Effect of opiates on respiration

The main concern is its effect on respiration. While the depression of respiration on the laboring woman is so mild that it is of little or no concern, the effect on the fetus is a different story. Since these drugs cross the placenta to affect the fetus as well, the newborn may have such marked respiratory depression that he or she may require special help.

The respiratory depressive effect becomes an issue after birth and not while in the womb. However, the general sedative effect on the fetus may have such an effect on the heartbeat to the extent of forcing intervention of some kind. In fact, in most cases, that intervention is later found to have been unnecessary.

Reversing the respiratory depressive effect of opiates on the baby

A narcotic antagonist drug called Naloxone can be injected to reverse the unwanted effects of Diamorphine and other related drugs on the baby. This works quite quickly (in less than 2 minutes) and is safe.

However, while Naloxone is extremely effective in countering the effects of Diamorphine, it is only partially effective in the case of Pethidine, Meptazinol or Pentazodne. Rarely, with these drugs, additional respiratory support may be required for the first few hours to allow the baby's body to completely rid itself of the drug.

Naloxone is also known by the name Narcan or Nalone.

Where use of opiates in labor is unsuitable

It is considered ill-advised to use these opiates such as Diamorphine in a labor where a premature baby is going to be delivered. This is because the immature organs do not process the drug as efficiently and the effect will be marked and longer-lasting on these very fragile babies.

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