "off-label" use of medications in labor and delivery is not all that dissimilar to using herbals - the FDA hasn't approved either one.<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10095774"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">And FTR, I would be pretty okay with a Poppy Tincture by mouth, if I was considering getting Morphine by IV! Of course I would want some information on the correct dose, but a few drops of a tincture by mouth of a plant is way safer than a synthetic opiate derivative by vein, sorry.</div>
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Just have to disagree on this one. I would prefer a dose of poppy derivative (aka morphine) where I knew exactly how much I was getting. The tincture, where I don't know how strong it is today - not so appealing to me. And, like mentioned above, morphine like we're talking about is not given IV. Out of curiosity, would it make a difference to you if you were offered liquid morphine? I guess I'm just curious if the real issue here is the actual drug and route it is given or the fact that the big pharmaceutical company makes the morphine.<br><br>
Just to be clear, I have nothing against herbals, and I do use them. But I treat them just like conventional medications. I assume they have risks, I don't assume they are "safer" because they are more "natural". Just like I don't assume something is safe because the FDA has approved it or the pharmaceutical company says it is. I look at - and discuss - the risks and the benefits of everything I recommend, and sometimes the benefits of morphine outweigh the risks. Most of the time, I have to tell people, we don't know if this is safe, but we don't see problems from it most of the time so we think it is OK to use on occasion. And some people choose to use it and some people don't. And that is their choice.
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Let's see....the last time I forced someone to take morphine as a condition to birthing in the hospital....um, never? I offer it to women, some turn it down, some take it.</td>
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Yeah, I am just discussing the bias inherent in the fact that one thing is offered and the other isn't. I'm a person who fundamentally likes to be "compliant", so when something is offered, and something else is something someone won't forcibly remove from me . . . my natural inclination, despite my heavily researched and sincerly held personal beliefs , is to go with the substance that is "approved" though I definitely think the idea that conventional meds are safer is a myth. Like many women, I think, I am a people pleaser!<br><br>
Correct me if I am mistaken, but doesn't the pharmaceutical company isolate the morphine and process it in some way? I would prefer it in it's whole form . . . with the active components simply extracted with alcohol. It is important to me to be able to understand any steps between nature and me, if that makes any sense. I feel like medicinal compounds are best left whole. Of course I would love a standardized product though . . . I don't simply distrust something because it comes from a Pharmaceutical company, it is more about what form it comes in: is it isolated or synthesized or is it in its whole, naturally occuring form?<br><br>
And yes, I would prefer liquid morphine first, over IM, or IV. I feel like that respects the body's normal boundaries and systems for absorbing chemicals, etc. Does it bypass the baby more if you get it by IM or IV? IDK. I would think it would reach the baby just as readily any way . . . I was given IV Nubain in my labor . . . I just feel like by mouth is really preferable, and if I had been less in labor, I would have loved to have requested liquid first and then IM. I was unaware there was any way besides IV at that time. (Which wasn't so long ago!)
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/10097586"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Yeah, I am just discussing the bias inherent in the fact that one thing is offered and the other isn't. I'm a person who fundamentally likes to be "compliant", so when something is offered, and something else is something someone won't forcibly remove from me . . . my natural inclination, despite my heavily researched and sincerly held personal beliefs , is to go with the substance that is "approved" though I definitely think the idea that conventional meds are safer is a myth. Like many women, I think, I am a people pleaser!<br><br>
Correct me if I am mistaken, but doesn't the pharmaceutical company isolate the morphine and process it in some way? I would prefer it in it's whole form . . . with the active components simply extracted with alcohol. It is important to me to be able to understand any steps between nature and me, if that makes any sense. I feel like medicinal compounds are best left whole. Of course I would love a standardized product though . . . I don't simply distrust something because it comes from a Pharmaceutical company, it is more about what form it comes in: is it isolated or synthesized or is it in its whole, naturally occuring form?<br><br>
And yes, I would prefer liquid morphine first, over IM, or IV. I feel like that respects the body's normal boundaries and systems for absorbing chemicals, etc. Does it bypass the baby more if you get it by IM or IV? IDK. I would think it would reach the baby just as readily any way . . . I was given IV Nubain in my labor . . . I just feel like by mouth is really preferable, and if I had been less in labor, I would have loved to have requested liquid first and then IM. I was unaware there was any way besides IV at that time. (Which wasn't so long ago!)</div>
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Many drugs are not absorbed orally. Fentanyl (which is a synthetic opioid) is one, for example. Nubain is not available orally. Stadol is not available orally.Drugs that are given orally tend to be given in much higher dosages, so the effect is similar anyway (you see this with IM v. IV administration, too -- standard on our unit is 15mg of morphine IM, where I would never give 15mg IV).
 

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<div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Let's see....the last time I forced someone to take morphine as a condition to birthing in the hospital....um, never? I offer it to women, some turn it down, some take it. I don't offer it lightly.</td>
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I imagine a birthing center works pretty differently from a hospital, but I can't even count the number of women who were told, "I'm just going to give you a little something to help you relax," without even being told it's a narcotic or what the risks and benefits are vs. other options. Some of the blame is on women who don't question, but honestly, we're conditioned to listen to these Authority Figures and they totally abuse that.
 

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<div>Originally Posted by <strong>SublimeBirthGirl</strong> <a href="/community/forum/post/10098228"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I imagine a birthing center works pretty differently from a hospital, but I can't even count the number of women who were told, "I'm just going to give you a little something to help you relax," without even being told it's a narcotic or what the risks and benefits are vs. other options. Some of the blame is on women who don't question, but honestly, we're conditioned to listen to these Authority Figures and they totally abuse that.</div>
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Right. All hospitals. All "Authority Figures".<br><br>
When did conventional medicine's practitioners sell their souls to Satan? Because I'm pretty sure I never got my cut.
 

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<div>Originally Posted by <strong>maxmama</strong> <a href="/community/forum/post/10099286"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Right. All hospitals. All "Authority Figures".<br><br>
When did conventional medicine's practitioners sell their souls to Satan? Because I'm pretty sure I never got my cut.</div>
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I hear about mythical hospitals where informed consent is the norm but they are NOT the hospitals near me (of which there are many).<br><br>
lorijds, I was responding to this:<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I can't honestly think of a time when I would have recommended Chamomile tea to a mom when I was considering an IM of Stadol (that's what we used).</td>
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<div>Originally Posted by <strong>lorijds</strong> <a href="/community/forum/post/10092872"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">At the birth center, we dont' use it every often--we never use the vial before it is expired, so we probably use less than 10 mg in 2 years--</div>
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I'm trying to follow this conversation and wonder if you're talking her about a free-standing birth center or a hospital-based "birth center"?<br><br>
Are there many of you here participating in this thread to who provide narcotic pain relief OOH? I'm more than a little nervous at OOH narcotics due to the limited capability we have to monitor mother and baby. I have no issue with transferring to hospital for pain relief/pharm. rest if that is necessary but hesitate to intervene this way OOH.
 

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Freestanding, completely unaffiliated birthing center.<br><br>
What is there to monitor with 1mg of stadol IM? We don't change our monitoring--babe every 30 minutes, mom's VS every hour. We wouldn't give it if babe wasn't reactive and healthy as a baseline, or if mom were compromised in a manner that would make us uneasy about giving stadol. You'd have to be pretty compromised to not be able to easily tolerate a miligram of Stadol IM, you know? I mean, when I work on the pediatric floor, I've given 80 pound kids several miligrams of morphine IV post-op--a 150 mom isn't going to into respiratory distress or bottom out her VS with that small of a dose of Stadol, you know what I mean?<br><br>
I think you will find that is quite within the recommended guidelines of NACC. If you are wondering about what is the norm in OOH birth situations, maybe you can contact NACC and see what their guidelines are regarding different protocols and procedures. Especially if you are working pretty alone (in an area where there aren't very many other OOH practitioners to discuss these things with), it'd be a nice resource for you to see what is the "standard of care" regarding OOH births (at least by NACC's standards).
 
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