Two approaches lowered opioid use after cesarean deliveries

While overprescribing opioids for women after cesarean delivery will probably have little effect on the opioid crisis, reducing prescription rates for these women post partum still has benefits for mother and child, Bankole Johnson, MD, DSc, said in an interview.

“The larger problem is with mothers who are dependent on opiates who get pregnant,” Dr. Johnson said. “These mothers give birth to children who need significant support and weaning off opiates, sometime in the NICU, and the mother also has to be treated by the addiction services. Sometimes, the mother simply abandons the baby who is difficult to nurse and comfort because he or she is weaning off opiates.”

Dr. Johnson said overprescribing has three main implications or risks: a risk of developing dependence in newborn babies that are breastfed, an increased risk of dependence for the mother, and a decrease in nurturing skills and bonding from the mother due to high opioid use.

He said these studies had “notable caveats” and noted there may not be much clinical significance because of the small numeric difference in opioid use.

“The best take-home message from these papers is that individualized care with supportive services decreases opioid use and optimizes the care of mothers and their babies after a cesarean section,” he said.

Dr. Johnson is the Dr. Irving J. Taylor Professor and Chair in the department of psychiatry; professor of both neurology and pharmacology, among others; and director of the Brain Science Research Consortium Unit at the University of Maryland, Baltimore. He had no relevant financial disclosures.