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6814174 tn?1385048960

26wks pregnant and quitting smoking H

Ok so I know that I am a horrible person and really don't need to be told this but my question is this, I am currently 26wks pregnant and am already planning a cesarean as I had to have one my last pregnancy. I am on day two of quitting heroin. I was never a daily user but when I did use I would smoke about a gram in 2-3 days. I know I can quit. I'm prescribed anxiety meds as well as a low dose of oxycodone currently by my OB  so that has been helping me a great deal in kicking my H habit. My baby is perfectly healthy and once my withdrawals are over with I am 100% for sure not going back to drug use. I know I should not have waited this long but I'm doing it now and that's what matters. I need to know though, whether the heroin will still show up in the baby's meconium once he is born even though both the baby and I will be 100% sober and withdrawal free. I'm scared of CPS getting involved and don't want to bring my OB into the mix unless absolutely necessary. Like I said, kicking now is not  a problem for me. I just want to be sure that my son will test negative in 14 wks  when he is born. Thank you all in advance for your help.
14 Responses
480448 tn?1426948538
For starters, it isn't safe to w/d from an opiate, the w/ds can be dangerous to the baby and your pregnancy.  You really need to be 100% honest with your doctor about this.  There is a good chance if tested, even if you quit now, that the baby will test +.  If you DON'T come clean with your doc and he/she finds out, the consequences will be very harsh.  If you're honest with him, it will be much better for you.

Also, you say you take anxiety meds, what do you take, and are they Rx'ed by a doctor?  If you're talking about a benzo, like Ativan or Xanax, those are strongly contraindicated in pregnancy, there is a significant risk for harm to the baby.  Make SURE your OB knows exactly what you're taking and how much.  You need to ensure the safety of your baby.

I wish you the best of luck.  Please do the right thing and talk to your doctor.  He will help you, they're heard it all.
Avatar universal
I agree with Nursegirl 1000%! If your honest your doctor is going to be much more understanding than if you lie and hide it. Best of luck to you and please keep us posted
5392063 tn?1390319154
Any drug infested by mama after week 20 is supposed to show up in baby's meconium. Not all hospitals test me indium without reasonable cause though. If the drug use is in your medical record or if your or baby is acting suspiciously, then there will be a test for sure. But I've heard some hospitals tests all meconium. For the safety of your baby, you should be honest with your OB so that you can withdrawal properly at the right time and all precautions are taken for baby's sake. I know that will be hard to do, but think its for your baby's health. Good luck mama...
6814174 tn?1385048960
Thank you for your advice. To answer one of the questions asked, my OB is the one who has prescribed my clonazapam as well as oxycodone so he does know about those. Im aware of the risk of going through w/d while pregnant but everything I have read said it is safest during the 2/3 trimester which is mostly why I waited so long.
6814174 tn?1385048960
Also my other reason for wanting to do it on my own if possible is because I don't want to be put on methadone or anything else that my baby will have to detox from after birth
480448 tn?1426948538
Have you ever researched the risk for yourself?  I would urge you to read this and then talk to your doc about it:

Pregnancy Risks

Data from several sources raise concerns about the use of Klonopin during pregnancy.
Animal Findings

In three studies in which Klonopin was administered orally to pregnant rabbits at doses of 0.2, 1, 5 or 10 mg/kg/day (low dose approximately 0.2 times the maximum recommended human dose of 20 mg/day for seizure disorders and equivalent to the maximum dose of 4 mg/day for panic disorder, on a mg/m2 basis) during the period of organogenesis, a similar pattern of malformations (cleft palate, open eyelid, fused sternebrae and limb defects) was observed in a low, non-dose-related incidence in exposed litters from all dosage groups. Reductions in maternal weight gain occurred at dosages of 5 mg/kg/day or greater and reduction in embryo-fetal growth occurred in one study at a dosage of 10 mg/kg/day. No adverse maternal or embryo-fetal effects were observed in mice and rats following administration during organogenesis of oral doses up to 15 mg/kg/day or 40 mg/kg/day, respectively (4 and 20 times the maximum recommended human dose of 20 mg/day for seizure disorders and 20 and 100 times the maximum dose of 4 mg/day for panic disorder, respectively, on a mg/m2 basis).
General Concerns and Considerations About Anticonvulsants

Recent reports suggest an association between the use of anticonvulsant drugs by women with epilepsy and an elevated incidence of birth defects in children born to these women. Data are more extensive with respect to diphenylhydantoin and phenobarbital, but these are also the most commonly prescribed anticonvulsants; less systematic or anecdotal reports suggest a possible similar association with the use of all known anticonvulsant drugs.

In children of women treated with drugs for epilepsy, reports suggesting an elevated incidence of birth defects cannot be regarded as adequate to prove a definite cause and effect relationship. There are intrinsic methodologic problems in obtaining adequate data on drug teratogenicity in humans; the possibility also exists that other factors (eg, genetic factors or the epileptic condition itself) may be more important than drug therapy in leading to birth defects. The great majority of mothers on anticonvulsant medication deliver normal infants. It is important to note that anticonvulsant drugs should not be discontinued in patients in whom the drug is administered to prevent seizures because of the strong possibility of precipitating status epilepticus with attendant hypoxia and threat to life. In individual cases where the severity and frequency of the seizure disorder are such that the removal of medication does not pose a serious threat to the patient, discontinuation of the drug may be considered prior to and during pregnancy; however, it cannot be said with any confidence that even mild seizures do not pose some hazards to the developing embryo or fetus.
General Concerns About Benzodiazepines

An increased risk of congenital malformations associated with the use of benzodiazepine drugs has been suggested in several studies.

There may also be non-teratogenic risks associated with the use of benzodiazepines during pregnancy. There have been reports of neonatal flaccidity, respiratory and feeding difficulties, and hypothermia in children born to mothers who have been receiving benzodiazepines late in pregnancy. In addition, children born to mothers receiving benzodiazepines late in pregnancy may be at some risk of experiencing withdrawal symptoms during the postnatal period.
Advice Regarding the Use of Klonopin in Women of Childbearing Potential

In general, the use of Klonopin in women of childbearing potential, and more specifically during known pregnancy, should be considered only when the clinical situation warrants the risk to the fetus.

The specific considerations addressed above regarding the use of anticonvulsants for epilepsy in women of childbearing potential should be weighed in treating or counseling these women.

Because of experience with other members of the benzodiazepine class, Klonopin is assumed to be capable of causing an increased risk of congenital abnormalities when administered to a pregnant woman during the first trimester. Because use of these drugs is rarely a matter of urgency in the treatment of panic disorder, their use during the first trimester should almost always be avoided. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Patients should also be advised that if they become pregnant during therapy or intend to become pregnant, they should communicate with their physician about the desirability of discontinuing the drug.

http://www.drugs.com/pro/klonopin.html

As for the other stuff, it's definitely better if you are honest with your doctor, and let her help you safely come off the heroin.
4113881 tn?1415850276
2011, Volume 22, Number 1
Detection of Prenatal Drug Abuse in Meconium

Ntei Abudu, PhD.

Because it is not recommended to screen all mothers for illicit drug abuse (4, 5), physicians follow set guidelines to identify newborns qualified for drug testing. Among the initial indicators triggering an investigation into prenatal drug abuse are (6):

    the mothers past history (checkups before delivery)
    unexplained premature birth or labor
    low birth weight
    intracranial bleeding
    small head circumference
    newborn signs of withdrawal (seizures, irritability, hypertonia, sneezing, yawning, sweating, GI dysfunction, feeding problems and muscle rigidity).
    mothers with certain diseases such as syphilis, gonorrhea and hepatitis B are also candidates for drug testing
    Self report

If there is sufficient reason to follow up these observations, in conjunction with maternal self report (usually unreliable for fear of losing custody or otherwise guilt), physicians or care providers request a drug test of the newborn, mother, or both, from the medical toxicology laboratory. The most accurate method for detecting prenatal drug abuse is testing of the newborn.

Meconium

Meconium is the fecal material passed by the newborn within the first three days of birth. The color is generally dark-green due to the presence of bile pigmentation. It begins to form between 12 and 16 weeks (second and third trimester) of gestation until birth and therefore it can provide a history of in utero drug exposure

http://www.wardelab.com/22-1.html
4113881 tn?1415850276
It is my understanding that since the Meconium forms between 12 and 16 weeks, its from that point until birth that the baby can be screened for drug use. It is in your best interest to tell your OB whats going on and if you are now clean....ask for constant urine analysis to show that you are and have been clean. Make sure its documented.

Good luck
6814174 tn?1385048960
I'm going to tell him at my next appointment that I am no longer using it and when I was it was very infrequent and request regular drug tests to prove that I am clean. Will this prevent them from taking my baby from me? That is my biggest fear. As for the klonopin, he didn't put me back in it until late in my second trimester because my panic attacks became severe and because since taking me off of it in the first half of pregnancy, he spoke with serveral neonatalogists who kept patients in second trimester and later on it when benefits outweighed the risks and monitored them closely. All had healthy babies but I plan to stop taking that to avoid baby withdrawals also once I get closer to my due date since I'm careful now only to take it if I really need it.
6814174 tn?1385048960
This was helpful. I have no record of previous drug use anywhere on record, I always go to appointments looking professional and well groomed and have given no reason to lead anyone to believe otherwise about me. This doctor has delivered both of my other children so we go way back. I am paying that as long as baby and I are not showing w/d symptoms, there should be no reason to suspect testing is necessary.
Avatar universal
Hi there,

I know what you are going through! I was on a high dose of Tramadol while pregnant and knew I had to quit. I tried both CT and tapering by myself, and was unsuccesful. I knew I HAD to tell my OB for her to help me taper. It is highly important that you not only tell your OB, but you STOP using if you don't want CPS to get involved. I told my OB and she helped me with a taper plan. My OB was not educated at all on Tramadol and the taper plan was too fast for me, so I ended up going to my Family Doc for a slower taper. I gave birth a month early, so I was still on the pills tapering. My OB thought I went behind her back to get more pills (which wasn't the case at all because my Family doc only gave me a certain # to taper, just at a slower rate), she called CPS on me and I had to go through a whole investigation. It as HORRIBLE to have CPS evaluate you as a parent. So please, tell your doc the truth if you do not want to go through that, because if it can happen to me, it can happen to anyone. Not trying to scare you, because I have been there. I am just tying to warn you of a possible bad outcome if you don't tell your doc and keep using. Good luck!
6814174 tn?1385048960
Yeah I'm in the process of quitting on my own if I can so that when I see my doctor in two weeks I can tell him I've been clean all on my own for two weeks and to please drug test me as often as he feels necessary to keep CPS away from the situation. I'm just hoping he is understanding and doesn't call CPS on me anyway. I would die!
Avatar universal
I'm sending prayers your way for you and your baby. Good Luck and God Bless.
6814174 tn?1385048960
Thank you from the bottom of my heart <3
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