Forgoing typical after-birth procedures
2junebabies
member
Hi everyone. I am a FTM due in June, and I have been trying to figure out which procedures might not be necessary during and right after the birth. Would anyone mind explaining their own reasons for delaying cord clamping or not, accepting or rejecting the vitamin K shot, hep B vaccine, or antiseptic eye drops, and the reasons that support declining baby's first bath? I have been trying to look online but it seems like most sources just accept these things as standard, and I want to be informed on both sides.
As far as labor and delivery, is there anything I should be mindful of? I know I do not want an epidural or any pitocin to move the labor along, but I don't know much about the benefits or concerns of continuous fetal monitoring or anything else the doctor might want to do.
Thanks in advance!
Re: Forgoing typical after-birth procedures
Here is some great info on delaying cord clamping. The video is really informative too:
https://midwifethinking.com/2011/02/10/cord-blood-collection-confessions-of-a-vampire-midwife/
As far as eye drops go, they are routinely given in case a woman has certain STDs that could get in the baby's eye and cause blindness. Since I am in a monogamous relationship and DH and I do not have STDs, I don't find the eye drops necessary.
As far as Vitamin K goes, I do not routinely give it to my babies. I breastfeed and believe that the colostrum is nature's way to protect them. I make sure to eat a diet rich in Vitamin K so that my colostrum/milk is also high in it. If I were giving birth in the hospital and something like forceps or a vacuum were used and there was evidence of serious trauma, I would maybe consider the Vitamin K, but I would do the oral dose over the injection.
Hep B we do not do at all with our kids. We will give them that shot when they are much older. My reasoning is that I feel the risk of them coming in contact with the disease at this age is small and they are already getting so many other vaccines. I like to space them out as much as possible.
First bath we avoid because I feel like the vernix they are covered in at birth is good for protecting their skin. We just rub off the excess and let it all soak in for a while. I think with DD her first "bath" (with water only) was around 3-4 days. We didn't use soap (natural) on her until probably 2 weeks. I have one child with eczema and other kids with very sensitive skin and a part of me feels like washing their skin too often or with excessive soap at such a young age could potentially cause problems in the future. I have no research to back this up, it's just a gut feeling and it "feels" right to wait. Also, I feel like there is benefit to the bacteria that they were introduced to in the vagina - studies have shown that the bacteria can help establish gut flora. If it helps gut flora develop, I feel that it would also help develop the good bacteria on their skin that helps prevent infection and other disease. Just sort of makes sense to me.
I would highly recommend reading some books about birth. I like Ina May's Guide to Childbirth. It will help you make some decisions about things like monitoring with your birth. Also, although The Business of Being Born and Organic Birth are pretty biased in their information, I feel like it does give you a starting place to look at what you want your birth to look like. It touches on things like monitoring and doctors forcing patients into certain positions. After looking at some of the things that are common in normal hospital births today you may be able to do more research and make some decisions for yourself.
Definitely do some reading - Ina May is good as mentioned. I also like the Thinking Woman's Guide to a Better Birth as a run down of pros and cons of lots of procedures.
As far as the things you mentioned...
I see no reason to not do delayed clamping unless there's something going on with you or baby that makes that not possible.
Vitamin K we do. For me the possible risks of not doing it far outweigh the risks of doing it.
Hep B we delay and do in the second year. I don't see a reason a newborn needs it unless a caregiver is Hep B+
Eye drops we skipped as we had no risk factors.
First bath we skip - i think that's becoming a more common thing to do, even in hospitals.
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We do delayed cord clamping so baby will have all the benefits including a lower risk of iron deficiency. Plus it gives the baby time to start breathing on its own, while still getting oxygen from the mother. Reasons to clamp right away would be an emergency situation where the baby needed immediate medical attention or if you were planning to bank your baby's cord blood.
We did the Vitamin K shot. DD most likely did not need it, but I wasn't willing to take the risk. Sometimes you can get oral Vitamin K which is from my understanding a lower dose. Something else to consider in your research.
We don't do Hep B in the hospital, but wait until BFing is well established. So we did it at DD's two week appointment.
For the eye drops, we did them even though I don't have any STDs. Probably laziness on my part, but I just didn't feel like putting up a fight over it. It's one dose, doesn't burn (I've used it myself), just blurs their vision briefly.
First bath, we did last time, but I'm not going to do this time. Poor DD screamed her head off as I think most babies do. There is evidence that their own smell and smell of amniotic fluid helps with BFing as opposed to the smell of Johnson and Johnson which most hospitals use. Newborns have a hard time regulating their own temperature, so why get them wet for no reason? And of course the benefits of vernix, which pp mentioned.
I agree with pp about reading "Ina May's Guide to Childbirth" and "The Thinking Woman's Guide to a Better Birth"
Delayed cord clamping - standard here in NZ for baby to get extra boost of blood. Although I believe it does increase risk of jaundice.
Vitamin k- risks of not outweigh risks of doing. DD2 had some quite bad bruising when she was born.
Hep B vaccine - this is not offered at birth here in NZ unless mother is infected.
eye drops - this is not standard practice in NZ.
declining first bath - bathing baby is not standard practice here. With DD1 we had to beg someone to show us how to bathe LO before we left the birth centre when she was 2 days old. They were really insistent that you should delay the first bath for a few days. All the vernix is good for their skin and provides nourishment and protection for the skin, and they're not dirty and really don't need to be cleaned.
Continuous fetal monitoring limits your ability to move. In labour you will naturally move into the most comfortable positions that will a) help you deal with the pain and b) help baby move into the best position and to move down the birth canal.
You can google labouring positions and find lots of charts of different positions that you might find comfortable on the day. I never once thought, "oh I'll try position 5," but I just did what felt most comfortable and in the back of my mind I could remember that chart and knew my body was doing the best thing to move baby down.
Elizabeth 5yrs old Jane 3yrs old
Delayed cord clamping - we do this, that blood is very beneficial to baby
Vit k - We did the injection with DS as he was circ'd. This baby won't be circ'd if it's a boy, but we'll do the drops as they're required by our pedi.
Hep b - We skipped this in the hospital with DS. We'll be delaying even further with this baby.
Eye drops - No risk factors here so we didn't do it.
First bath - this was required at the hospital with DS - I wasn't there for it. They used J&J and I found out later that you can bring your own wash if you want. This baby will be a homebirth and we'll do a bath with water whenever we feel the need.
growing a foosa
Cord clamping: This probably makes me the odd man out, but it wasn't a huge deal to me either way. My midwife took everything post-birth pretty laid-back, and delayed slightly, though not the classic "til it stops pulsing."
Vit K: We did this because I felt benefits outweighed risk.
Eye drops: It's state law that you have to, and frankly after 24 hours in labor I didn't feel like fighting it. I do, however, think it's unnecessary and was kinda ticked that, when I mentioned this to the nurse, she claimed that the preventative benefits were not only for STD bacteria, which I've never heard to be the case...
Hep B: We delayed until the 2 month pedi appointment. No argument from anyone.
Baby had her first bath during our hospital stay, but not until the next day. She needed it--had gunk in her hair like you wouldn't believe.
What we did do: Immediate skin to skin and nursing was very important to me, and we got this with no questions asked. The nurse didn't even ask to take her to weigh her or measure her until I said she could. To me this one thing was more important than all the other stuff we declined or didn't argue.