Routine hospital procedures for newborns : You have more choices then you might realize..

I’m sure most women aren’t even aware that they have choices when it comes to what is done to their baby in the hospital after birth.   Most women go blindly into labor and delivery, putting full trust into the doctors and nurses to do what they will.  Who can blame them?!  It’s not like the hospital presents them with any options. It is important to know that most medical procedures done at birth are elective and may be refused if the parents wish.  I am thankful for all of the wonderful hospitals and OB’s out there, but as patients we deserve to understand what the procedures are, know why they are done and then be able to choose for ourselves whether or not they are right for us and our babies.  Every birth and baby is different, so why do they treat them all the same?  Hospitals are well oiled machines and frankly they don’t have time for individualized care, not to mention they are worried about liability in the case of a lawsuit.  It’s easier and less risky for them to just do all of the same preventative procedures to all of the babies, just in case.  Well, I am of the belief that less is more and I didn’t want any procedures done to my baby at birth unless they were absolutely necessary.  That’s why my husband and I did our research and chose what we felt was right for our baby.   In this post, I will break down the five standard procedures in a typical hospital birth, why they are done and what your options are.  I hope that this sparks a conversation between you and your partner about what you feel is best for your baby and that you’ll consider making a birth plan of your own, instead of just handing your baby over to the protocols of the hospital.  It is very empowering to make your own educated decisions and it makes the process a lot less scary when you understand what is being done.

1) Vitamin K- At birth, newborns are routinely given a .5 milligram or 1 milligram shot of Vitamin K.  Vitamin K aids in the clotting of the blood and newborns are not born with a sufficient amount.  The danger in that is if there is some sort of internal injury at birth, the baby’s body may not be able to stop the bleeding and that could result in permanent injury or death.  This happens in 1.8 out of every 100,000 babies born. Now, on the other side of things, extracting data from available literature reveals that there are 1.5 extra cases of leukemia per 100,000 children due to vitamin K injections.  1 milligram is about 200 times the suggested daily amount of Vitamin K for an infant under 6 months.  But there is good news! There is a happy medium, which is what we chose for our son at birth. You can opt for several low dose oral drops that are given over a one to two-week period instead of blasting your baby with such a high dose.  Some people choose to opt out of the shot all together and just eat a diet extremely high in vitamin k rich foods in the weeks leading up to birth, but the evidence in this affecting your baby’s vitamin k levels (although it seems logical) is inadequate.  So talk to your doctor about these options!

2) Eye Drops (tetracycline or erythromycin)- Antibiotic eye drops are put into every newborn baby’s eyes immediately after birth in the hospital.  These drops can temporarily blur your baby’s vision(which many experts speculate may interfere with infant/mother bonding during the crucial first moments after birth), cause burning or redness and in some cases cause clogged tear ducts.  They are administered to prevent infection in the baby’s eyes caused by bacteria in the birth canal from the sexually transmitted diseases Chlamydia, syphilis or gonorrhea. These bacterias can cause blindness in infants. So if a mother has been exposed to these diseases or if her status in unknown, this procedure is a good idea.  Simple tests can be done at the end of your pregnancy to determine whether or not there are any dangerous bacteria present in the birth canal.  Then you can decide whether your baby should receive the ointment at birth or not. Personally, if those diseases are not present, I don’t feel there is a need to do this.

3) PKU (phenylketonuria) Test- The PKU test is done to check whether a newborn baby has the enzyme needed to use phenylalanine in his or her body. Phenylalanine is an amino acid that is needed for normal growth and development. If a baby’s body does not have the enzyme that changes phenylalanine into another amino acid called tyrosine, the phenylalanine level builds up in the baby’s blood and can cause brain damage, seizures, and intellectual disability. We chose to do this test because we felt that the pros outweighed the cons.  The cons only being the pain from the heel stick where the blood is drawn and the emotional trauma that the mom goes through watching the procedure.  Everyone I know, me included, has cried harder than the baby when this procedure is done! Also, be prepared, in some instances the heel may have to get pricked more than once to get enough blood for the test.  My little guy’s blood was clotting so fast that the nurse had to do it 3 times!!  I was hysterically crying by the end of it. Ugh. 

4) Clamping of the umbilical cord- In most hospitals it is standard practice to clamp and cut the umbilical cord almost immediately after the baby is born.  The benefits and possible harms of this procedure are highly debated.  During pregnancy, the baby’s blood circulates in a constant loop in and out of her body. It flows through the body, back into the cord to the placenta, then back through the cord into baby’s body. This pattern of circulation continues until shortly after the birth when the placenta separates from the inside of the uterus.  At any given time, up to 30% of the baby’s blood volume may be in the cord and placenta!  So if clamped immediately, your baby could be prevented from receiving 30% of its blood supply that is rich in stem cells and oxygen.  It is because of this that we decided to wait until the cord stopped pulsating before clamping and cutting it.  It took about 5-10 minutes for us and during that time my son started breathing on his own, but continued receiving blood and oxygen from my placenta.  When it stopped, we cut it and soon after my placenta was born.  When cords are not clamped early, they say that the total blood loss for the mother after delivery is substantially less than when cords are clamped early. This might be because when cords are not clamped, the placenta is allowed to give up its volume of blood to the baby.  It thereby contracts and separates more easily from the uterine wall.  Nature designed a system for insuring a smooth transition from womb life to breathing.  This system is especially useful to the distressed newborn.  Some doctors will not wait long enough for the cord to stop pulsating,  but may wait up to a minute before clamping.  Talk to your doctor about your options on this.

5) Circumcision- This is usually a decision that most women leave to their husbands, and I would guess that a majority of the time the man chooses what ever was done to him.  Well, you (and your man) should know that the table has turned on this topic in the medical world. No national or international medical association recommends routine circumcision anymore and only the US circumcises the majority of newborn boys without medical or religious reason.  That number is now at 55%.  So if you are worried about how your boy will do in the locker room, you can rest assured that he won’t be the odd man out.  For those worried about the son not looking like the dad, I don’t think you are giving your child enough credit.  A simple explanation like “when daddy was a baby the doctors recommended removing some of the skin, but they don’t recommend that anymore and that is why yours looks different” I’m sure would suffice.  In Europe, where only 10% of men are circumcised, it is a growing opinion that circumcision is a barbaric act that should be banned.  I personally feel like if it ain’t broke, don’t fix it.  I just refuse to believe that every man is born with a part of their body that they are not supposed to have.  That said, this is a serious decision that deserves research and discussion.

I hope this post helps you to feel like you can make educated decisions when it comes to your baby at birth. I can’t stress enough the empowerment that is felt from making a decision from an educated place instead of a fear based place.  Knowledge is power!  Hallelujah!

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