Natural Birth

eye ointment/vitamin k

Hi ladies! I am planning to have a natural birth in the hospital and I was feeling pretty confident about everything, until I went to childbirth class this weekend. The nurse mentioned how antiseptic eye ointment and the vitamin K shot are state mandated in Pennsylvania, and how it might be difficult to opt out of them. I don't have STDs and I am not convinced that vitamin K is necessary, so I was hoping to opt out of both. I had already asked my OB about this a couple months ago, and she told me it was a conversation I would have to have with the pediatrician. However, when I looked up declining state mandated procedures, I came across something that said Child Protective Services could be called if I decline these two things. Obviously I am not willing to risk that and if that is truly the case I will just take the ointment and vitamin K, but it annoys me that I don't have the final say on this as the parent. Did any of you have trouble declining these things? I was planning on putting it in my birth plan, but I want to make sure I don't have to do more than that. One site said something about signing the birth plan in front of a Notary? I'm not sure what that means. Thanks!
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Re: eye ointment/vitamin k

  • *LrCg**LrCg*
    1000 Comments Fifth Anniversary 250 Love Its Name Dropper
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    My 2nd was born at a hospital and I declined everything: eye ointment, vitamin K, rub down after birth (and bath), hearing test, hep B vac, etc.  Eye ointment, vitamn K and hearing test are all required in my state.  I never had to sign a thing, it was no big deal, I just said don't do it.  I'm assuming it must be a lot like vaccines in schools- they say they are required but they aren't type of thing- if you don't vaccinate you just send in a slip (which a lot of people don't realize). 
  • I'm in CA so things might be different from a legal standpoint, but I'm refusing both.  Unless it's a boy (we're team green) - in that case we'll get the vitamin K because we do plan on circumcising. I'm with a private MW practice too, so they're automatically more accepting of these requests.  I can't imagine the hospital can force you to do either. 

    As for your other question, I'm a notary public, so I can explain that a little.  That just means that someone witnessed you sign the document and stamped or sealed it to prove that it was indeed you who signed it.  You can find notaries at places like the UPS Store usually, or just Google your town name + "notary public."  It should only cost about $10.  You just need to show your photo ID and sign in front of the notary.   I don't know that doing this is really necessary, however.  If you are saying that this is your birth plan, no one is going to argue that it's a fake document or something.  Seems a little excessive.  Getting something notarized doesn't make it more valuable in the eyes of your medical team.

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  • I didnt, but I also had a homebirth with a midwife. I declined the eye ointment but agreed to the vit K.
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  • image kriskell:

    I'm in CA so things might be different from a legal standpoint, but I'm refusing both.  Unless it's a boy (we're team green) - in that case we'll get the vitamin K because we do plan on circumcising. I'm with a private MW practice too, so they're automatically more accepting of these requests.  I can't imagine the hospital can force you to do either. 

    As for your other question, I'm a notary public, so I can explain that a little.  That just means that someone witnessed you sign the document and stamped or sealed it to prove that it was indeed you who signed it.  You can find notaries at places like the UPS Store usually, or just Google your town name + "notary public."  It should only cost about $10.  You just need to show your photo ID and sign in front of the notary.   I don't know that doing this is really necessary, however.  If you are saying that this is your birth plan, no one is going to argue that it's a fake document or something.  Seems a little excessive.  Getting something notarized doesn't make it more valuable in the eyes of your medical team.

    Thank you for explaining that, that was very helpful. And we are team green too! 

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  • And thank you to everyone in general for the replies. Hopefully opting out won't be as difficult as I was thinking.
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  • I'm in NY where it's also mandated. I had my MW perform a test showing that I was STD free shortly before I gave birth, maybe at 38 weeks i think, because I refused the erythromycin (we did do the vitamin k shot). We signed a waiver that the hospital provided.

    CPS never did follow up, but I just planned on having all of my ducks in a row with documentation in case the state decided that I was being a negligent parent. Smile

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  • image Into+the+Kitty:

    I'm in NY where it's also mandated. I had my MW perform a test showing that I was STD free shortly before I gave birth, maybe at 38 weeks i think, because I refused the erythromycin (we did do the vitamin k shot). We signed a waiver that the hospital provided.

    CPS never did follow up, but I just planned on having all of my ducks in a row with documentation in case the state decided that I was being a negligent parent. Smile

    That is good to know. What kind of documentation did you have? Was it the waiver and proof that you were STD free, or more than that?  

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  • We decided we are going to allow both procedures, however, we do want them delayed 1-2 hours.  The ointment will also help with any possible bacterial infections that he may pick up, even beyond STDs, and especially since I tested GBS+ it is important for him to have as much protection as possible. 

    From the research I did and from talking to my Bradley instructor and to my MW, there is no risk (or at least minimal) in either procedure so long as it is done after the initial skin-to-skin bonding time. They can also have life saving benefits.   

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  • I have always found there to be a notary on staff at my bank...no charge. That said, I have never heard of anyone getting a birth plan notarized. I think your pediatrician's attitude should inform where you go from here. My baby's doc is fine with not vaccinating, encouraged me to consider oral vitamin K (unless there is some obvious trauma during birth) and said it was fine to skip the eye ointment given my negative results on the std tests.

    10 years ago I had a midwife that was really adamant that we do the eye ointment, but was fine with skipping the vit k...I think the research has changed a lot in the last decade.

    Do your research, so if CPS is called you can make a good case that your decision is informed. I seriously doubt they will give you a hard time if you demonstrate how deeply you care about the decision...being protective of your child is what they want to see! In my experience with Social Services, they do not harass good parents for making alternative choices...but I do not live in PA.

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  • casey78casey78
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    We've decided we will go with standard procedures after an hour. The state requires administration within 2 hours of birth. 

    While on the hospital tour, a nurse mentioned controversies over the eye ointment and that CPS must be called with refusal.  She winked and said sometimes parents request the nurse place on baby's brow so the med is officially administered but parents are trusted to wipe into baby's eyes themselves. 

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  • I think CPS is only a serious problem in NY for declining those things. I declined the eye goop in PA 4 years ago, no questions asked. I signed a simple form. We did the vit K. 
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  • image CRLSMC2011:

    We decided we are going to allow both procedures, however, we do want them delayed 1-2 hours.  The ointment will also help with any possible bacterial infections that he may pick up, even beyond STDs, and especially since I tested GBS+ it is important for him to have as much protection as possible. 

    From the research I did and from talking to my Bradley instructor and to my MW, there is no risk (or at least minimal) in either procedure so long as it is done after the initial skin-to-skin bonding time. They can also have life saving benefits.   

    Just an FYI, in case you didn't know, there is strong research that GBS infection occurs before birth, and an any abx given after birth will not have an impact.  

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  • I think calling cps is largely a scare tactic. Cps has FAR better things to do than police eye goop at birth. Say I do not consent and it won't happen. You are informed, you know what it's for and you know you don't have STDs. Hospitals just have policies, but there's always a way around it.
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  • Thank you again for all of the replies. I had an appointment this morning with my doc and she said that declining them wouldn't be a problem at all. She said they wouldn't call CPS, so that is good news. 
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  • I'm opting out of the Hep B vaccine at least until my first baby check-up.  I do plan on the vitamin K shot, since babies have trouble clotting without it because their bodies cannot regulate that particular action yet.  I was unsure about the eye ointment myself.  I don't have an STD, either, but my husband, who is an optometrist said that it can also help with other types of infections and so he felt it was important to get done, so I'll be going ahead with that as well.  I didn't receive any information saying that I HAD to have it done or child services would be notified.  You probably have to sign a waiver with an explanation, though.  Might want to talk to the L&D floor before you go in.

    Shannon

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