The saga of controversy with my new little job (coordinator of prenatal
education) continues. I haven't changed anything in the programs, but
complaints are surfacing from docs.  Up for grabs--- do all labor drugs get
to the baby? Will they "drug" the baby?---  birth plans and "unreasonable"
patient requests--- parents "determined" to have natural births and who think
that they can make the pain go away and are disillusioned in the experience,
requiring drugs---  need for IV's, and food/drink protocol during birth.

My question for any and all experienced/knowledgeable people in childbirth:
Have we seen any effects of nubane upon babies post-delivery? I have seen
nubane asked about on Lactnet before, but no responses posted.  How about
ITN's (intrathecal nubane)?  We rarely do epidurals, don't do demerol; they
say it is all nubane.  In some of our classes we show the video "Delivery
Self-Attachment" by Righart and Alade, and we use it as a motivational tool
for parents to minimize their use of labor drugs; the anesthesiologist viewed
it and said that he hates it and doesn't agree with it. I don't know
specifically what drugs were in use for that study, but my nursing adm mgr is
challenging the video's applicability to our situation.  PLEASE, I need help
in answering this challenge, either way, and need any references that can be
found. I also need to find a way to address this wherein I don't come across
as caring only about breastfeeding and not the mother, because then I will
lose everyone.

Secondly, I believe in allowing patients to eat during labor, but realize
that this is not well accepted in the medical community. Since I don't teach
the childbirth classes myself, it is a moot point for me, but I am wanting to
answer an issue brought up: Heplocks vs IV. The complaint seems to center
around moms not wanting to have IVs even when they are dehydrated. Nurse
pointed out that in long labors, mothes can dehydrate and end up with low
blood sugar and lack of energy for finish, yet refuse drinks. Well, I can
tell them they'll have to accept drinks OR IV's, and also want to make sure
that they can have more than just water to boost their energy as well as
hydration; to the best of my knowledge, fruit juices are clear liquids and
should be "ok" under the "no foods" protocol. Anyone know of references I can
get hold of quickly? I don't have time to do my clumsy internet search; my
program is on the line and I need to rebut quickly and cleanly.

These aren't directly related to breastfeeding, but then we all know that
birth can affect breastfeeding and mother-infant relationships so
drastically...........

-Lisa Marasco, LLLL, IBCLC
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