Sue Ann Kendall expressed concern

>....about something that is going on at a local hospital here.
>They have begun routinely giving c-section mothers something in their
>spinal called "duramorph" (I can't spell it because I have never seen the
>word in print) as they ar being sewn up. Form the "morph" part I assume it
>is some kind of morphine, which is an opiate, right?  I hear that these
>mothers are then totally zonked for the 24 hours immediately following the
>birth, to the extent that they need extra nursing care and can't be allowed
>to room in.

Duramorph is, as you suspected, a type of morphine.  At our institution it is
given through the epidural catheter, just before the catheter is pulled in
the recovery room.  It is long-acting and lasts about 24 hours.  We see a lot
of duramorph use at our hospital, and my take on it is that, instead of being
zonked, the moms feel better, move better, and thus are better able to nurse
their infants than with the use of injectables like demerol.  As there is
very little colostrum ingested in the first 24 hours, I don't think the
babies are in much danger of being sedated.

There are a few possible side effects.  The main one is itching--not an
allergic reaction, but caused by stimulation of the histamine receptors. The
great majority of women do experience itching.  Another, much less common
one, is vomiting.   Both of these may require additional medication, but many
women who get the standard injectables also require meds for nausea.  Very
infrequently, there is respiratory depression, which is possible with any
type of narcotic, of course.

The women who get Duramorph usually don't need much pain med in the first 24
hours--they may take a couple of Tylox once or twice, but that's about it.
 As for extra nursing care, we do check respirations and level of
consciousness every hour, but we rarely find a problem.  Otherwise, these
moms are treated the same as any other woman who delivers by section.

I thnk any mother who has a section is going to find it hard to room in if
she's entirely by herself, whether she has Duramorph or not, as her mobility
is limited by discomfort, her IV line, and her foley catheter. All mothers at
our hospital are allowed to keep the baby with them whenever they feel like
it.  Most of our section moms have a family member with them a good part of
the time in the first 24 hours, so their babies are not in the nursery much
more than babies of moms who deliver vaginally.  (We don't have many moms who
are willing to room-in entirely, no matter how they deliver, although that is
 our policy, and I certainly encourage it.)

Perhaps the drug is given in a higher dose at the hospital Sue mentioned, or
perhaps there's some other factor (if it is given with a spinal instead of an
epidural, for instance), but, from my perspective, I haven't seen a big
problem.   I do think that the sleepy babies are a product of our obstetrical
practices--epidurals in general, the analgesics given during labor, the
practice of taking baby away from mom for the initial exam and bath instead
of putting them skin-to-skin for the first hour or two, and who knows what
else--but I don't think Duramorph is the culprit. I'll certainly be
interested to hear anything to the contrary.

Judy D in WV