Systemic Analgesia

A variety of opioid analgesics have been used to reduce the pain of labor. All opioid analgesics given in equianalgesic doses have similar advantages and disadvantages. The choice of opioid is often institutional preference. These medications are ordered by the obstetrician or midwife and administered by the patient's nurse. The advantages of systemic opioid analgesia for labor are ease of administration, low cost, maternal acceptance, and lack of the need for obstetrician or anesthetist presence. The disadvantages are failure to provide adequate analgesia, maternal side effects, and placental transfer of medication to the fetus.

Maternal side effects include altered respiration (hypoventilation between contractions), reduced gastric motility, nausea and vomiting, sedation, dysphoria, and inadequate analgesia. Fetal effects include loss of heart rate variability, neonatal respiratory depression, and a lower likelihood of successful breastfeeding. Systemic opioids can be administered intramuscularly, subcutaneously, intravenously, or using intravenous patient-controlled analgesia (IV-PCA) (Table 22.2).

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New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.

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