美国国家公共电台 NPR Childbirth In The Age Of Addiction: New Mom Worries About Maintaining Her Sobriety

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SCOTT SIMON, HOST:

It's common to use opioids during childbirth. They're administered in epidurals and during C-sections. Women are often sent home with a bottle of pills. For most women, it doesn't become a problem. But for mothers recovering from addiction¹, a pain-free childbirth isn't so simple. April Dembosky from member station KQED explains.

APRIL DEMBOSKY, BYLINE²: Nicole Veum says when she was in her early 20s, she made a lot of mistakes.

NICOLE VEUM: I was really sad, and I didn't want to feel my feelings. And I turned to the most natural way I could find to cover that all up and started using drugs.

DEMBOSKY: She got into opioids.

VEUM: Prescription³ pills, heroin⁴ for a little bit of time.

DEMBOSKY: Her family got her into treatment. Nicole had been sober for nine years when she and her husband decided⁵ to have a baby. This was something she wanted to feel. She told her doctor if she needed an epidural, she didn't want any fentanyl in it. She didn't want to feel high.

VEUM: Because I'd remembered seeing, like, other friends and stuff. They'd used it, and they were feeling good and stuff. And I didn't want that to be a part of my story.

DEMBOSKY: Epidurals are usually a mix of two types of medications - a numbing⁶ agent and a painkiller⁷, usually fentanyl. But addiction expert Dr. Kelly Pfeifer says it's easy to formulate⁸ one without the fentanyl.

KELLY PFEIFER: There's no medical reason why someone should be forced to be exposed to opioids if they don't want to.

DEMBOSKY: Pfeifer says there's another issue for women who are in active treatment for opioid addiction and taking methadone or suboxone. Some other narcotics⁹ commonly used for pain during labor¹⁰ can immediately reverse the effects of those treatments.

PFEIFER: And suddenly, you're in the middle of labor, which is already painful, and now you're in the middle of the worst withdrawal¹¹ of your life.

(SOUNDBITE OF RADIO CHATTER)

UNIDENTIFIED PERSON: Control 2, Battalion¹² 7's responding to Sutter Hospital area.

DEMBOSKY: For Nicole Veum, it was the worst wildfire in California history that interrupted her birth plan.

VEUM: There was a ton of smoke in the hospital. Like, you could visibly see it outside and smell it.

DEMBOSKY: She was in active labor when nurses said everybody had to evacuate¹³. Veum was transferred to another hospital 5 miles away, and the special instructions for her epidural got lost in the chaos¹⁴.

VEUM: And then when I - when they went to change the drug, I saw the tube said fentanyl on it. And by that point, I was starting to feel the itchies (ph).

DEMBOSKY: One of her familiar signs of starting to get high. Then, Veum needed a C-section, and doctors sent her home afterward¹⁵ with a bottle of Percocet, another opioid. Expert Kelly Pfeifer says in a situation like this, ibuprofen would've been fine.

PFEIFER: Any parent will tell you there's nothing more stressful than the first week of being a parent and having a baby and being in sleep deprivation¹⁶. And here, you have a little bottle of Vicodin that you use to turn to make you feel better when you're stressed.

DEMBOSKY: First, the fires, then the fentanyl in her epidural, then the Percocet - it was Veum's first test, seeing how her sobriety and motherhood would line up.

VEUM: I was OK. I was OK with it. It was just - it just was something that had happened.

DEMBOSKY: She called a friend who's also in recovery and talked it all through. She said the Percocet could've sent her down a rabbit hole, but it didn't. She was fine leaving that behind.

(SOUNDBITE OF CHILD'S TOY)

VEUM: You know, a lot of people metaphorically¹⁷ felt it as the baby coming out of the ash - you know, the life coming from the ashes and stuff. And I feel that. I feel like it was a big time for our community and me, personally, to be reborn in some way, you know?

ADRIAN VEUM: (Babbling).

DEMBOSKY: She says taking care of Adrian this past year has taught her how to take care of herself. For NPR News, I'm April Dembosky in Santa Rosa.

(SOUNDBITE OF DAVID CROSBY SONG, "BALANCED ON A PIN")

SIMON: And this story is part of a reporting partnership¹⁸ between NPR, KQED and Kaiser Health News.