Place if woman had significantly long and painful vaginal
a a woman had
delivery with significant pelvic floor trauma
a
a cesarean surgical birth, she may be provided with patient
controlled analgesia using morphine while being maintained
on buprenorphine and then be transitioned to oxycodone-
acetaminophen s/500, one to two tablets every 4 hours (Alto
& OConnor. 2011)
The risk of relapse is greatest during the immediate post
partum period because the motivation to prevent fetal harm
is no longer present. Recommendations for continuation of
buprenorphine maintenance therapy are critical during this
transition women should be monitored closely for postpar
tum depression. particularly if the newborn is hospitalized with
NAS or if child protective services are involved. Women who
decide to breastfeed should be generously supported because
the benefits of maternal attachment are enormous. However,
women who choose to breastfeed a newborn with NAS need a
tremendous amount of lactation support because of challenges
of poor latch. newborn irritability, excessive sucking and poor
suck coordination, all of which require patience, expert advice
and support. In addition, challenges with the newborn at home
an lead to impatience, frustration, poor maternal bonding and
depression (Goodman, 2011)