|photo credit Ginger Horsburgh
You’ve carefully analyzed the multitude of choices available for childbirth. But your job doesn’t end there. After birth, you need to protect your newborn from 5 routine interventions.
PREMATURE CORD CLAMPING
Immediately clamping the cord, sometimes even before the baby’s body is entirely born, became the unquestioned norm in the early part of the century largely due to the infamous Twilight drug. Babies needed to be clamped and protected from exposure as soon as possible after birth to reduce the negative symptoms associated with this drug in their system. That coupled with unfounded beliefs on how the placenta and circulatory system works has led to immediate clamping being one of the longest standing unnecessary interventions in obstetrics. Until now. Researchers are finally looking twice at this practice and urging medical providers to change their ways.Clamping the cord prematurely shocks the newborn during a critical time of transition and deprives the newborn of a large portion of blood, including vital stem cells and iron stores.
What to do instead? Request that the cord remain intact for at least 1-2 minutes or until it stops pulsating. This also gives you the opportunity to bring your baby to your chest for immediate bonding. Is your care provider skeptical? This link provides study written by an OB.
Actually, studies involving preterm babies and cord clamping show the strongest evidence FOR delayed clamping.
C-section with general anesthesia
This situation is the one most likely to need immediate cord clamping to prevent additional drug transfer to the baby.
Newborns needing intervention after birth
Many hospitals are set up so that they need to immediately clamp the cord to move the baby for intervention. If you foresee interventions required at birth, look for hospitals with mobile carts or other accommodations.
Cord blood banking
It might be difficult, but some health providers know how to work with you so that you can delay as much as possible but still obtain enough of a blood sample to bank. Dr. Brian Gosser, a St. Louis OBGYN, notes that he can milk the placenta to obtain the volume required.
VITAMIN K INJECTION
High doses of synthetic Vitamin K are routinely injected immediately after birth. For babies with a rare hemorrhagic disease, early administration of very high doses of this vitamin might help them. But this routine practice comes with controversy such as conflicting studies on association with leukemia and a concern about preservatives in the shot.
What to do instead?
Assess your newborn’s individual risk. Traumatic birth and surgery after birth are both risk factors that could make this intervention necessary. Oral administration is an alternative, but is often discouraged because it requires two doses and providers fear the parents won’t administer the second dose later on, leading to increased hemorrhagic disease rates.
If you do choose the oral option, you will most likely need to purchase and bring your own since American hospitals are not equipped with it. Otherwise the contents of the shot will just be squeezed into the newborn’s mouth.
Most, but not all states have exemption processes for this intervention.
NEWBORN OCULAR PROPHYLAXIS
Dripping antibiotics into the newborn’s eyes right after birth is another common intervention for Americans. But, do you know the reason for this intervention? The drops are to protect against untreated chlamydia or gonorrhea. In other words, after all the prenatal testing and questioning, this intervention covers those situations where the parents might be lying about or hiding their STD status.
What to do instead?
Obviously, those without a disease don’t need this intervention. If you’re unsure about your status or your partner’s status, you can request testing and/or treatment. And if you do consent to this intervention, you can still delay it until later after birth, protecting the “Golden First Hour” after birth where the baby makes eye contact and per-orms the breast crawl. Here are a few studies on the topic.
THE FIRST BATH
Parents might look forward to this milestone, but when performed in the hospital immediately after birth it strips the newborn of vital vernix protection and separates the newborn from the parents during this important time. Hospitals will usually place great pressure on the parents to bathe the newborn after birth because otherwise the staff is required to wear gloves when handling the newborn.
Before accommodating these employees at their convenience, take time to learn more about vernix and why to delay the first bath.
What to do instead?
Birth is admittedly messy so if you feel your newborn has too much meconium or blood to handle, consid-er spot cleaning those areas with a warm, soft wash loth. If you’ve decided a newborn bath is necessary sooner rather than later, request the supplies to bathe your newborn yourself in your room so that you can do so gently and peacefully.
As with immediate cord clamping, this routine surgery was twisted up in the early part of the century. Obstetricians would immediately perform this surgery, hoping to “shock” the newborn out of the adverse reactions from the overuse of drugs on the laboring mom. This surgery also became popular in an attempt to reduce sexual feeling in boys, feeding the Puritan movement to abolish masturbation.
Over the years, a multitude of myths cropped up to convince parents to give into this medically unnecessary surgery, which even today is not backed by any medical organization in the world.
What to do instead?
Bring your baby home with all his body parts. Research normal care of the penis to avoid common pitfalls such as forceful retraction. You can begin to learn more about circumcision here.
Where the urethral opening is not in the normal area at the tip of the penis, sometimes requires surgery. Research carefully as not all cases require surgery and certainly not in the newborn period. Circumcision is also not a necessary component of correcting this birth defect.
What really needs to be emphasized here is that no matter what interventions are necessary after birth,they should all be administered with full consent, performed respectfully and in a way that supports the vital bonding time following birth. A respectful, necessary and consensual intervention is something you and your baby absolutely have the right to expect from any care provider no matter where or how you birth.
Guggie Daly, while transitioning from the field of neuroscience to mother of four, hopes to share relevant, up-to-date information with other parents so that they can take advan-tage of foresight and not live with hindsight.You can find more information on her blog at http://guggiedaly.blogspot.com and her Facebook: Facebook.com/Guggiedaily.