PA: Questions about newborn Vitamin K, silver nitrate, and Hep B - Mothering Forums
New York, New Jersey, Pennsylvania > PA: Questions about newborn Vitamin K, silver nitrate, and Hep B
annettemarie's Avatar annettemarie 12:13 AM 08-15-2010
OK, I'm trying to decide what battles I want to fight here.

1. If I'm reading the law correctly, I can claim a religious/philosophical exemption to the Hep B vax, but only a religious exemption from the eye goop and Vit. K. Am I correct in that? I mean, I suppose my religious grounds is that I don't believe in unnecessarily risking the life of a baby, but I'm not sure if that counts.

2. If I can't refuse the silver nitrate, I would be more OK with erythromycin. Do I have the right to demand that?

3. When do they usually do the Hep B? I am concerned that in the rush of two babies being born, they'll sneak it in there and I will miss it. I don't even know if they do it in the hospital-- they did with my first, they didn't with my second and third, and my fourth was a homebirth.

4. I feel a little more ambiguous about the Vitamin K. If the babies have a rough birth and need interventions, I'm not opposed to the Vitamin K. But if it's just being given for the sake of being given, I have an issue with it.

I just want to do the best thing for babies. I don't object to giving them this stuff if there's a reason, but I do object to doing it just for the sake of doing it.

annettemarie's Avatar annettemarie 12:33 AM 08-15-2010
Also, does anyone have a link to the law requiring Vitamin K? I can't find it.
Llyra's Avatar Llyra 12:35 AM 08-15-2010
I've been reading the information you linked to. I'm in NJ, so it's different, but I think I understand what it's saying. What I'm getting out of if is maybe if you wrote your exemption based on the sexually transmitted disease angle, that would cover the eye goop and the hep B vaccine, but leave you free to allow the Vitamin K. You don't mention the metabolic screening-- will you be getting that?
annettemarie's Avatar annettemarie 12:38 AM 08-15-2010
Yeah, I'm fine with that.

I don't think I am legally required to explain it to them, but I'd like to have my reasoning straight in my mind just in case it comes to that.
Llyra's Avatar Llyra 12:42 AM 08-15-2010
I'm also not finding anything about Vitamin K in PA-- weird.
serenbat's Avatar serenbat 06:58 PM 08-15-2010
Quote:
Questions about newborn Vitamin K, silver nitrate, and Hep B

none are required at birth and PA hosp do not take exemptions-there is no need, they could careless and have nothing to do with an exemption same goes in the ER

you can state it prior in a birth plan, have it also written and verbally tell who ever is working with the birth-OB, mid-wife, etc

the only "requirement" so to speak (and this depends on the hosp, not statewide) is antibiotics after the birth without a prior test for step (this is in some northeast hosp and the OB can't do anything about it if it wasn't done prior to admission with results)

you don't need to even have the baby washed after birth if you don't want it-

if you are not going to be with it after the birth have who ever is with you watch that nothing is given and that they are not removed without someone going with them
annettemarie's Avatar annettemarie 07:00 PM 08-15-2010
Quote:
Originally Posted by serenbat View Post
none are required at birth and PA hosp do not take exemptions-there is no need, they could careless and have nothing to do with an exemption same goes in the ER
Are you sure about this because it directly contradicts what I found in the links above. BTW, I wouldn't actually write out an exemption. But according to the law and the sources quoted above, I would need a religious opposition to it not to have it done.
annettemarie's Avatar annettemarie 07:03 PM 08-15-2010
The law on eye treatment:
Quote:
Eye Prophyalaxis...

§ 27.98. Prophylactic treatment of newborns.

(a) Physicians and midwives attending women in childbirth shall instill in each eye of the newborn child, as soon as practicable after birth, either a 1% silver nitrate solution, or erythromycin ophthalmic ointment or solution as a single application in both conjunctival sacs, or appropriate medication approved by the Department.

(b) If the parent or guardian of the newborn child objects on the ground that the prophylactic treatment conflicts with the parent’s or guardian’s religious beliefs or practices, or if in the opinion of the attending physician treatment is not advisable, prophylactic treatment shall be withheld.

(c) An entry in the child’s hospital record indicating the reason for withholding treatment shall be made and signed by the attending physician and the parent or guardian.
So, it is the law and I'll have to sign something indicating the reason for not doing it.

As I said above, I am having a hard time pinning down the law on Vitamin K.
serenbat's Avatar serenbat 07:09 PM 08-15-2010
I didn't sign a thing and wasn't even asked to.

I told my OB prior NO to all and the hosp didn't bat an eye

This was in Allentown 2 years ago and I know plenty since who didn't have to do anything and didn't need to sign anything

I know several people that work at local hosp and even in the ER and they don't take exemptions.
annettemarie's Avatar annettemarie 07:11 PM 08-15-2010
Again, I am not talking about writing out and handing in an exemption, and I'm talking about birth and not the ER. I am talking about what the law (quoted above) says I'll need to do. I just want to be prepared and not count on the hospital ignoring the law. That's great that your hospital didn't give you any problems though.
serenbat's Avatar serenbat 07:13 PM 08-15-2010
also, newborn screen is NOT required

I choose several weeks later to have it done at another hosp than the one I gave birth at and they saw what insurance we had and they ran (without a script!!) additional test---the total cost was $60.00- they billed our insurance over $500.00---They got insurance fraud charges and the state health dept complaints and paid a nice fine well over $500.00!!! all because we HAD insurance and they knew they could get away with it.
serenbat's Avatar serenbat 07:17 PM 08-15-2010
Quote:
Again, I am not talking about writing out and handing in an exemption, and I'm talking about birth and not the ER. I am talking about what the law (quoted above) says I'll need to do. I just want to be prepared and not count on the hospital ignoring the law. That's great that your hospital didn't give you any problems though.
did you check with the hosp or speak to you OB about this?

this can be put in a birth plan

how do you think you can give an exemption other than stating in writing or verbally that you do not consent?

if you can not speak for yourself after the birth, you should have someone act in the interest and not allow anything you do not consent to

my OB ASKED me what I wanted and what I didn't want done at the birth so there was no guessing this goes for how the birth was to go under all problems and even about not cutting the cord
aeiou's Avatar aeiou 08:55 PM 08-15-2010
Maybe I'm not understanding the question, so my answer might not be helpful if that's the case. I gave birth last year and I basically had to sign waivers saying that I didn't want those things done.
annettemarie's Avatar annettemarie 08:58 PM 08-15-2010
Quote:
Originally Posted by aeiou View Post
Maybe I'm not understanding the question, so my answer might not be helpful if that's the case. I gave birth last year and I basically had to sign waivers saying that I didn't want those things done.
Thanks! Were they pre-printed? Do you remember what they said?
mamalade's Avatar mamalade 12:59 AM 08-16-2010
I had to sign stuff saying what I wanted and didn't want, but we did not get the eye ointment or hep, and the bryn mawr hospital didn't care at all. We did get the vit k, though. It was totally our choice. I don't know about the laws, etc, just wated to share my experience. Good luck.
serenbat's Avatar serenbat 09:01 AM 08-16-2010
hosps really aren't looking for a fight-

a JV I know, recently had her knee done, she spoke with her Dr prior and said what she would and would not do--- the hosp didn't even question her religion just confirmed she objected to blood-products and didn't give her a hard time--they are use to it in other sections as well as in the OB section, they really don't care what your religion is of why you don't want something--just best to speak prior about your desires and in writing is always good too!

medical mistakes happen all the time- people just need to watch what is going on
amyfarr's Avatar amyfarr 11:25 AM 08-16-2010
I didn't read your links and I honestly didn't thoroughly read the responses. I refused the eye ointment with both of my children and just had to sign a paper saying I was refusing it. Nobody gave me a hard time about it. I was told I could refuse the Vitamin K but we went ahead and did it. I have had several clients refuse the Hep B (which they don't usually give them until after the first 24 hours) and none of them have been given a hard time.

I did have one client who refused all of the above and the doctor did go over the benefits of them for the sake of being thorough with them but he didn't give them a hard time about not getting them.
aeiou's Avatar aeiou 01:56 PM 08-16-2010
If I remember correctly, it was the basic consent form but you signed in a different spot if you did not consent or you checked a box to that effect. They were really ok with it, they just reviewed the forms with me to make sure that I'd signed where I wanted to and that was that.
PrincessAnika's Avatar PrincessAnika 03:09 PM 08-16-2010
not sure what facility but check with the hospital/facility - the hospital i delivered dd at does not use silver nitrate. also, in signing the refusal for the hepB at that particular hospital, basically what it said was 'i am refusing to have this administered at this particular time, at this facility' - the nurse goes, "it doesn't say you arent gonna get it just that you aren't getting it here - a lot of ppl refuse it and have it done at the peds office"
we opted to delay the e-mycin and the vitK - put in the birth plan that we are delaying all interventions except those medically necessary, until AFTER we have had time to bond with BABY. this includes: weight, measurements, footprints, vitK, eye ointment, bath, etc. ABSOLUTELY NO HEPB VACCINE IS TO BE GIVEN!
and then we also made sure we told every nurse that came in the room. our dr was well aware of our preferences and helped out (fortunately). we got hassled about hte hepb - every time they walked into the room they asked if we wanted it - but they didn't have any objection to delaying. my mom refused all for my lil sis and they did not give her any sort of hassle about any of it. she just said no.
hth a bit.....
AndtheStars's Avatar AndtheStars 06:33 PM 08-16-2010
I delivered DS at Heart of Lancaster, Lititz, PA and refused everything. Like a PP, they just made me sign something that I was refusing the HepB. I don't think they even said anything about the Vit K and eye goop. It was very easy and no one gave me a hard time. I don't think they even mentioned it after my initial refusal.
greenemami's Avatar greenemami 01:37 PM 08-18-2010
I used birth centers both times-I refused hep b the first birth with no problem. I refused everything with the second birth and again, no problem. I might have had to sign something stating that I was refusing it, but I don't remember it specifically and don't recall having to give any particular reason other than that I didn't want it and accepted the risks of not getting it done.
Phoenix~Mama's Avatar Phoenix~Mama 02:05 PM 08-18-2010
With the birth of DD, my MW at the hospital just had a paper I could sign before hand that would go in my file. I didn't have to state why I would decline any of it, just sign that I was declining.

Have you checked with your OB/MW? They should know the accepted procedure for where you are delivering. It seems to vary across the state/hospital.
wjey's Avatar wjey 02:19 AM 08-20-2010
I had DD last October at Montgomery Hospital in Norristown. They just asked me if I wanted those things done and I had to sign a waiver refusing them. There was a spot to put the reason, but the nurse didn't make me fill it in. I think they need the signature more than the reasoning, but I suppose theoretically they could give you a hard time, depending on policy.
momoftworedheads's Avatar momoftworedheads 04:10 AM 08-20-2010
I delivered in Philadelphia and Montgomery County, PA and my children did not get anything at birth (eye drops, vit K, Hep B, etc) and there were no issues. I told my MW in the beginning with my 3rd son and she had me sign a waiver.

With my last birth, my OB had my birth plan in my chart and I was never asked about it again. I did not even have to sign a waiver or anything. This was a year ago.

Good luck.
paquerette's Avatar paquerette 10:18 PM 08-20-2010
I was an "emergency" hb transfer, without a support person, and I was able to refuse them all. I do not believe I was asked to sign anything; I vaguely recall a consent for hep B which I did not sign because I was not doing that. The only thing they gave me guff about was the vit. K, within an hour of the birth, and I just continued to verbally refuse and eventually he left me alone. This was MTH in 05.
tbone_kneegrabber's Avatar tbone_kneegrabber 04:50 PM 08-23-2010
I delievered (3 years ago!!) in Philadelphia. I spoke with my midwifery practice before the birth and wrote out a birth plan.

We wanted to refuse Hep B, DELAY eye goop, and do the Vit K (and not circ). Well Hep B and not circ'ing was totally easy because they had an additional consent form and we didn't consent (we were required to fill out all the paperwork prior to going into labor),

However they totally gave ds eye goop before I even got to hold him, (I had been in a birthing suite and they wouldn't have done it over there but I got transfered to regular L&D and they did it out of habit) but my midwife yelled/scolded them and felt really bad about it. DP and I were too out of it (50 hours of labor!) to stop it in the moment, that kinda sucked.
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