How do drugs like Stadol affect mom and baby during birth?

Many birthing moms use analgesics to take the edge off pain early in labor. Obstetrician/Gynecologist David Barrere discusses how these drugs work.

Your question
Can you tell me about how Stadol and similar drugs affect mom and baby during birth?

The expert answers
Obstetrical analgesics are quite frequently used in the early stages of labor, prior to the placement of an epidural. They can also be useful for women who are planning to avoid an epidural, but must be used more cautiously and sparingly.

The typical mediations utilized are Stadol (Butorphanol tartrate), a synthetic opioid, and Nubain (Nalbuphine hydrochloride), a synthetic narcotic. Both medications can be given by the intramuscular (IM) or intravenous (IV) route. Onset of action is approximately 15 minutes with IM injection, compared to only two to three minutes for IV. They effectively control pain and may be given periodically during labor without risk of affecting duration or progress of labor.

Both drugs, however, readily cross the placenta and enter the fetal circulation. When used on women choosing not to have an epidural, they are typically withheld once the patient reaches eight centimeters of dilation. This is for fetal reasons only. If a baby is born shortly after receiving a dose of Stadol or Nubain, its initial respiratory efforts may be weak. This in no way increases the risk for long-term health problems to the baby.


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