My wife sent me this video, and we were both a little upset by it. Newborn Care Immediately After Birth
Let me tell you what bugs me. First off, they’re clamping the cord immediately after birth. That’s just dumb. There’s blood in the placenta that is trying to get into the baby. The uterus is tightening, the cord is pulsing, everything is trying to get that extra, oxygen-rich, nutrient-rich blood into the baby’s tiny body. He doesn’t have much blood to begin with, and depriving him of what blood remains in the cord and the placenta just seems silly. Also, allowing the cord to finish pulsing before clamping and cutting makes delivering the placenta much easier on the mother. For reals, now, what’s the downside? I don’t see any. I just see a very normal, natural process that has been perfected by every other mammal on the planet being screwed up by a modern society that thinks every aspect of our lives isn’t good enough and needs to be poked or prodded or injected with something.
This is my thing. Birth is a natural process. It isn’t necessarily a medical emergency. If a medical emergency presents itself, then emergency medicine is exactly what we need. And I am as thankful as I can be that we have that available. But there are so many procedures we perform upon newborns that really don’t need to be done. There are certainly complications that can arise during birth, and those need to be prepared for and managed, but we don’t need to treat diseases that the infant doesn’t have. Does that make sense? Let me give you some specifics.
Right away in the video, you see the baby with cord clamped, being taken to a table with an overhead warmer to be cleaned up and examined. For one, your baby doesn’t need to be cleaned up. Maybe he can be dried off, but he has something on his skin called vernix. It’s kind of a waxy substance, and it’s on his skin in the womb so he doesn’t get all pruney. It has some antibacterial properties and it’s a great moisturizer for his skin, too. Why would you rub that off with a towel? Babies often have dry skin, and I think this is part of the reason for it. That vernix can be rubbed into his skin like an ointment. That gives him the rubbing that he needs, but the rubbing is done by mom and dad’s loving hands, not a rough towel. That’s another thing. Baby only needs an overhead heat lamp because he’s not allowed to rest on his mother’s chest. If he gets some immediate skin to skin contact with mom, his temperature regulates perfectly. Hearing her breathing and heartbeat through her chest, smelling her, hearing her voice the same way he’s heard it for the past 40 weeks, all of these are good things you don’t get in your rolling baby warming tray.
Okay, after all that, then you hear about the head to toe exam that your baby gets. Here’s my thinking. The nurse can examine the baby just fine while he’s hanging out on mom’s chest. He gets his bonding time. He gets his temperature, breathing and heartrate cues from the skin to skin, and everyone’s happy. I’m thinking that they can do the most important checks on him right away and leave the rest for a few hours. His weight, length, head circumference and footprints aren’t changing in the next 2 hours, so they can get that stuff from him while we’re in the recovery room.
Now, the baby gets a vitamin K shot, a Hep B vaccine and an antibiotic ointment on his eyes. Why does the baby need Vitamin K? Because about 1 in 10,000 babies will have a spontaneous bleed, and the vitamin K helps prevent that. If you’re circumcising within those first few days, then the shot is necessary. If you’re not, then he really doesn’t need it. I just want to think about this from an evolutionary biology perspective. In our world, baby is going to be wrapped up in blankets and carried around and put into child-safe cribs and basically be protected from any possible injury for those first 7-8 days (and probably well beyond that). In our ancestors’ world, that baby would be at a significantly increased risk of minor scrapes and scratches, I think we can agree. If nothing else, they didn’t have emery boards so he’d probably scratch himself with his little nails. So why do we think that millions of years of evolution gave us babies without clotting factors for 7-8 days? My thinking is that if he isn’t born with it, and doesn’t get it from breastmilk, he doesn’t need it in his body in the first few hours of life. That might make me a filthy dirt-worshiping hippie, but whatever. The same thing generally holds true for the Hep B vaccine. I’m going to try to keep my baby away from intravenous drug use and barebacking Haitian prostitutes until he’s at least 6 months old. Since sharing needles and sexual partners is how 99% of people get Hep B, it seems like I should be able to delay that vaccine for at least a little while. Not saying he won’t get it, just that I don’t think he needs it at birth. The antibiotic ointment they put on the baby’s eyes is the one that I think bugs me the most. They put it on all babies, but the reason for it is that babies born to mothers who have gonorrhea/chlamydia can get the infection in their eyes and go blind. That sucks. But you get a lot of blood tests running up to birth, and a test for STDs is in there. If you and your partner are both monogamous and you test negative early on during pregnancy, there’s no reason to put that stuff in their eyes. There’s also a good reason not to, as it keeps the baby from being able to see mom while nursing. The baby can only focus at about a foot away, which is eerily similar to the distance from baby’s face to mom’s face while nursing. You think that’s an accident? Bonding in these first minutes and hours is absolutely essential, and so much is geared toward maximizing that bond. If you don’t have the funk and you put that stuff on the baby’s eyes anyway, you’re losing something valuable for absolutely no reason. That sucks.
Then, they swaddle the baby and then you actually get to hold him. They’ve completely removed the possibility of skin-to-skin contact after birth. It’s insane, but I can’t say I’m surprised. If you learn a bit about the history of birth in America, it’s amazing we’ve gotten as far as we have. There’s still a lot of thinking that’s hanging around from the 50s and 60s, and I’m hoping that it will change as more people start doing research and thinking about how important those first hours are.
Okay, so there’s that stuff. We’re opting out of all of it. We’re going to go for two hours of direct, skin-to-skin contact with Jenna and I after birth. We’re going to rub his vernix into his skin, so there won’t be a bath or a rough toweling. There may be some dabbing with a towel just to dry him off, but he won’t be roughed up. No pricks, pokes or shots. They don’t need to do a genetic screen on him either (we’ll do one at his 2 week pediatric appointment, and his genes won’t change in the meantime), so they don’t need to take blood at birth. He’ll nurse, he’ll sleep, he’ll get to spend a lot of time seeing, hearing, smelling mom and dad, and we’ll get a wonderful chance to bond with our little man. I’m really looking forward to it.
Here’s the thing that bugs me. See if you can spot the similar thread in these. Some people have STDs and some of the babies of those people will get an eye infection. Therefore we treat all babies. Some babies have a spontaneous bleed, so we treat all babies. Some babies are born into homes where newborn intravenous drug use is a thing, therefore we have to vaccinate all babies. Some babies are born into homes where they won’t go to a 2 week pediatric appointment, so we treat all babies as if they won’t. Do you see it? We’re not just being aware that there is a risk for this stuff, or keeping our eyes open for it, or testing for it, or asking questions and basing our recommendation based on medical history, we are actually treating babies for a wide range of issues that will only affect a very tiny portion of the population. An especially tiny portion of the insured, employed, clean cut, attractive young families. I know that’s profiling, but seriously. To avoid profiling, they’re going to inject my baby with stuff, put junk on his eyes, and take his blood at birth? That tells me there’s a problem with our priorities. But you’ve already heard all that from me, I’m sure.
That’s probably enough of my rambling for now. I’ve got a lot more things coming, specifically a post on circumcision. I know you just can’t wait for that one, so I’ll try to get it done sooner rather than later. Thanks for reading!