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Text Alternative of Video: Opioid Use During Pregnancy

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To view the original video, please go to https://www.nichd.nih.gov/news/releases/Pages/060917-opioid.aspx.

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NIH/Eunice Kennedy ShriverNational Institute of Child Health and Human Development logo

Research for a Lifetime
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What factors have contributed to the rise of opioid use in the United States?
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A woman is sitting on the floor, opening a bottle of pills and emptying some into her hand.
Dr. Uma M. Reddy: What happened in the 1990s, that’s really when the root of this current problem started.
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UMA M. REDDY M.D. NICHD Pregnancy and Perinatology Branch
Dr. Reddy: First of all, physicians were being told that we’re ignoring pain. That pain is the sixth vital sign.
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A pregnant woman is reclined in a hospital bed and talking to her doctor (female). The doctor is filling out a chart.
Dr. Reddy: So, we started asking everyone about their pain, and rating it from a scale from zero to ten.
Camera view of Dr. ReddyDr. Reddy: And then really...
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White pills are dispensed into clear bottles.
Dr. Reddy: ... the prescription of pain medications in general, a much more liberal use of pain medications.
Camera view of Dr. ReddyDr. Reddy: And so, I think it was a combination of physicians but also patients.
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Blue pills are counted and moved around on a tray.
Dr. Reddy: Patients also did not understand that these medications are addictive.
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Can you give an example of how opioid use affects women during or after pregnancy?
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Camera view of Dr. ReddyDr. Reddy: So, C-section is the most common surgery in the United States. Thirty-two percent of women deliver by C-section. And it turns out, when we prescribe, we typically prescribe short-term narcotics to help women get through the pain after a C-section. 
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Stock image of white pills next to a prescription pill bottle lying on its side.
Dr. Reddy: But ninety-three percent of women have leftover pain medication. They don’t even know how to dispose of it, so it’s left around.
Camera view of Dr. ReddyDr. Reddy: And then what was really shocking was that 1 out of 300 women... 
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Stock image of white pills in front of a prescription pill bottle.
Dr. Reddy: ... after a C-section become persistent opioid users.
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How does opioid abuse in pregnancy affect the newborn?
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Stock image of a newborn infant sleeping in an incubator.
Dr. Reddy: Every thirty minutes, there’s a baby being born to a woman...
Camera view of Dr. ReddyDr. Reddy: ... who’s used opioids and is having a withdrawal syndrome, neonatal abstinence syndrome.
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A baby’s hand grasping an adult’s finger, as the baby sucks his or her thumb in the background.
Dr. Reddy: And what happens is, once the baby is born...
Camera view of Dr. ReddyDr. Reddy: ... it’s not receiving through the mother, the constant dose of opioids. So, the baby undergoes a withdrawal. So, you have tremors and hyperactivity of the central nervous system.
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Zoomed view of the kicking feet of a newborn in the hospital. There is an ID tag on the baby’s foot.
Dr. Reddy: So, these babies need to be treated, basically, because they’re withdrawing.
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What was the goal of the NICHD workshop?
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Camera view of Dr. ReddyDr. Reddy: So, we brought these people together to really understand, what do we need to do, in terms of research, to be able to combat this crisis.
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A pregnant woman is sitting in an exam room, and her blood pressure is being taken by a nurse (female).
Dr. Reddy: First of all, with screening.
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A female patient and doctor are having a discussion.
Dr. Reddy: We don’t screen women, we don’t even ask them. But everybody at the workshop agreed...
Camera view of Dr. ReddyDr. Reddy: ... we should ask women, in a non-judgement way. Explain to them that we ask all women about this, just like with alcohol, cigarettes. It’s a routine part of prenatal care.
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A baby is lying down, and a doctor is examining the baby’s chest with a stethoscope.
Dr. Reddy: And then we talked about neonatal abstinence syndrome.
Camera view of Dr. ReddyDr. Reddy: And really, even neonatal abstinence syndrome, there are six different scales. It’s very difficult to really treat these babies well.
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Stock image of a newborn sleeping in an incubator.
Dr. Reddy: And, we have very little data on how these children do...
Camera view of Dr. ReddyDr. Reddy: ...exposed to opioids in utero. So, we had a lot to talk about at the workshop. So, we identified a lot of gaps.
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(Edit/effect) NIH/Eunice Kennedy ShriverNational Institute of Child Health and Human Development logo appears against a black screen.
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