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Before I got pregnant with my first, I thought the only decision I needed to make regarding birth was deciding whether or not I wanted to get an epidural.
I now know that there is actually quite a lot you have to decide on once baby is born. Living in Texas, I also know that there are many common newborn procedures parents can opt out of.
Location Matters
Before we get into the common newborn procedures that are routine at the hospital, I thought it would be important to mention that your ability to refuse a procedure will depend on where you live.
For example, if you live in New York, your infant is mandated to receive the vitamin K shot and eye ointment. I have heard stories of hospitals going as far as calling child protective services on parents who have refused these measures. This is one of the many reasons I moved from New York to Texas.
So, you’ll want to double check with your birth team on all of these procedures, and do your own due diligence on learning what you can (and can’t) opt out of.
Now, let’s get into the common newborn procedures you can opt out of at the hospital!
Suctioning
It is routine in many hospitals to suction the baby’s mouth and nose with a syringe or suction hose. In some hospitals, this actually occurs right when baby’s head is emerging out of the birth canal.
The thought process here is that you want to remove any mucus or meconium that may be present or blocking air flow. But, it is very unlikely that your baby will have taken their first breath until they are fully birthed.
Baby is also still receiving oxygen through the placenta at this point. Unless they are clearly struggling to clear their airway on their own, suctioning can really be delayed until after baby is born or put off entirely.
Delayed Cord Clamping
Right after you birth your baby, the umbilical cord is still attached inside of you to the placenta.
To fit better through the birth canal, your baby leaves about a third of their blood supply in the placenta. That is THEIR blood that belongs in THEIR body.
As your baby is being delivered, the umbilical cord will be pulsating blood to your baby. If you cut and clamp the cord right away, your baby will be deprived of about a third of their blood.
That is why many moms are opting for delayed cord clamping. Delayed cord clamping is the act of delaying the clamping and cutting of the umbilical cord until the cord goes white and/or stops pulsating.
There are many benefits to delayed cord clamping, such as improving oxygen and iron levels for your baby. The World Health Organization also recommends delayed cord clamping for EVERY birth. Given that it is evidence based, I really wonder why delayed cord clamping isn’t one of the common newborn procedures.
It can take anywhere from three to 30 minutes for the umbilical cord to stop pulsating, and it is VERY unlikely that you will get this much time at a hospital. However, you can ask to wait until the cord goes white and at least pulsates less. This will be about three to five minutes.
Cord Milking
As more mothers are getting educated on delayed cord clamping and requesting this for their birth, some providers have gotten really cute and have begun to practice cord milking.
Cord milking is when the doctor pushes the blood towards the baby, hurrying the process so that the cord can turn white faster.
This is too much too fast, and only benefits the provider because it saves them time. And because you may be a little bit distracted with a new baby on you, it is a good idea to have someone else present with you, such as your partner or a doula.
If they know that you do not want the cord to be milked, they can watch out for that potentially happening and remind your provider that you want delayed cord clamping.
Immediate Skin To Skin
Once baby is born, your provider should put them on either your belly or your chest. They should not look to remove your baby from you.
There are many benefits to doing immediate skin to skin, which include but are not limited to:
- Easier regulation of body temperature for baby
- Increased flow of oxytocin which helps to increase postpartum contractions and expel the placenta
- Decreased chance of postpartum hemorrhage
You should be advocating for anywhere from 45 minutes to 1 hour of uninterrupted time. Even if you had a C-section, you can still request immediate skin to skin. This can happen where either you are doing it in some modified manner or your partner is doing it.
Breastfeeding
Breastfeeding goes hand in hand with delayed cord clamping and immediate skin to skin. If baby is still attached to you, it is easier to do skin to skin. If baby is already on your chest, they will most likely instinctively try to latch.
But, just because something is natural does not mean it will come naturally. You need to put yourself in the best position possible. The best way to do that is by breastfeeding as early as you can.
Hepatitis B Vaccine
The Hepatitis B vaccine is given to newborns to prevent them from being infected with Hepatitis B.
Hepatitis B is a virus that attacks the liver, and is transmitted through blood, semen, or bodily fluid. If you don’t anticipate your newborn coming into contact with any of this, you may consider opting out of the vaccine.
Unless you specifically decline this vaccine (pending on if your state allows you to do so), it will be given to your baby. If you decline the vaccine at the time of your stay, you will have the option to get it at your first pediatrician appointment.
Vitamin K
Vitamin K is naturally found in colostrum, which is another reason to breastfeed right away.
The purpose of the vitamin K injection is to help clot the blood and prevent any kind of internal bleeding. The use of forceps during birth was more common years ago, which is why vitamin K became more routine, as it would help to prevent bleeding in the brain. Now, bleeding in the brain is very rare.
There are oral vitamin K drops available as an alternative to the vitamin K injection. No oral vitamin K has been approved in the United States, but it is widely used in European countries. I used the Biotics brand for my sons when they were born.
However, if you’re having a baby who is having a circumcision, the oral vitamin K alone is not recommended. As an alternative, you can request a preservative free vitamin k injection.
Circumcision
Circumcision is the act of clamping and cutting the foreskin of the penis.
The foreskin has about 20,000 nerve endings, compared to a clitoris which has about 8,000. The foreskin also has blood vessels and sebaceous glands. This plays an important role during sex by providing a natural lubrication.
Parents choose to circumcise their child for religious, cultural, or personal reasons. The rates of newborn circumcision have declined over the years. Experts agree that not only is it medically unnecessary, but research also shows that there is no link between circumcision and improved health.
If you are thinking about circumcision, I would encourage you to watch a video of a baby being circumcised. Most of the circumcisions are performed with no anesthesia, so keep that in mind as you watch the videos.
Eye ointment
The eye ointment, also known as erythromycin, is an antibiotic that is put over baby’s eyes in the first hour of birth (unless you specifically decline it).
This is done to protect against any sexually transmitted infection that baby may have come in contact with while going through the birth canal, such as gonorrhea or chlamydia. The logic is that a lot of women can have chlamydia and not know it so it’s a safety precaution.
But, if you’re in a monogamous relationship where both partners don’t have sexually transmitted infections, this preventative measure may not be necessary for you. It may even be harmful, as it can blur baby’s vision when they’re trying to bond with you. There may also be a small chance that baby can be allergic to it, although the chances of that are fairly low.
Washing Baby
When baby comes out of the birth canal, they will be covered in a white, cream cheese looking substance. This is called vernix. This is your baby’s natural defense mechanism that helps to keep their skin nice and soft.
Some hospitals will routinely wash a newborn within 24 hours. The WHO recommends delaying the first birth for at least 24 hours. This is because bathing your baby can make it more difficult for them to regulate temperature and blood sugar.
Conclusion
Just because something is routine does not mean that it is what is best for your baby. In fact, it takes an average of 17 years before hospitals change their practices (source link here).
There are a lot of decisions you’re going to have to make right after your baby is born. Luckily, there is no one more qualified than you to make those decisions.
I hope this post about common newborn procedures was helpful to you.
Remember that you have choices, and that you are in control of your birth.
If you’re interested in having a birth outside of the hospital, I wrote about my experience at a birthing center. You can find my birth story here!
