Choices Matter in Pain Management

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I delivered my third child via Caesarean section on 11 May 2007.

I was told that after two rather traumatic large natural no-meds births that an elective C-section was the only way to go for my baby’s health and safety. If I chose to attempt to deliver naturally that could lead to complications and an emergency C-section, it could be dangerous.

I thought I was prepared.

With an elective C-section, almost everything was out of my control.

I felt like a failure.

But my perfect little girl was all worth it.

I didn’t have many options for pain management in a military hospital.

The anesthesiologist administered an epidural for the surgery. I received oral pain meds during my hospital stay that made me nauseated. I got an opioid prescription to take at home.

I didn’t receive any helpful post-care or information about pain management, healing, scar care, or effects of opioids on my nursing baby. I was simply sent home with an opioid prescription, stool softener, and some brochures.

My parents were visiting but are no help to me or my family. I had to entertain them when all I wanted was rest. My husband had to return to work within the week. I had pressing concerns  – caring for my newborn and other children while recovering from major surgery – and doctors are supposed to be trustworthy professionals.

Right?

The medical professionals all assured me it was safe to take my prescriptions while nursing. I took as few of the opioids as possible, for only a couple days, because they made me feel nauseated. Then I moved on to milder and most likely safer pain meds – non-steroidal anti-inflammatories (NSAID). Luckily, I was young and strong and healed well and quickly. I had two other kids to care for and I couldn’t afford to be laid up for long. Great pain management options also include CAM treatments, long-acting anesthetics, warm baths, heating pads, or ice packs. I utilize integrative methods when I can.

I recommend doing your own research and discussing options before surgery so you won’t have to make quick important decisions while groggy or in pain.

My daughter is now 11 years old and is by far my healthiest child of four, and surely is fine despite the opioids I took for pain those first few days after her birth while I was nursing her. But what if the meds had affected her? How many children have been or are being affected by side effects of strong pain meds? We don’t have all the answers to exposure. There are lots of options for pain management for nursing moms after C-section.

Choices Matter is a campaign designed to educate and empower patients, caregivers, and physicians to discuss pain management options, including effective non-opioid options, prior to surgery. The use of non-opioid options before, during, and after surgery can significantly decrease or, in many cases, completely eliminate the need for opioids after many common procedures, including C-section deliveries.

Some Caesarean section statistics:

• More than 1 in 3 women had C-section deliveries; overall, 1 in 5 C-sections were unplanned
• More than 1 in 3 (36%) women did not have a birth plan, which is an opportune time for a patient to speak with their doctor about pain management options, including non-opioids
• 38% of women are open to pain management options, but think some kinds of pain medications are or could be harmful to them or their baby

Opioids and childbirth:

• 19% believe they are fine for other procedures, but not childbirth
• 25% believe they will be able to handle the pain without opioids
• 21% have no issue taking opioids
• 35% prefer to let their doctors decide what is best
• Nearly nine-in-ten (88%) of mothers have concerns about taking opioids during and after childbirth. Despite these concerns, more than half (51%) of C-section patients are prescribed an opioid.

Leading concerns surrounding opioids and childbirth:

• Breastfeeding/impact on baby: 53%
• Side effects: 52%
• Nearly a quarter (24%) of those surveyed fear the risk of dependence or addiction
• While C-section patients had more opioids and anesthetics in the hospital and at home, they were less satisfied with their overall pain management
• 44% of C-section mothers were not completely satisfied with how their pain was managed during birth

The US is currently in the throes of an opioid crisis.

Interesting facts:

There were more than 42,000 deaths attributed to opioids in 2016, and 40% of all opioid overdose deaths involve prescription opioids.
In 2012, there were 793 million doses of opioids prescribed in Ohio, enough to supply every man, woman, and child, with 68 pills each. Roughly 20 percent of the state’s population was prescribed an opioid in 2016. And Ohio leads the nation in overdose deaths.
The state of Ohio has sued five major drug manufacturers for their role in the opioid epidemic.
The Justice Department report shows that federal prosecutors investigating the company found that Big Pharma knew about “significant” abuse of opioids in the first years after the drug’s introduction in 1996 and concealed that information. For children growing up in the shadow of the opioid crisis, public schools have become the safety net of last resort.
Center for Disease Control (CDC) statistics report that one in 10 Native American children will use prescription opioids for nonmedical use — twice the rate of white children.

Our church supports charities to counter the opioid epidemic, like Brigid’s Path.

Have you experienced a Caesarean section birth? What was it like?