Your Options Explained
Oftentimes, people will put so much work and research into labor. They consider their options and the risks and benefits of the recommendations they are given. They eventually become comfortable leading conversations regarding their care and even become really good at saying "No." However, it seems like all those skills disappear when it comes to deciding what newborn procedures they agree to.
Just like labor/pregnancy interventions, newborn procedures are all YOUR choice, and whether or not something seems mandatory, it's totally up to you. But be prepared for some pushback from your medical team or be asked to sign a waiver if you decline. I've seen many hospitals not give parents any trouble for declining certain newborn procedures. You may also choose to delay any of these procedures. Here are the ones you can expect at the hospital:
Eye Drops (Erythromycin)
Erythromycin is the name of the ointment that is placed in a newborn's eyes to prevent ophthalmia neonatorum (neonatal conjunctivitis). Your baby is at greater risk if you have STDs. Even if the baby got it, it's still treatable. In fact, breastmilk drops do wonders for babies with pink eye! This is the procedure that most of my clients decline. Read Evidence Based Birth on eye drops. Vitamin K Shot This shot helps prevent a very rare but serious blood clotting issue. People who are against it are worried about the ingredients/toxins in the shot and the "black box warning." Sara Wickham has a short read on this shot but if you want some extensive reading, look into EBB's article. If you are planning for a circumcision, it might be hard to find a provider willing to perform the procedure without this shot due to the risk of blood loss. However, you might find a few local providers who don't require the shot. Routine Suctioning This procedure involves the use of a soft-tipped bulb to remove excess fluid and mucus from the baby's nose and mouth. It's relatively benign but could cause the baby to become worked up and not latch. It could also result in minor injury to the nasal cavity if done very forcefully. Babies typically remove these fluids by coughing, sneezing, crying, or spitting up. The WHO recommends no suction if the baby is born in clear amniotic fluid. If the baby is struggling to breathe after a minute or so after birth, or meconium is present in the amniotic fluid, suctioning is recommended. Heel Prick/PKU This test requires just a few drops of blood from your baby's heel to detect certain disorders. Personally, I believe the pros outweigh the cons. Depending on your state, this test can be "mandatory." To help the baby feel as comfortable as possible, you can request this be done while the baby is feeding or being held on your chest. Hepatitis B Shot Hep B is a contagious liver disease. Contact with infected blood is the most common way to get it. Infection could range from very mild to very serious. Parents who opt out feel the risk of the baby coming in contact with an infected person's bodily fluid is very slim. Read here for more info on this disease and the risks and benefits of the shot. Cord Clamping Most hospitals wait 1-2 minutes before clamping the cord but I'd recommend a more accurate sign that your baby has received all of their cord blood. And that means waiting until the cord is white and limp. Be sure you are specific with your provider about what delayed cord clamping means to you. I've seen home births where the cord stays attached to the placenta and unclamped for almost two hours but in a hospital setting, it's done as soon as possible. How long you wait to clamp depends on what you prefer but be prepared to get some questions from your provider if you choose to clamp AFTER the placenta has been delivered, although there's no risk to waiting. It's just a bit unconventional and inconvenient for hospital providers. Obviously, if there is any complication, the cord might need to be cut sooner than expected. Mama Natural has a great article on delayed cord clamping. Wipe Down This procedure is so quick and standard that parents may not notice it and nurses almost reflexively do it. The reason they wipe the baby down with a towel or blanket is to stimulate the baby to cry or breathe to ensure he's adapting well to his new environment. They may also be trying to remove blood, stool, or the protective white coating on their skin called vernix to present you with a "clean" baby. In my experience as a home birth doula, this wipe-down is not standard nor necessary. The midwife simply places the newborn on the mom's chest and allows him through his own efforts to breathe and become alert. Not all babies need to be born crying and active, some are just more calm. If the baby is breathing well and has good a good APGAR score, stimulation is not needed. There are many reasons why the vernix is beneficial. Circumcision This procedure is a hot topic and it carries more risks than benefits. Even ethicists have chimed in on the topic, as it involves much more than being a "medical procedure." I suggest you get cozy and settle in for this long but detailed article from Evidence Based Birth. Comments are closed.
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