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-   -   Possible to avoid/refuse newborn post-partum protocol in a hospital? (http://www.mothering.com/forum/213-birth-beyond/1322805-possible-avoid-refuse-newborn-post-partum-protocol-hospital.html)

got2w84it 07-24-2011 12:36 AM

Just wondering if there is any way to avoid or refuse the post-partum newborn treatment they do in hospitals?  You know, the immediate whisking away of baby to suction, clamp, scrub, weigh, wrap, etc - all of that so unnecessary.  It takes away from bonding time.  

 

Is there any way to demand this NOT be done - or at least demand it be delayed for a while - if delivering in a hospital - or is homebirth (or birth center birth) the only alternative???

 

I'm scared to deliver in a hospital for this reason - and because I just don't have faith that the staff would even care or respect my demand for all that unnecessary newborn treatment to be delayed till after I get a chance to hold and bond and feed my baby.

 

(My location is SW Florida, fwiw).


stik 07-24-2011 01:09 AM

First, find out if that actually is the protocol at the hospital where you plan to deliver. Many hospitals still do all that unless asked not to, as a matter of routine, but in a lot of places it's no longer protocol.

I'm not in Florida, but I requested that my babies be placed on my chest immediately and that cord clamping, weighing, and the newborn exam either be performed with baby on my chest or delayed until we had time to bond and nurse. It was no problem.

Comtessa 07-25-2011 12:20 PM

I'm with the PP: your first task is to check out the hospitals in your area -- it is entirely possible that they might have more progressive or evidence-based protocols.  The situation you describe is common but by no means universal.  I have birthed in two hospitals, and in neither hospital did they "whisk the baby away" for anything.  In the first hospital, I knew it was their routine protocol so I made a point of vocally refusing it.  In the second hospital, it was not their protocol so it was never an issue. 

 

Even in a not-so-great hospital, you can usually get what you want if you have a combination of a good birth plan, a sympathetic care provider who understands your wishes, and a loud voice and willingness to say "no, thank you" to whatever they're trying to do. 

 

The most important thing to do first is to know what you're dealing with in terms of routines.  You might be pleasantly surprised!  Take a tour and ask lots of open-ended questions. Here are some you might try:

  • "Tell me about what a normal, uncomplicated birth looks like in this hospital."
  • "After the baby is born, what happens?  Walk me through the first hour after birth." 
  • "What kinds of  birthing options do I have here?"
  • "What should I expect when I come here in labor?"

 

You could ask for statistics (they should have a pretty good idea of what these numbers are for their hospital):

  • "What is this hospital's C-section rate?"
  • "What % of laboring women get epidurals here?  Episiotomies?  Pitocin augmentation?"  etc.

 

If they're a little vague, you can ask more specific questions about certain interventions you want to avoid:

  • "Do you routinely do _____ ?  Do women frequently refuse this?"  (If they look at you like you're crazy for suggesting the refusal of routine procedures, especially the non-evidence-based stuff like continuous EFM, IV, nothing-by-mouth orders, etc., run the other way.) 
  • You could also just try "How do I go about refusing _____ ?  What is your process?"  (If they don't have a process, or act like they've never done this before, again, run the other way.  A good woman-centered birthing hospital is going to have a crystal-clear process in place for refusing pretty much any routine procedure, and they're going to be well-versed in how that works.) 
  • "If something goes wrong, how do I ensure that my wishes regarding _____ are followed?"

 

And you can ask specifics about things you want:

  • "Medical evidence seems fairly clear about the benefits of ______ while in labor/ during birth/ for a newborn.  Do you regularly do _____ here?  [If not, why not, when the evidence supports it?]" 
  • "What facilities are available here for _________?" (i.e., waterbirth, hydrotherapy during labor, whatever it is)  
  • "Are you a designated baby-friendly hospital?"  (Many hospitals are not, but most of them will know what it is and can probably help you get a 'baby-friendly' experience.  If they act like they've never heard of the term, run away fast.) 

 


Danielle283 07-26-2011 09:31 AM

I just had a hospital birth, and did skin to skin right away. After a few minutes a nurse asked to take the baby over to the table to check him out and I just said no thanks, he's fine here. Another nurse piped in and told him he could do all that later and to leave us alone. I had him for quite a while until I was ready.


savithny 07-27-2011 07:53 PM

One of the things on the birth plan form that my hospital requests people fill out is "Please delay newborn procedures."

 

if you check that, they don't do anything for up to an hour, and they do as much as they can in-arms or on your belly.    My DD was covered with a towel and we nursed and I held her for a full hour, and then they took her for a quick exam and the rest of it.  And I wolfed down a turkey sandwich and drank a bunch of water! 

 

(With #1, they took him a bit earlier, but he'd passed mec right at birth and was all sticky, so they degooped him and checked him out and then we nursed.   And I was starving hungry and handed him off to DH after awhile so I could eat with that birth, too.   


Cassaba 08-08-2011 10:52 AM

Yes, have a written and detailed birth plan and be sure to go over with your provider and any other providers who might attend the birth in his/her absence. Let the nurses know you have a birth plan when you arrive. We refused vit K, hep B, and bathing altogether. We were skin-to-skin immediately before cord was clamped and cut. We delayed weighing, measuring, diapering, and swaddling for several hours. They were totally fine with it all. I will add that I gave birth in a small hospital that is home to an exceptional CNM who has had a great influence on the L/D nurses. So they had read my birth plan and didn't even ask me questions - they just honored it.


MamatobabyA 08-08-2011 11:04 AM

It's part of our hospitals breastfeeding procedure that any healthy, breastfeeding newborn go straight to mom's chest for at least 30 minutes of skin to skin.  It's just part of our protocol.  I would definitely call and ask about your options.



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