Narcotics



What narcotics are in common use in the U.S. for relieving labor pain?

What are the effects of narcotics on labor pain?

How are narcotics administered?

What are the advantages of narcotics?

What are the drawbacks of narcotics?



What narcotics are in common use in the U.S. for relieving labor pain?

Narcotics (also known as opioids) popular in the U.S. include Sublimaze (fentanyl), Stadol (butorphanol), Nubain (nalbuphine), and Demerol (meperidine, also known as pethidine).

What are the effects of narcotics on labor pain?

Narcotics dull pain.

How are narcotics administered?

Narcotics can be injected into a muscle (usually the hip) or into a port on IV (intravenous) tubing.

A new alternative is patient-controlled analgesia (PCA). With this technique, you can give yourself a small dose of IV medication when you need it by pushing a button. A lockout mechanism keeps you from going beyond a preset dose.

A nasal spray version of butorphanol (Stadol NS), which was developed to treat migraine pain, is used in some maternity settings. The manufacturer's "label" for this drug, which has been approved by the U.S. Food and Drug Administration, does not recommend use in labor as it has not been studied for this purpose.

What are the advantages of narcotics?

Narcotics:
  • have a short lag time between requesting a narcotic injection and receiving it; there is no lag time with patient-controlled analgesia (PCA) once it's set up
  • do not interfere with labor progress or ability to push
  • can be helpful if backache between contractions prevents rest
  • do not require presence of an anesthesiologist for their administration and monitoring.

What are the drawbacks of narcotics?

Narcotics:
  • are not very effective at relieving contraction pain: in some settings, quite a few women with narcotics go on to have an epidural as well
  • may confine you to bed
  • can cause nausea: for this reason, another medication is often given along with narcotics to counteract this effect
  • can lower your blood oxygen level: this is unlikely to be a problem in a healthy mother with a healthy, full-term infant
  • can make you drowsy: the way that alcoholic beverages might
  • may make it more difficult to work with contractions due to the effects they can have on mental alertness
  • may result in a sleepy and unresponsive baby: baby may need resuscitation and a medication (Narcan) to reverse the effects on respiration; PCA may cause more problems in this regard depending on permissible dose and whether you are allowed to use it late in labor
  • have adverse effects on newborn behavior, including breastfeeding, that last several days; this is because opioids and their breakdown products cross the placenta, and the baby's immature liver and kidneys take a long time to process them
  • may increase the likelihood that the child develops addictive or self-destructive behavior patterns later in life.
Most recent page update: 11/16/2012


© 2014 National Partnership for Women & Families. All rights reserved.

Founded in 1918, Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families. Together, these two women's health powerhouses are transforming maternity care in the United States.
News and Features
Special Announcement

Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families.
Read more


Our History

This interactive timeline highlights our trailblazing work since 1918.
Launch timeline


Our Vision

We want all women and babies receive the best possible maternity care.
Play video


Featured Resource

Check out our resource, "New Cesarean Prevention Recommendations from Obstetric Leaders:What Pregnant Women Need to Know"
Read more


Get Involved

Read our 2020 Vision, Blueprint for Action, blog and more
Sign up for email updates
Find us on Facebook
Follow us on Twitter
Support us