Evidence Based Birth, Parenting

Newborn Procedures – 8 Decisions to Discuss Before Birth



Families often have many, many questions about what will actually take place at their baby’s time of birth.  Most people, it seems, like to have an idea of how things will play out once their little one makes his entrance into the world.  Every family is different, every birth is different, and so every baby will have different needs.  Depending on your care provider and birthing location, the standard procedures at the birth of your baby will vary. Only you will know which choices are best for you and your family, but knowing your options and starting up a conversation with your care provider are the first steps in the decision making process. My goal here is, by no means, to tell you which decisions are best for you and yours. It is important to me, however, that families be made aware of their options so that they may find the support they desire as they welcome their babies.

Below you will find some examples of procedures that may or may not be routine in your chosen place of delivery – I encourage you to talk them over with your care provider so you know what to expect when the time comes.  Ask your doctor or midwife what happens at a typical birth and what happens in the baby’s first hours.  In many cases, even routine procedures can be declined if you so choose by expressing your wishes to your care provider and staff in advance.

1. Suctioning of Nose and Mouth

In many practices, it is still standard practice to suction the mouth and nose of the newborn with a bulb syringe. Recent research shows that, provided there are no complications, most babies will clear the fluid just fine on their own after birth. Start up a conversation with your care provider to find out what their standard procedure is and their reasoning behind it.

2. Skin to Skin Contact

Studies have shown that immediately after your baby is born, the very best place for him is on the mother’s chest, skin to skin. More and more, this is becoming the standard practice in many facilities. The simple act of placing the newborn directly onto the mother’s chest or belly has numerous benefits not limited to: stabilizing the baby’s heart rate, temperature and blood sugar levels along with a more content baby and mother. So long as there is no medical emergency, any required tests or procedures can be performed while mom and baby bond skin to skin, so talk to your care provider if you are interested in making this a priority for your baby’s birth.

3. Immediate or Delayed Cord Clampingbaby-840136_1280

When your baby is born, he remains attached to the placenta by the umbilical cord, through which he continues to receive oxygen and nutrient rich blood. It is becoming increasingly common for facilities to support delayed cord clamping, which can have numerous benefits.  I encourage parents to research how delaying cord clamping can impact their little one and then to discuss it with their care provider well before the birth.

4. Prophylactic Eye Ointment

Upon birth, an antibiotic eye ointment is generally applied to the baby’s eyes.  This routine practice is performed to prevent an infection that can be contracted by the baby if the mother has chlamydia or gonorrhea.  If the mother has tested negative for these diseases, the ointment is not needed, but it may still be applied depending on the standard procedures of your facility.

5. Vitamin K Injection

Vitamin K is essential to blood clotting, and babies are born with a lower level of Vitamin K in their bodies, so they are routinely given an injection or an oral dose.  Again, every birth is different, as are the needs of every baby, so if this is something you wish to decline, you will definitely want to discuss your options with your care provider in advance.

6. Hepatitis B Vaccine

Hepatitis B is a disease that is spread through sexual contact and infected blood or needles.  If you know that the mother does not have Hepatitis B, the chances of the the baby contracting it are extremely low.  Your options are to have your baby receive the vaccine after birth, to wait and have the vaccine administered by your pediatrician at a future date, or to forgo or postpone the vaccine.  Again, this is a decision you will want to research for yourself and discuss with your care provider prior to your birth.

7. First Bath

In many cases, the baby is wiped clean immediately after birth then taken shortly after birth to the nursery for the first bath.  You can talk to the staff at your birthing facility to find out what their standard procedures are.  Depending on your wishes, it’s most likely possible to delay the first bath or to perform it yourself or with your partner, which can be a wonderful bonding opportunity.

8. Blood Screening

It is generally routine to test newborns for several disorders via a blood sample taken by pricking their heel.  This is usually done when the baby is at least 24 hours old, sometimes before you leave the hospital but sometimes a few days later.  You can talk to your care provider or your pediatrician about what types of things are detected with the blood screening and about whether or not you desire to have the test performed.

parents-406325_1920While the above list does not contain every possible procedure for newborns (that would be a very long, very overwhelming list), it may give you a few ideas to discuss with your doctor or midwife.  Open communication with your care provider is key to a positive birthing experience, so don’t hesitate to strike up a conversation at your next appointment.  Again, it is not my goal to tell you which decisions are best for you and your family, rather to encourage you to do some research, consider your options, and discuss them with your care provider.

Wishing you the very best as you welcome your little one!

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