Having a baby is a unique experience to each and every mother. Whether one has a plan for labor and delivery, a dream of bonding with the newborn immediately after birth, or snuggling up with the new family in the days that follow in the hospital, each experience is as unique as the new mother and baby.
That being said, procedures followed for the care of newborns in a hospital environment are largely the same. Regimented, sometimes even antiquated newborn care is implemented in hospitals all around the world, even right here in the old USA. According to Mother Rising, a holistic pregnancy blog, the first hour of life is an extremely sensitive time, and should remain largely undisturbed by medical interventions. Of course, they do specify that they are speaking about "normal and healthy" mothers and newborns that do not require immediate emergency care following complications during labor or delivery.
Why is this relevant? Well, the fact is, that if you do not specify that there are certain things for which you do not give your parental consent, doctors and nurses can go ahead and follow their own procedures, and have your sweet smelling, brand new bundle of joy in a situation that you would prefer to avoid.
Over the following pages, we will discuss some of the areas in which a new parent needs to step up and take notice. An informed parent is a prepared parent.
20 Slather The Baby In Gooey Ointment
According to MothersRising.com, although the use of antibiotic eye ointment in newborns is standard procedure, in most cases, it is absolutely unnecessary. The purpose of the ointment is to protect the newborn's eyes from contracting certain STD's during birth. If mom has tested negative for these problems, there is truly no urgent need to slather baby up in that gooey ointment.
If however, there is any doubt about the mother's known exposure, MothersRising goes on to say that it would not be unwise to go ahead with the treatment just to be on the safe side. Of course when in doubt, always ask your doctor for their reasons for recommending a certain treatment, and then make up your own mind.
19 Bulb Suctioning
According to The Journal of Family Practice, there is no benefit to suctioning newborns at birth. In fact, they go on to say, it could actually do more harm than good. If a newborn is healthy and has been delivered from the clear amniotic fluid without the presence of meconium, guidelines from The Neonatal Resuscitation Program (NRP), recommend against using this procedure on your new little bundle of joy.
Of course, each medical team has their own beliefs, and it would benefit each new mom-to-be to discuss these before the moment of birth draws near. The NRP also suggests that wiping the newborn's mouth and nose with a towel is a feasible alternative to suctioning. In fact, they go on to say that newborns who have been wiped with a towel often have higher APGAR scores than those that have been suctioned. Something to consider.
18 The Baby's First Bath
According to Today's Parent, there are some reasons that you may want to wait to have your newborn bathed as part of standard procedure. The waxy coating on newborns is a natural moisturizer and cleanser, and is designed to protect the newborn from infection, so why wash it off immediately? In addition, Today's Parent goes on to remind us that babies are not yet good at regulating their body temperatures, and a bath may hinder this process even more.
"Babies are not born very dirty", says Michael Farmer, head of The Department of Family Practice at BC Women's Hospital. He goes on to say that there is no urgent need to have the baby bathed, and the process can absolutely be delayed at the parents' request. Rubbing the baby with a clean towel is more than sufficient to remove any undesirables that are leftover from delivery.
In an article written by Deborah Batic of The Globe and Mail, whether or not to swaddle a newborn is the new parental question. She compares the urgency of this new debate to that of breast vs. bottle, and crib vs. co-sleeping. Although it is commonplace in most hospitals, this is indeed something that you can revoke consent for if you see fit.
"Really, parents shouldn't be doing this", said Maureen Luther, a pediatric physiotherapist at Sunnybrook Health Sciences Center in Toronto. "Swaddling is really not that beneficial". That being said, The Globe and Mail goes on to say that not only is it not beneficial, but may even be harmful to your precious baby.
As with all parental decisions, do your homework, ask questions, and come to your own conclusions when it is time to care for your brand new baby.
16 Baby Hat
According to MotherRisingBirth.com, putting a hat on a newborn baby's head may actually interfere with mommy/baby bonding. They go on to suggest that the reasoning behind the need for these hats is to protect your brand new bundle of joy from breezes, etc. in the environment.
However, this author goes on to say that it is ok (and should not only be requested but expected) for the birthing environment to meet the needs of the baby. There should be no need to add extra items (barriers if you will) between mother and child.
Everybody involved in the birthing process should be considered in the environmental variables contained in the room. If this is done, there should be no need for immediately "protecting" the baby from the big bad world that they just entered.
15 The APGAR Test
APGAR testing has become routine in most American hospitals. However, although these tests are now referred to as, "mandatory" that is not truly the case. According to FamilyDoctor.org, APGAR testing may be refused, and the reasons need only be stated to your doctor. If this is not arranged before the birth of your little one, however, it may be more difficult to wiggle out of, as this test begins moments after birth, when Mom is still pretty well busy with other issues.
In any case, if you do object to this process, it is best to discuss the pros and cons with your medical team before the big day arrives. If your doctor is a good listener, you should be able to communicate your desires and concerns without much issue.
14 Immediate Cord Cut And Clamp
In a story covered by CBS News, they suggest that moms and dads wait a bit longer before cutting the umbilical cord. CBS News goes on to say that, "Keeping the umbilical cord of a newborn intact a little longer may lead to better health benefits for the baby."
The reasons for this are plentiful, but to name just a few, the cord delivers air and nutrients directly from the mother, into the baby's blood. This process continues until the cord eventually stops pulsating. Why stop these valuable commodities prematurely?
Standard procedure is to immediately cut and clamp the cord right after birth, however, it is certainly something that can be discussed in a parental birth plan, or even at some point during mom's labor and delivery. Once again, just because it is "standard procedure" does not mean that you cannot have a say if you have a differing opinion.
13 IV Lines
Of course, none of us want to think about the possibility that something could go wrong during our labor and delivery. Everybody wants everything to go completely according to the best laid plan. Unfortunately, that is not always the case.
In an emergency situation, doctors are authorized to treat without "informed consent". This means that not only do they not require your permission before proceeding, in a true emergency, they may not even have the time or inclination to tell you exactly what they are doing!
According to Babble.com, consent forms are usually a standard procedure in hospital admittance. However, it is at that time that you may choose to cross things off or change the wording. You decided who and what you give your permission to.
Once again, of course, the hope is that all will be perfectly fine, normal, and healthy in the first few hours following labor and delivery. If an emergency does arise, however, the medical staff will make quick decisions on behalf of you and your child. Basically, according to Babble.com, they will act first, and explain later.
Would we want it any other way? Honestly, I don't think there is an honest way to answer that question. Obviously, if the baby is suffering from some sort of emergency situation, effective and quick care is not only required but welcomed.
The slippery slope comes in if there is time to go one direction versus another. In your birth plan and hospital consent forms, be as clear as you can about your desire to be involved in each and every decision regarding your brand new bundle of joy.
11 Taking A Sample
"Required" blood tests are varied across the world, and each hospital may have a different list of recommended analysis for individual babies. Risk factors for both Mom and baby often come into play when the medical team is deciding which tests to run. Most permission is asked as a blanket statement. If you want to know the specifics, be sure to ask your pediatrician which tests they will be ordering.
Another issue with your baby's blood sample could relate to research and data collection. According to The Washington Post, "Newborn blood samples have recently been found to be used for research without parental consent." This, of course, does not sit well with many parents, and will likely be a featured story in the pregnancy world for some time to come.
10 Taking Measurements
According to an article on LiveRenewed.com, many times babies are not necessarily treated the way that we would like them to be during "standard procedures" such as weighing and measuring.
This author's experience with her sister certainly made her point crystal clear. Apparently, when the nurse decided to whisk the baby out of his mama's loving arms, she took him to a little table and left him there to cry while she went and gathered the necessary supplies. When questioned, the nurse simply replied, "It's good for the baby to cry and get some air in his lungs." Seriously?
The mom was understandably upset and decided then and there that any other "procedures" were to be done with her immediate consent in the moment. No more willy-nilly for her precious little baby.
9 Taking The Baby To The Nursery
Contrary to popular belief, allowing hospital staff to remove your baby from your sight and whisk them away to the nursery is definitely not mandatory. I was (and still am...lol) a mom that wanted to keep my eyes on everything that was being done to my precious little one. Not only did I include my wishes in my birth plan, but I also informed doctors and nurses that this was how I wanted things as well.
In fact, for whatever reason, even after you make it clear that you do not wish to utilize the nursery, they will still keep trying. I even had to lie to a nurse to tell her I was feeding the baby when we were both actually sleeping. LOL. She wanted to take her to the nursery to let me rest, but I was not interested.
In any case, use your own judgment, just know that you have an important say.
8 Giving The Baby A Pacifier
Okay, this is kind of a challenging one to navigate if you do allow your baby to be taken to the nursery. Personally, I was a breastfeeding mama, so I did not want either of my babies to be exposed to a pacifier until we learned what the heck we were doing with our feedings.
HOWEVER...my son (first born) was taken to the NICU for an hour of observations immediately after birth (he was late, so they were worried about meconium), and when they brought my beautiful boy back to me, guess what was in his mouth??? YEP!! A little paci from the NICU, and he was thoroughly enjoying it!!! LOL.
According to WhatToExpect.com, moms should ask that a little note be placed on the child's bed name tag if you do not want a paci to be given. The irony in all of this? During that same hour that they had my son, I had my first consult with a lactation specialist who told me to avoid giving a paci until he learned to latch on correctly. DUH!!
Antibiotics have become a hot and debatable topic in the world of parenthood. Of course, we all know that sometimes the are necessary to help our sweet little ones fight off an infection. The school of thought these days, however, is that less is more. Antibiotics can actually reduce a baby's ability to fight off future infections if they are overused.
Why then, according to ChildrensMD.org, are they sometimes given without parental consent, in the hospital, as a preventative treatment? Not to fight an infection that is there, but to fight an infection that may or may not occur?
Once again from my own experience with my son, his one hour in the NICU brought about an IV full of antibiotics that I had no knowledge of until I was wheeled in to see him. Did he have an infection? No!! He was in there for "observation" only. It was apparently standard procedure for potential meconium inhalation (which he did not have). Ugh.
6 Sugar Water During The Snip
Obviously, the decision on whether or not to circumcise your little darling is a personal choice, and is completely up to you. Parental consent is 100 percent required in order for this procedure to be ordered by your physician. However, what happens during the procedure is not always on that ever growing list of items that should need to be parent approved.
According to KitchenStewardship.com, doctors and nurses are allowed to dose your precious baby with a bit of pure sugar water, in hopes of dulling the pain a bit. Sounds innocent enough, but if you are concerned with the introduction of pure sugar into your innocent little baby's guy, which may cause bad bacteria to flourish, you may not want this to be administered to your little guy.
Just a little food for thought. Stay informed on everything.
5 The Vitamin K Shot
The Vitamin K injection is also part of the "standard procedure" package is hospitals these days. Although it can certainly be a lifesaver if your baby happens to be among the two percent of newborns that develop a bleeding disorder shortly after birth, it is still something that parents should have the right to decline if they see fit.
According to ChildrensMD.org, declining the vitamin k shot can be catastrophic to the newborn, and may even allow uncontrolled bleeding to go into their little brains. For this reason, they recommend that parents do not decline this shot, although they do say it can be delayed for the baby's first hour of life to allow for bonding between mama and baby.
4 Hepatitis B Vaccine
Yes, doctors absolutely DO need parental consent in order to give your precious baby a Hepatitis vaccination, but many times parents have not educated themselves on the many ins and outs of hospital procedures before they are in the middle of their new baby whirlwind. By the time the nurse hands you a big stack of papers and a pen to sign your life away, it is too late to make an educated decision.
According to ChildrensMD.org, the time to get educated is while you are still pregnant. There is nothing wrong with choosing a pediatrician, and even scheduling an appointment or two with them before the grand entrance of your little one draws near.
There's a lot to know, and there is absolutely no reason to knowingly keep yourself in the dark until it is go time.
3 PKU Test
According to Mothering.com, an informed consent form can be obtained to refuse the ever so standard PKU test that is usually given on your child's first day of life. The test includes a painful poke in the tiny little heel of your precious one, they "stamp" the blood across a few different pieces of paper, and then send the samples on to the lab for testing. Mothering.com goes on to say that the site of the heel poke can then be a place for infection, and it is perfectly fine to do your research before giving consent for this test.
You will need to be specific in telling the staff (in writing) that you are refusing the test because if you do not, the test will go along as part of the standard operating procedure for your baby. As with many things in parenthood, there are usually pros and cons to everything.
2 Hearing And Vision Screening
Ah yes...hearing and vision screening for baby. Hmm. Well, I have to say that for my own babies, I refused both of these tests. It seemed to me that is would be a silly waste of time, and another moment that they wanted to whisk my baby away into another room while I was left to wait impatiently.
Once again, mamas, do your research and listen to your gut. If you do not want the hospital staff to poke and prod at your precious bundle every ten seconds, it's perfectly understandable. Keep in mind, however, that standard procedure is standard procedure, and many, if not even most new parents are more inclined to just go with the flow.
It is definitely to your benefit to be fully informed before the madness even begins. Going one step at a time is okay too, but believe me, the days following labor and delivery are kind of hectic.
1 Skin To Skin Contact
Many studies have suggested that the first hour of mother and baby bonding is important on several levels. MotherRisingBirth.com says that "Benefits of an undisturbed first hour are temperature regulation, breathing regulation, and better blood glucose readings." Bottom line? Babies do better when they are left alone with their mamas for a little while. There is no reason that it is necessary to start the frenzy of tests and measurements immediately after a child is born.
Motherrisingbirth.com also says that although some of the testings may indeed be important, most of the time a healthy mother and baby can push those times back a bit, allowing for that very important first hour of bonding. Without your insistence, however, this time will not be given. You must be clear on your desired protocol, or standard procedure will be followed.
References: MothersRising.com, The Journal of Family Practice, Today's Parent, The Globe and Mail, MothersRisingBirth.com, FamilyDoctor.org, CBS News, WhatToExpect.com, Babble.com, LiveRenewed.com, ChidrensMD.org, KitchenStewardship.com, Mothering.com