"The opioids commonly used in childbirth include morphine and remifentanil. Morphine is usually used in the early stages of labor. If used too close to delivery, it can cause temporary breathing and heart rate problems in your baby after birth. Your baby may need help breathing if this happens."
An ob-gyn discusses common pain relief options and how to think about your choices.
www.acog.org
Thanks for the quoted link.
I concur with OP that Morphine Sulfate Injection, (USP is supplied as a sterile solution in single-use Carpuject™ and iSecure™ syringes for intravenous administration) is typical treatment during early labor with warnings to closely observe neonates whose mothers received opioid analgesics during labor for respiratory depression-- especially if administered during later stages of labor.
It appears to me the defense is alleging that AT was receiving a Morphine IV when she told staff about her immediate urge to defecate and requested to get out of bed to go to the restroom.
Defense Attorney Mitchell alleges the Morphine IV is seen in hospital surveillance videos being removed from AT by an attendant as she makes her way out of bed to walk down the hallway to the restroom where she soon after gave birth.
However, what's not clear to me is whether the dosage AT received at hospital was a therapeutic level for late labor, and considered safe for the neonate.
Linked research indicates Morphine syringes specifically for intravenous are supplied in strengths from 2mg/mL, 4mg, 8mg, 10mg, to 15mg/mL with 15mg being the highest.
Attorney Mitchell alleges toxicology for the newborn indicated the baby tested at 14mg/mL but this has not been confirmed.
FDA provides the following about Morphine Sulfate injection label Use in Specific Populations:
8.2 Labor and Delivery
Morphine readily passes into the fetal circulation and may result in respiratory depression and psycho-physiologic effects in neonates. Naloxone and resuscitative equipment should be available for reversal of narcotic-induced respiratory depression in the neonate. In addition, parenteral morphine may reduce the strength, duration and frequency of uterine contractions resulting in prolonged labor. However, this effect is not consistent and may be offset by an increased rate of cervical dilatation, which tends to shorten labor. Closely observe neonates whose mothers received opioid analgesics during labor for signs of respiratory depression.
8.3 Nursing Mothers
[..] see linked data
Other unknowns include any action by AT leading up to her arrival at the hospital that may have placed the neonate at risk and/or contributed to the infant's death -- especially if true AT had been in labor for a couple of days at home.
Nonetheless, I think the defense will have a difficult time excusing AT's behavior if they insist on a defense that the 19 yr old honor student was simply in "shock." -- That and if AT's mother continues to enable the defendant from now until the October trial date where AT's somehow the victim. JMO
Of course, the real tragedy, and what I think most are reacting to, is that the infant was actually exactly where it needed to be to receive any required neonate care including respiratory assistance.
ETA: parenteral morphine means by IV or bypassing the gastrointestinal system, and also may have increased the rate of cervical dilation and/or shortened labor.