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https://journals.lww.com/greenjournal/Fulltext/2020/03000/Are_Peripartum_Stress_Dose_Steroids_Necessary_.5.aspx
Given that labor is a physiologically stressful situation, stress-dose steroids have been used empirically in women on chronic steroids at the time of vaginal or cesarean delivery. Contemporary scientific evidence, however, obtained from other surgical disciplines, does not validate the use of stress-dose steroids in these patients.
http://www.perinatology.com/Reference/OBPharmacopoeia-Public/Corticosteroids,%20systemic.htm
However, initial cortisol values may be higher in women undergoing induction of labor and elective cesarean [11,12]. The timing of these increases in cortisol should be considered if "stress dose" steroids are to be prescribed. Recommended Perioperative Hydrocortisone Glucocorticoid for Patients on Long Term Steroid Treatment [4,5].
https://www.uptodate.com/contents/inflammatory-bowel-disease-and-pregnancy-beyond-the-basics
Women who are taking steroids during pregnancy will need to be given a "stress dose" of steroids by IV (into a vein) during labor and delivery. The increased dose helps the body respond normally to the physical stresses of childbirth. Steroids (eg, prednisone) are compatible for use with breastfeeding.
https://www.womenandinfants.org/for-physicians/upload/StressDosePreOpOrder.pdf
Date Time Stress Dose Steroids for Gynecologic Surgery and Vaginal or Cesarean Delivery (PRE-OPERATIVELY) Nurse Signature Time posted Hypothalamic-Pituitary-Adrenal (HPA) axis suppression ‘unlikely’: • (see reverse)Less than 5mg of prednisone or equivalent per day for any duration.
http://www.uptodate.com/contents/search?search=stress+dose+steroids
…stress such as surgery, the adrenal glands may not respond appropriately. Protocols for "stress dose" steroids followed reports in the 1950s of possible surgery-associated adrenal insufficiency due to…
https://www.ncbi.nlm.nih.gov/pubmed/9759153
Corticosteroid therapy in pregnancy is appropriate to control clinically active maternal illness; to treat an in utero infant suffering from neonatal lupus-associated carditis; in stress doses (in corticosteroid-treated patients) for labor and delivery: and, pre-delivery, to induce fetal lung maturation. PMID: 9759153 [Indexed for MEDLINE]Author: Lockshin, Sammaritano Lr
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