Eye ointment -- a hill to die on, or go along to get along? UPDATE

[msmiranda]

Just took the hospital tour last night, and out of all my obnoxious natural-minded mama questions, the one I got the most attitude about was declining the freaking eye ointment.  The nurse who did the tour was very pro-breastfeeding and seemed in favor of natural childbirth and (when I talked to her later) critical of too many C-sections, and this hospital seems very progressive as hospitals go, but when I mentioned declining the eye ointment she got kind of huffy.  I understand their perspective, I really do -- from a public health point of view, they don't know whose partner has been cheating on them or what have you.  But *I* know that I don't have any STDs and that my baby does not need the ointment.  It's been a few years, it sounds like, since she actually worked on L&D, but she said they might have to type up a form because no one ever declines the ointment.  I was like, seriously?  In a hospital that has a reputation as being a good place for natural childbirth, no one ever declines it?

So, here's my question:  If you were in my position (e.g. birthing in hospital), would you be insistent on this issue, or is the ointment de minimis enough that it's not worth fighting about?  Couldn't I just wipe it off the minute they give the baby back?   Or is it not having it worth possibly alienating the L&D nurse, who it would be really helpful to have in my corner? 

P.S.  No, I do not have the option to birth OOH right now, nor is there a better/different hospital I could birth at.  This is what I have to work with, and honestly I learned a lot of really great, encouraging things on the tour as well, this was just the one issue that seemed like it might cause ruffled feathers.

[~Amy~]

When my son was born, I was a homebirth transfer for a semi-emergency situation and I decided that the eye ointment was one thing I wasn't going to fight about.  There were things we declined that ruffled a few feathers, but for me, this wasn't a hill to die on, as you put it.

[Tumble Bumbles]

I wouldn't choose to give my baby something unnecessary and potentially harmful in order to 'keep peace'. You can be respectful about it and still decline it. I'd thank them for their "information and concern" but decline it.

[Jayray]

If I were you I would try to politely decline it.  You really shouldn't have a problem doing so.  But it also isn't something that I feel so strongly about that I would make it my main concern.  You can always wipe it out of the babe's eyes. 

You will also need to be very vigilant about it, especially if they take the babe to the nursery for anything.  I watched, helplessly, as the nurse in the nursery gave my sister's babe the ointment (even though I knew she didn't want it and she had told her midwife).  She had had an unexpected c/s and the babe was taken to the nursery while she was in recovery.

[NSmomtobe]

I was unsure about the eye ointment so I got talked into it and there were no problems. I expected it to hurt his eyes, but it didn`t upset him at all. They waited until after I had breastfed him before putting it in and then he went to sleep. It was not worth fighting over in my opinion.

[JenRN]

I am a L&D RN. We have a generic form for the parents to sign if they don't want Vitamin K or the eye ointment, and you check both boxes or whichever one they decline. It's not a big deal. If the hospital doesn't have a "special" form, certainly they have a way to chart that a certain medication was refused.

Where I work, we don't give the eye ointment until just before the bath (you have up to 6 hours to give it, and it's preferable to give it after the first successful breastfeeding). I know of other hospitals who give it right on the spot, when they take baby to the warmer. So just be vigilant, and if you don't really want it, decline. No decent nurse should give you a problem, after explaining the risks of not receiving the ointment to you (we have to do this to make sure you are fully informed of your decision). If you do get problems, report the nurse to the charge nurser/director/supervisor.

If you don't feel comfortable declining for whatever reason but still don't want it - it takes a few minutes to work, so you can wipe it off immediately after.

[mmaramba]

So, I'm not overly worried about it hurting baby's eyes, but in a hospital especially, the concern is unnecessary exposure to antibiotics.  However, for me, this is probably not the hill I would die on.

That said, I am incredibly uncomfortable with the oft-repeated, "Well, I KNOW that I couldn't possibly have an STD" reasoning that I hear all the time.

Now, say you got pregnant via IVF, and haven't had any sexual activity since then.  Or say you were just tested relatively recently and haven't engaged in sexual activity since then.  Okay.  But that's not usually who is making this statement, because it almost always comes along with "I am 110% sure my husband isn't cheating on me."

I don't know what the thought process is here.  Defensiveness?  At being treated like "one of those" dirty people?  At the fact that all women are sort of guilty-until-proven-innocent?  But what of that "guilty?"  To me, that speaks of there still being more stigma on STIs than almost any other health issue.  People don't react in exactly this way about lots of veiled "accusations" surrounding many of the standard procedures of hospital births-- and many of those procedures don't have anything to do with the behavior of another adult who is completely out of our control.

I mean, I kind of do get the indignance at being assumed "contaminated."  Frick, that's the general problem with the standard of care in hospital birth-- to treat everyone like a worst case scenario and a disaster waiting to happen.  And it's certainly not as though some docs and nurses don't roll their eyes and get schoolmarmish with you-- "Honey, no one ever REALLY knows for sure."

I mean, kiss my butt.

However.

People cheat.  Even partners you'd never suspect, even partners who appear devoted, who only leave your side to work-- or maybe who work with you!  And it is more common during pregnancy.

That doesn't mean we should go around suspecting everyone!

But if 20% of partners cheat during pregnancy, then even if your chance is a mere 1/4 of the average, it's a 5% chance.  If your chance is 1/10 the average, it's 2%-- higher than the failure rate of BCP, and we all know someone who got pregnant on the pill. 

Of course, the chances of a partner cheating AND infecting you with one of these diseases is significantly lower than that, so if you want to work out the numbers-- or not-- and you don't want the ointment, fine.  If you just don't want the ointment for any reason-- fine!  Statistically speaking, this is one of those things where the likelihood of a good outcome is extremely high no matter what decision you make.  Even if your overall risk of Something Bad doubles in one case or the other, it may be similar to the risk of getting injured driving a mile to the grocery store at 10 mph vs. the risk at 25 mph.  Your risk is probably 2 or 3 times as high going 25 mph, but the overall risk is tiny.  In the case of the ointment, overall risk is higher-- yet still pretty danged small.  

But it kind of chafes me when people talk about being 110% sure that their partner hasn't cheated on them.  THAT's what I'm talking about in this context, not necessarily the ointment or even the chance of having an STI.

I can't quite put my finger on it yet, but it does chafe.

I'm FAR from the most rational or logical human being on the planet, but "My husband would never cheat on me" is not a good way to assess health risks.  IDK.  Just saying.

[kltroy]

My doc simply suggested that I take an STD test when we did my group B strep test.  Then she just wrote down in my chart (and I reiterated on my birth plan) that I had a recent negative test and was therefore declining the eye ointment.  I was asked once or twice *why* I was declining, and I simply said that there was no reason because I was not at risk. 

The other option is to simply wipe it out as soon as they put it on.  *shrug*  If it's going to be a big pissing match I wouldn't worry about it so much, but you will be done with your birth at that point, so you'll have the mental resources to spend on this sort of thing I suspect.

[goinggreengirl]

I declined and didn't get any negative attitude. Remember, it's YOUR baby! Decline, decline, decline. Sign the form (even if they have to type it up) saying that you don't want it. You should not have to argue with your doctor or nurses about choices that you have researched and made! I tend to think that every decision regarding my baby is a hill to die on. No one but myself and my husband have the right to say what chemicals/ medicines/ procedures are done to our child.

Easy way to make sure it isn't done- never let your baby out of your (or your husband's sight). DH went with DS anytime they needed to examine him in the nursery and he slept in our room the rest of the time. And, every time DH left the room with baby and the nurses, I reminded him, no shots, no ointment! I bet the nurses thought I was crazy but I didn't notice any substandard care because of it!

[Marissamom]

I declined and was given no issues. I had it in my birth plan, which I filed with the hospital ahead of time and then went over with the charge nurse and my nurse when I was being admitted. 

[carriebft]

I wasn't aware that eye ointment helps prevent infection in the first couple weeks from other bacteria not related to STDs. My daughter did get an infection in both eyes and we declined the ointment. I think i would continue to decline though because she got the same stuff they would have put on her at birth and i controlled the goop with breastmilk as well. she was fine after one day of use. It seems like a bit much to get it on all my kids though just because of that issue. when it comes to abx, i would rather treat as it happens in this case.

[katelove]

I would decline, especially if it seems like they are cool with everything else and this would be the only issue. But, eye ointment is not routinely done in Australia so that colours my perspective.

[LiLStar]

It wasn't a big deal for me to decline. For me, it WAS a hill to die on, largely because I was a home birth transfer. so, everything I wanted for my birth was completely out the window. No natural birth at home with a midwife, a very medical, surgical birth with an OB in an operating room :( So, my end of the birth sucked. but they sure as hell weren't going to do anything to the baby that I didn't approve of. So I refused everything. Before surgery, every person who came into my room, I told them no eye ointment, no vitk, no hep b, no bottles, no pacis, no nursery! So, they were sorta confused about my refusal, brought in the head nurse, and she was like, yeah whatever, just have her sign a waiver. The waiver was hand written! rofl! But it really wasn't a big deal. 

[Evergreen]

With my first I had an STD test at 36 weeks (with the GBS test) just in case of hospital transfer.

With my second I actually did transfer and it wasn't a hill to die on. She got the ointment after she nursed and by the time she woke up it was pretty much gone.

This time I have decided to get it if I birth at the hospital. If I birth at home I am not going to worry about it.

[Evergreen]

dp

[Magali]

I would push to not have the eye ointment.  Either you have std's or you don't.  Yes, people cheat.  I explained to my dh that I wasn't going to get eye drops for our dd and that if he had cheated on me I needed to know or our chuild could go blind.  I had no reason to suspect him of cheating in the first place, but I just put it that way to him for my own peace of mind.  My first baby had red eyes after they put it in, and it was important to me that since I knew better for the next time, that my dd wasn't subjected to unecessary antibiotics.

[sunnygir1]

I declined with both my unplanned hospital births without a problem.  That would be my first choice.  As a second choice, I would ask them to delay an hour or two so that you and your baby can gaze at each other as you snuggle up and initiate breastfeeding -- that's supposed to be a very important bonding experience that involves vision for the baby and the mama.

[Beauchamp]

Edited by Beauchamp - 3/23/11 at 11:45am

[gypsymama2008]

Originally Posted by Beauchamp 

Not meaning to hijack, but what STDs are supposed to be prevented by using the eye ointment? This is embarrassing and TMI but DH acquired herpes in college (ugh) and has since passed it onto me. Is this a factor, or is it just chlamydia and gonorrhea?

I hope someone else who knows more about this answers you, but to my understanding the ointment just addresses gonorrhea.  I would definitely talk to your Doctor/Midwife about having herpes because I know that it can cause complications with the baby if you give birth during an outbreak.

I declined the eye ointment with my DD and no one gave me a hard time at all.  I would just say no, be polite but firm and just keep saying "I understand that.  I still have to decline."  I wouldn't say it's a hill to die on, but you deserve to be treated with respect and should not have to do something to your baby you don't feel comfortable with.

[TCMoulton]

Originally Posted by Tumble Bumbles 

I wouldn't choose to give my baby something unnecessary and potentially harmful in order to 'keep peace'. You can be respectful about it and still decline it. I'd thank them for their "information and concern" but decline it.

Just curious - how is the ointment "potentially harmful".

Personally, to me this isn't a hill that I would choose to wage a battle on - it's quite simple to wipe it off after application but it really didn't seem to bother my older daughter (younger was a c/s and didn't get the ointment)