SPD, Morphine & Neonatal abstinence syndrome

In both pregnancies I was struck by Symphasis Pubis Dysfunction (SPD) a debilitating, disabling and excruciating problem with the ligaments in the pelvis where they move excessively during pregnancy. My son was born with neonatal abstinence syndrome as I suffered from SPD – I describe my first experience with SPD here.

After tying support belts, physio and crutches my next step was pain relief. This started with paracetamol and was soon upped to cocodamol, then when this was not effective at max doseage I was given oral morphine for breakthrough pain. I questioned the effects on the baby but was advised that there would not be any issues with the baby as it was a relatively small dose and it was being taken for pain relief, rather than if I was taking hard drugs for recreational use..!

It was an exhausting struggle to get to my induction day, by then I couldn’t walk as it felt like my leg was going to rip off (take into account that this is WITH opiate pain killers!!) I was depressed and in agony every single hour of the day and night. Miraculously though my labour was the easiest part of my pregnancy and I really focussed. My midwife happened to be a schoolfriend and once Freddie was born it was she who told me we would need to stay in due to the opiate effects and be monitored.

He was born perfectly and did not need a team to supply oxygen for breathing difficulties which the morphine could have caused.This was my first shock. I knew nothing about this and I suppose I didn’t really take it in.

Getting to know my baby in that newborn bubble, the first 24 hours were fine. He was a perfect newborn. 36 hours in, it was a different scenario. Initially, he started to sneeze, lots. This was the first symptom of withdrawal they looked out for and it hit me in the pit of my stomach. As soon as the cord was cut Freddie would have started to withdraw. I felt SO guilty and heartbroken. He then became extremely fussy with his feeds, he was starving hungry and rooting so much but just couldn’t grasp to suckle, he just couldn’t do it. Then when he did take any milk he was forcefully sick. The neonatal abstinence syndrome was cruel and took no prisoners.

Sadly, things declined very quickly after this, he became so fretful and his cry even changed. He was like a screeching little cat now and nothing would soothe him. It was a constant high pitched cry. The midwives even got me an old pushchair to wheel him round in but it didn’t work. By this point he was really jittery and his startle reflex was extremely heightened. Any loud noises, especially other babies crying, bright lights or loud/fast movements – he just couldn’t tolerate it. The only thing I could do to bring light relief was to alternate between lying in the bed with him doing skin to skin or to swaddle and have him next to me. I remember one lovely, angel of a midwife coming to me at about 4am, I was emotionally drained and so upset, just lying with him by my side in the hospital bed. She put the bed side up and said “this is the safest way for him to be, snuggled up and making him feel you are there so you both get some rest” and put a blanket over me. It makes me well up even now. No judging, no rules, she did what was best for me and Freddie.

He also had a low temperature as part of his withdrawal and so this didn’t help how irritable and fretful he must have felt. I just made sure I kept him warm, close to me and offered regular breast feeds to try and wean him off gently with the remaining amount of opiates in my system.

After about three days he started to really calm down and took feeds beautifully and kept them down. On his fifth observation day they were pleased with him and we could go home!!

I was elated- my biggest worry was that he would be taken to the Neonatal unit and would have to have opiate replacement therapy.

Since that day he hasn’t had any other issues with the N.A.S and has grown beautifully. He put on weight rapidly once we got home and flourished.

The hardest part is the guilt I felt and still feel. It can be very easy to look in and judge (I was even judged on the ward by some of the midwives who presumed I had a hard drug addiction- they never even asked me) “it’s selfish to take those pain killers when having a baby” I feel that myself sometimes – but that’s in the days that I forget just how much pain, horrific, continuous pain I was in. If you have never had SPD I can’t even describe adequately how the pain feels or makes you feel. It’s soul destroying.

I was given two options

  1. To not control the pain and have the cortisol increase causing stress to me and my baby and risk premature labour
  2. To take opiate pain killers to help manage the pain

It seems like an easy choice to make, until you are left with the consequences. I’m so sad Freddie suffered neonatal abstinence syndrome but we dealt with it head on.

If you are currently suffering from SPD, I wish you all the best xx

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