The Virgin Mary's Birth: A Metaphor for the Conscious Mother

Mary’s virgin birth of Jesus Christ can be regarded as an incredibly meaningful and powerful metaphor.

And although 83% of Americans state that they do, in deed, believe that Mary was in fact an actual virgin during the birth of her first son - I am not here to confirm or deny the merit to this claim.[*]

Although scientists have observed virgin conceptions (known as parthenogenesis) occurring in nature, it has never been observed as occurring in humans, except in unique births as mentioned in various religious (not just Christian) documents.[*] 

A Metaphor

Jesus, himself, preferred to teach his message using a form of metaphor called parables and the virgin birth may be on of the most powerful and universal metaphors to exist.[*][*]

Many current and past scholars have regarded the Virgin Birth is a metaphor for a woman’s process (Mary’s in this case) into motherhood and a spiritual life.

The events that occur within the soul of a woman cause a shift during birth - A birth of compassion; when you begin to live out of compassion rather than from selfish motivation.

“The emotional labor pains of becoming a mother are far greater than the physicals pangs of birth; these are the growing surges of your heart as it pushes out selfishness and fear and makes room for sacrifice and love. It is a private and silent birth of the soul, but it is no less holy then the event of childbirth, perhaps it is even more sacred.” – Joy Kusek LCCE

Although I can not speak for any other person other than myself, motherhood has transformed all that I am.

Motherhood is an extraordinarily profound gift which I think our society tends to forget and, in some cases, undermine.

The Virgin birth does not refer to the biological condition of Mary, but to events that occur within the soul that every mother holds the potential in experiencing. With this insight, we must do our best to honor every mother.

This renewal of the self which occurs in a woman during the passage from woman to mother is enshrouded in obscurity and wonder.  A woman is born again with discernment existing in the soul that experiences the Divine in a unique way – through her child, through her heart and as an instrument of Love and compassion.

I encourage every mother to do their best never to lose sight of what a magnificent influence they have.

The Epidural: Less Satisfying and More Painful Birth?

Pregnancy and birth are filled with many unpredictable features, whether this be your first go at the rodeo or 5^th.

Pain experienced during labor is also unpredictable. Pain may be manageable without medication, or it may become severe and exhausting.

If you find yourself calling the United States your home, then you are among the majority if you opt for epidural pain relief during labor.

Ladies in the U.S. have fewer options for labor pain management than our counterparts in other industrialized nations (such as the UK and Canada). It is uncertain if the excessive use of epidural analgesia is a true preference in the US or if it is simply chosen because of the lack of other presented options.[*]

Interesting, none-the-less….

What is certain is that epidural use is nearly always an elective procedure. Although it can be a useful tool in supporting a laboring mother, the use of epidural medication expands the chance for complications, this does not occur in drastic numbers. Each family has their own comfort level with side effects and risk – what one family may consider safe, another may become uncomfortable. (you can learn more about risks associated with epidural use here and here) 

Everyday, devoted and loving soon-to-be mothers opt for epidural anesthesia pain relief during the birth of their babies.

I was among them, choosing an epidural with my first daughter because I thought it would help with pain and allow me to have a more enjoyable experience. In actuality, I experienced agonizing break-through pain and a cascade of interventions that I wasn’t anticipating (urinary catheterization, artificial rupture of membranes, internal fetal monitoring, use of synthetic oxytocin). 

Was my disillusionment with epidural anesthesia in the minority? 

Higher Pain Recall Among Those Opting for Epidural Analgesia

A remarkable finding from a longitudinal study (2009 BJOG) regarding women’s memory of labor pain found that mothers who opted for epidural analgesia reported higher pain scores at all time points versus those who went without.[*]

Another study (2006 JPOG) substantiates the above findings and also goes to on to provide data that women who received epidural analgesia not only had higher recollection of intense pain at two months and one year but also had greater difficulty forgetting pain 10 months later.[*]

If a mother chooses an epidural in most part to experience a labor that is less painful then one without anesthesia the data above can be sobering.

Research also suggests that pain experienced during labor is not entirely a negative experience, with more then 1 out of 4 women (28%) assessing pain as more of a positive than a negative – suggesting that coping with pain is a rewarding experience for some women.[*]

Lower Satisfaction Among Those Opting for Epidural Analgesia

Although women and care providers may assume that effective pharmaceutical pain relief during labor will ensure a more positive birth experience, there is mounting evidence that the opposite is true.

Several studies have shown that women who use no labor medication are the most satisfied with their labor and birth (times being assessed at time of birth, six weeks and one year after birth).[*][*][*][*][*][*]

Also worth noting, women who cope with labor using non-medical alternatives such as water birth, massage, positioning, focusing and breathing done with the support of another person report more satisfied than with standard pain relief given during childbirth.[*]

Natural techniques utilize a woman’s own strengths and places her in control of her own body. They also have been assessed to improve obstetric outcomes compared to pharmaceutical relief.[*][*] 

Interestingly, the influence of pain relief on satisfaction is not as powerful as the attitudes and behaviors of the mother and caregivers involved. Consider a 2002 study published in the American Journal of Obstetrics & Gynecology which concludes four factors that appear to override pain experienced in labor:[*][*]

1. Personal expectations

2. Amount of support from caregiver

3. Quality of caregiver-patient relationship

4. Mother’s involvement in decision making

This reaffirms the main key to satisfaction and managing labor pain effectively, is to ready yourself in advance – arranging continuous support, accurately understanding pain control options (and the interventions involved) and having an active role in the decision making process.[*][*]

****

As much as some might like to discount natural childbirth as a progressive trend among a small number of women, research affirms that women who opt for epidural anesthesia experience more pain, have a more difficult time forgetting the pain, and experience less satisfaction overall.  

Women do not decline an epidural simply to “win a medal” – instead information on different types of pain relief are assessed and balanced against other goals such as walking, pushing effectively, or minimizing maternal/neonatal side effects and/or risks.

How much of an effect an epidural medication can have on a newborn or mother is not easily predetermined and can vary based on dosage/mix of pharmaceutical drug combination, the length of labor, and each individual.[*]

Opting for an epidural anesthesia is one method (among many) that can aid in relief of pain and discomfort during the labor process. This type of pain relief requires a mother to give some control to the hospital staff. It does involve risk and additional intervention.

The decision, rightfully, rests for each woman to make. In due course, researching the procedure and talking others who have may be able to offer different perspectives could help a mother decide on what is right for them.

As the data suggests, most women who choose unmedicated birth (and prepare for it) find the pain intense but manageable and they are happier with their experience afterwards.

Ultimately, what can be said, each woman should use the insight into herself to be the best guideposts in directing her toward a positive decision regarding pain relief during labor.

"You gain strength, courage and confidence by every experience

 in which you really stop and look fear in the face."

- Eleanor Roosevelt

Witness to Normal Birth

It was about the best thing I ever experienced.

The minute she came out, I was born again. It was like we’d just been born together.



paper dolls photography



If you are privileged enough to have witnessed a woman giving birth naturally in a place she has chosen, what will you have seen?

You will first be in awe of her strength.

 

And you will think – for how could you not – what a phenomenal creature a woman is. But you will only have seen this astonishing sight if you have understood that if you disturb her in her work, she will be thrown off course. One must sit quietly and patiently, almost invisible, breathing with her, not disturbing her internal rhythm. And you will see that the pain of her labor seldom overwhelms her.

A deep significance to the mother, the momentous quality of pain, as she is surrounded by the deep sense of inwardness, forced to recognize her independence, her loneliness, selfhood, becoming conscious of her own existence. Paradoxically, this actual self-consciousness exposes a woman to her wholeness, her strengths and her endurance.

Nature would not have organized labor to be intolerable. It is the limits of our human understanding that wish to control all that is surveyed, that has conquered women by making them labor in the most tortuous environment constructed.

Let us bring them into harsh rooms with bright lights. Let us make them lie on their backs on hard narrow beds. Let us tether them to machines so they cannot move. Let us make them stay silent. Let us restriction their eating and drinking. Let us expose their most private parts and threaten them with cold steel. Let us make them push their babies upwards, against the pull of gravity. Let us monitor and measure and chart every move they make. Let us swab, wipe, prod, poke, irate, confuse and frighten them as much as we can.

In these conditions, labor swiftly becomes unbearable and pain relief becomes a woman’s only hope. Get me an epidural, cut it out of me, anything, make it stop. Please help me!

This is not the natural cry of a woman in labor bringing a child into the world, although if you have only ever witnessed labor and birth in a medicalized setting you might be inclined to think so. Her only hope for salvation lies in the anesthetist who numbs the pain or the obstetrician to remove it.

And a woman spoke, saying, Tell us of Pain.

And he said: Your pain is the breaking of the

shell that encloses your understanding.

Even as the stone of the fruit must break, that

it’s heart may stand in the sun

so must you know pain.

- Gibran

Altered passage and excerpts can be found in:

Normal Childbirth: Evidence and Debate. Chapter: The Role of Pain in Normal Birth and the Empowerment of Women (Nicky Leap and Tricia Anderson). Pages 25-39. 2004. http://readinglists.lib.monash.edu/items/5BB0FE73-9C52-D121-1760-8D2D7F4AACC9.html

Surigical Birth: Recent Review Illustrates Risks of C-Section

Whether you are pregnant, have been pregnant in the past, have a friend that is pregnant, or you are of child bearing age – you might wonder if you will have a cesarean section in your future. Heck, the odds right now are pretty good that you very well might. Approximately 1 in 3 women have a c-section – the most common operating room surgery performed in the US.

You may even wonder if a c-section is safer or easier then having a baby the old fashion way.

A report published (DEC 2012) analyzes the available published research to compare health outcomes between cesarean delivery and planned vaginal birth. This report was developed to support the effort of the National Priorities Partnership (NPP) which is a group of 52 major national organizations with a shared vision to achieve better health and their goal of reducing c-sections in low-risk mothers in half - to 15%.  

This is what the assessment found:

Key: (of every 10,000 women or babies)

Moderate = 10 to 99

Large = 100 to 999

Very Large = 1,000 to 10,000

The physical effects in women following a cesarean deliver

Cardiac arrest: Limited evidence suggests that a MODERATE excess number of healthy women may experience cardiac arrest in association with cesarean delivery compared with similar women planning vaginal birth.

Urgent hysterectomy: A SMALL to MODERATE excess number of women having initial cesarean delivery undergo unplanned hysterectomy compared with women having vaginal birth.

Thromboembolic events (blood clots): A SMALL to MODERATE excess number of healthy women having cesarean delivery experience a blood clot.

Anesthetic complications: Limited evidence suggests that a MODERATE excess number of healthy women having cesarean delivery may experience complications with anesthesia compared with similar women having spontaneous vaginal birth.

Major infection: Limited evidence suggests that a MODERATE to LARGE excess number of healthy women having planned cesarean delivery experience major puerperal infection compared with women having or planning vaginal birth.

Wound infection (cesarean or genital): A LARGE excess number of healthy women having cesarean delivery have wound infections compared with women planning vaginal birth.

Hematoma (cesarean or genital): Limited evidence suggests that a LARGE excess number of healthy women having cesarean delivery have wound hematomas compared with women planning vaginal birth.

Length of hospital stay: Planned cesarean delivery increases length of hospital stay by at least 0.6 to 2 days compared with planned vaginal birth.

Hospital readmission: A MODERATE to LARGE excess number of healthy women having cesarean delivery require readmission to the hospital.

Problems with physical recovery: With the exception of the presence of hemorrhoids, which are more common with vaginal birth, a LARGE to VERY LARGE excess number of women having cesarean delivery experience problems with physical recovery, including general health, bodily pain, extreme tiredness, sleep problems, bowel problems, ability to carry out daily activities, and ability to perform strenuous activities, compared with women having spontaneous vaginal birth.

Chronic pelvic pain: More women experience chronic pelvic pain after cesarean delivery than after vaginal birth, but the excess number cannot be calculated from the studies examined.

The effect on babies delivered via cesarean

Respiratory distress syndrome: When birth occurs before 39 weeks, more babies born by cesarean than by vaginal birth experience respiratory distress syndrome (RDS), but the excess number cannot be calculated from the studies examined.

Pulmonary hypertension: Limited evidence suggests that a MODERATE excess number of babies delivered by elective cesarean may develop pulmonary hypertension.

Asthma: Cesarean delivery increases the likelihood of developing asthma in childhood, but the excess number cannot be calculated from the studies examined.

Type 1 diabetes: Cesarean delivery increases the likelihood of developing Type 1 diabetes in childhood, but the excess number cannot be calculated from the studies examined.

Allergic rhinitis: Cesarean delivery increases the likelihood of developing childhood allergic rhinitis, but the excess number cannot be calculated from the studies examined.

Symptomatic food allergy: Limited and conflicting evidence suggests that cesarean delivery may increase the likelihood of developing food allergy in childhood, but the excess number, if any, cannot be calculated from the studies examined.

Obesity: Limited evidence suggests that a LARGE excess number of children delivered by cesarean may be obese at age 3.

The complications resulting in cesarean delivery

Operative maternal injury: Among women having first delivery via cesarean, a MODERATE number of women experience bladder puncture, and a SMALL number experience bowel injury or injury to a ureter.

Surgical cuts to the baby: Limited evidence suggests that a MODERATE number of babies are cut during cesarean delivery.

Re-operation: Limited evidence suggests that a MODERATE number of women having cesarean delivery require re-operation.

Persistent pain at the site of the cesarean incision: Limited evidence suggests that a LARGE to VERY LARGE number of women still experience pain at the incision site 6-10 months or more after cesarean delivery.

Cesarean scar endometriosis: Limited evidence suggests that a SMALL to LARGE number of women having cesarean delivery develop cesarean scar endometriomas.

Cesarean scar ectopic pregnancy/early placenta accreta: Some women becoming pregnant after cesarean will experience a cesarean scar ectopic pregnancy or placental implantation within the uterine scar, but the number cannot be calculated from the studies examined.

Dense intra-abdominal adhesions: Limited evidence suggests that a VERY LARGE number of women develop dense adhesions after cesarean delivery.

Complications unique to vaginal birth

Anal sphincter injury: A LARGE number of women experience anal sphincter injury at vaginal birth.

Perineal or genital lacerations of any degree: Exclusive of episiotomy, a VERY LARGE number of women experience trauma to the perineum or genitals at vaginal birth that requires suturing.

Persistent perineal pain: Limited evidence suggests that a LARGE number of women experience persistent perineal pain lasting at least six months with spontaneous vaginal birth, and a VERY LARGE number of women experience perineal pain lasting at least six months after instrumental vaginal delivery.

Potential effects of cesareans on women in future pregnancies and births

Voluntary infertility: A LARGE to VERY LARGE excess number of women choose not to conceive again after cesarean delivery.

Placenta previa: A SMALL excess number of women with first delivery by cesarean develop placenta previa in the next pregnancy, but the excess number cannot be calculated from the studies examined. A LARGE excess number of women develop placenta previa after two or more prior cesareans.

Placenta accreta: A SMALL excess number of women with first delivery via cesarean develop placenta accreta in the next pregnancy. A LARGE excess number of women develop placenta accreta after multiple prior cesareans.

Placental abruption: A MODERATE excess number of women with first delivery via cesarean have a placental abruption in subsequent pregnancies.

Hysterectomy: A MODERATE excess number of women with prior cesarean delivery require an urgent hysterectomy during the next delivery admission compared with women with only prior vaginal birth. Limited evidence suggests that the excess increases with subsequent pregnancies.

Uterine rupture: A MODERATE excess number of women will experience uterine rupture with prior cesarean delivery compared with prior vaginal birth.

Intensive care admission: Limited evidence suggests that a LARGE excess number of women with prior cesarean are admitted to intensive care at the next delivery compared with women with prior vaginal birth.

Hospital readmission: Limited evidence suggests that a MODERATE excess number of women with prior cesarean are readmitted to the hospital after discharge at the next delivery compared with women with prior vaginal birth.

Conclusion

This data supports efforts for women to strive to avoid a c-section and reduce the rates for future generations.  

I do believe it is worth noting that not all women will be able to deliver their babies vaginally - a c-section, in some cases, is the only safe option for delivery. Because of this, we must continue to give all women support and encouragement no matter how a baby was born – avoid judgment and condemnation at all costs.

We must unite as one front to effectively alter the rate of cesarean surgery for all women and our daughters.

Because how you give birth can not only effect a mother, but also her baby and future babies – it is important to gather information and understand the options before being faced with situations/events that will increase risk of surgical birth.

Here are a few ways to reduce the chances of having a c-section:

Ask hard questions – Don’t be afraid to interview prospective OBGYNs. Ask them what their c-section rate is. Don’t be afraid to ask whether the doctor is knowledgeable about natural/low intervention childbirth. Be inclined to contact the local hospital and ask for recommendations!

Plan ahead and be clear – Don’t plan on presenting your birth plan the day of your actual birth! Discuss your plans during all your prenatal visits. Be very clear and continue to re-affirm your goals to everyone involved.  

Don’t be induced – This one is important! As tempting as it might be in those last few weeks and days of pregnancy, never ask to be induced or give into the pressure to electively induce (unless medically needed).

Hire help – Hiring a doula has been known to increase the chances of vaginal and low-intervention birth. If you can’t afford one, still contact one and they may offer other payment arrangements. Many doulas believe that everyone woman should be supported during labor – no matter what.

Eat like you mean it – So you are serious about avoiding a c-section? Well, consider striving for the most optimal food and supplements. Eating nutrient rich foods help women reduce the risk of having a c-section (predominantly because it reduces your likelihood of gaining too much weight during pregnany – despite the common saying, you are NOT eating for two). Also consider something more then just a prenatal vitamin. Studies have been published illustrating that higher levels of vitamin D consumed during pregnancy may enhance your chances of a vaginal birth.  Sign me up!

Reference:

Read the report here-

Childbirth Connection (2012) Vaginal or Cesarean Birth: What is at stake for women and babies? New York: Childbirth Connection.  

Check out more on-

Transforming Maternity Care

Executive Summary

Newborn Procedures to Reconsider

For me, being a first time mother, I never knew that there were routine hospital procedures that influenced the welfare of my child AND that I had the authority to manipulate them.

My advice to a new mama is to learn about what to expect in the hospital beforehand.

There are several routine practices that should can be considered for you to declined, delayed or modify.

Since your number one priority is to the welfare of your child, take the time review the information available on the procedures used in hospital maternity wards – surprisingly, most are not evidence-based practices, instead they are in place due to the ease and convenience of the staff or because that is what has been done in the past.

Cord Clamping

Clamping the cord within 30 to 60 seconds after birth is one of three steps in an "active management" approach to the third stage of labor in hospitals.

The reason for this routine medical procedure is because immediately following birth the new mother is most vulnerable to excessive blood loss.[1]

However, The Cochrane Library (a publication of The Cochrane Collaboration, an international organization that evaluates medical research-systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic) found that in terms of the amount of bleeding, delayed clamping did not reduce the mother's risk of bleeding.[2]

In fact, there are many benefits of delaying this procedure until the newborn’s umbilical cord has stopped pulsating. The benefits of waiting are well documented and many parents are not aware of the large impact this particular routine procedure can have on their new baby.

Here is a good resource to start learning about the many benefits to delayed cord clamping.

One benefit that has recently received a lot of attention is the effect of iron levels in a newborn. The amount of iron in the blood at birth influences health, particularly an infant's risk for anemia in the first months of life.

This is especially relevant when considering that iron deficiency is the primary cause of anemia which can lead to central nervous system effects and cognitive impairment. In addition, delayed cord clamping can increase the rate of transfer of hematopoietic stem cells to the newborn, which may play a role in the prevention of certain blood disorders and immune conditions.[3]

Please consider telling your partner to watch and be vocal about what you wish when giving birth. Delaying clamping of the cord is an easy one to watch for and your hospital should be able to abide by your request.

Vitamin K Injection

The injection of vitamin K to every newborn infant was a practice that began in the 1950’s. The injection is used to artifically alter the naturally occurring level of vitamin k in the baby and to promote blood clotting.

To account for a rare liver disease (called Hemorrhagic Disease) that occurs approximately about 5 out of 100,000 births – the answer the CDC has come up with to tackle this rare bleeding trauma is to inject all infants with not double the amount…not 10 times or not even 100 times ….but rather 20,000 times the newborn level of vitamin k.

Yikes.

You might ask yourself, why is every newborn baby born with a “low level” of vitamin k? From what research recognizes, the newborn’s tight regulation of vitamin k levels control the rapid rate of cell division (which is rather useful during fetal development). It has been documented that high levels of vitamin k may lead to cancer due to uncontrolled, rapid cell division. (Ahh….this may explain the link to the prophylactic use of the vitamin k injection and a rise in childhood leukemia).

If you opt out of the vitamin K injection, the baby will gradually raise their levels after birth by breastfeeding (colostrum is extremely high in vitamin k).

You can also consider giving vitamin k drops orally (liquid vitamin K9) which is a significantly lower dose then the 20,000x level of the injectable vitamin k. If you consider this - I would contact the pediatrician to determine how this will be administered and how to attain it.

If you are a mother at higher risk of having a baby with Hemorrhagic Disease or if your baby is at a higher risk, then you may want to consider the vitamin k injection more thoughtfully. Those mothers and babies would be:

-Women on anticonvulsant drugs during pregnancy (for epilepsy)

-Babies that had premature clamping or cutting of their umbilical cord (this deprives the baby of up to 40% of their blood volume which includes platelets which aid in clotting) - another reason to delay cord clamping!

-Women who had a vacuum extractor assisted birth (this often causes bruising and internal bleeding) – another reason to try for a natural birth

-Women/newborn on antibiotics

The administration of any injection into the blood stream of a newborn carries risk, particularly of infection…especially in an environment that contains the most hazardous germs.

It has also been known that trauma from injections during the first moments of life can jeopardize the establishment of the breastfeeding relationship. Breastfeeding assists vitamin k levels and absorption monumentally more then the synthetic vitamin k injection.

I imagine there is a very delicate, complex relationship between blood clotting levels and a newborn’s cell growth. To go all ‘willy-nilly’ (sorry no other term applies here) and inject a synthetic vitamin in the blood stream (20,000 times higher then normal, a level chosen with no rhyme or reason) to alter something we don’t fully understand seem a tad bit reckless.

Erythromycin Eye Ointment

Erythromy-what?

Erythromycin is an antibiotic ointment applied to a newborns eyes just minutes after birth.

The administration of erythromycin is on the grounds of preventing blindness from exposure to maternal gonorrhea.

Yes – if you have gonorrhea, then you might want to consider keeping this procedure in place – if not, pass on it.

Please note that it is common practice to screen mothers for STDs during their prenatal care so if you don’t have an STD

I’m not sure why it would make sense on administering it.

Again, the administration of this groundless routine intervention is waive-able, but could include a fine of $5.00 in most states (however, in New York it is much more difficult to decline).

If you are considering administering “just in case” - is there risk?

The antibiotics in the ointment enter the bloodstream through the eye – the potential for diaper rash, thrush, and digestive problems are all present when this happens.

The bottom line-is it necessary and effective?

According to the several medical studies listed below (and in more detail here), that answer is no:

Bell TA, Grayston JT, Krohn MA, Kronmal RA.  Randomized trial of silver nitrate, erythromycin, and no eye prophylaxis for the prevention of conjunctivitis among newborns not at risk for gonococcal ophthalmitis.  Pediatrics 1993 Dec;92(6):755-60.

Chen JY.    Prophylaxis of ophthalmia neonatorum: comparison of silver
nitrate, tetracycline, erythromycin and no prophylaxis.  Pediatr Infect Dis J 1992 Dec;11(12):1026-30.

Black-Payne C, Bocchini JA Jr, Cedotal C.  Failure of erythromycin ointment for postnatal ocular prophylaxis of chlamydial conjunctivitis.  14: Pediatr Infect Dis J 1989 Aug;8(8):491-5.

 

Krohn MA, Hillier SL, Bell TA, Kronmal RA, Grayston JT.  The bacterial etiology of conjunctivitis in early infancy.  5: Am J Epidemiol 1993 Sep 1;138(5):326-32.

These studies “prove that the eye ointment routinely applied to newborns does not significantly alter eye infections as opposed to no ointment of any kind.  Also, there is evidence that the bacteria which cause these infections are not passed to the infant in the birth canal, but after birth.  Also, it has been found that a significant number of infants develop an infection even though they HAVE received the ointment.”

Circumcision

Being that this is a sensitive issue – I will not discuss this subject in detail or my personal views on the matter.

I will ask that if you are expecting son, please carefully assess the information available. This is definitely a procedure that the hospital will honor in declining, in fact, the rate of circumcision is declining because evidence-based knowledge is mounting.

If you are unsure, consider viewing a circumcision video to understand what your son will experience. (note-I did NOT view this video, I can’t handle stuff like that).

The majority of these surgeries in America are done without any anesthetic.  Some will utilize a topical cream which takes nearly 45 minutes to numb the skin, yet these creams have not been studied in newborns.

Please be diligent in this decision, many faiths that commonly recommend circumcision have large followings that support keeping sons whole. Please take time to learn more then what is offered in a brochure at your OBGYN.

Hepatitis B

To begin with, hepatitis is a viral disease associated with sexual contact, blood transfusions, re-use of contaminated needles and vertical transmission (mother to child).

Prevelance of Hep B

The virus has the ability to cause an infection of the liver that can have long-lasting effects. For infants – this disease can be exceptionally serious and this is found when the mother is positive for the hepatitis. 

Now in countries that have a much better infant mortality rate, such as Sweden and The Netherlands, medical professionals only administer the vaccine to mothers who test positive for the disease, not all newborns.

It’s also important to note that it has been recommended that the routine vaccination of all newborns for Hepatitis B is performed only in areas where the carrier prevalence is greater then 2% - this does not include the United States![*] 

You might say that the vaccine is safe, so why not be extra sure? However, do you know how many safety studies have been performed on the Hepatitis B vaccine for newborns?

None.

 

You may want to consider delaying this vaccine until your next pediatric visit (2 months) or declining it until the risk is more prominent. Click here to learn more about hepatitis B and the vaccine used.

First Bath

Although it might seem somewhat logical to wash a baby immediately after birth, there are significant drawbacks that you might not have otherwise considered.

Firstly – if you decline or delay washing your newborn in the hospital, you might find more resistance then any other routine produce listed here. You will be met with the counter, “It is hospital policy” – this may very well be true but it does not mean you are required to abide by the policy, you have every right to decide what or what not procedures or performed on your child. [4]

If you alter the routine schedule of bathing, the hospital staff may insist on wearing gloves to handle your child – which is fine by me – this is because the medical thought is that your child will be posing a hazard to the staff.

Consider this-who is posing more of a hazard to who?

Newborns have a valid risk of nosocomial infection (infection that is caused by hospital staff) especially with MRSA strains. Bacteria have adhesive pili on their surface to attach to skin – the vernix that is rubbed into the baby’s skin and is allowed to stay on the newborn significantly inhibits growth of bacteria, as well as being antimicrobial in nature (similar to breast milk).[5][6][7]

A baby is born with exceptionally senstitive skin. Vernix can be rubbed into the skin and is highly effective at deterring the growth of common pathogens found in the hospital: as group B Strep, K pneumoniae, L. monocytogenes, C. albicans and E coli.[7] 

The Department of Health (in conjunction with the World Heath Association) sets forth protocol for newborns: specifically in the section addressing the 0-3 minutes after the baby is born which states - Immediately dry the baby but “do not wipe off vernix” and “wait at least six hours to wash the baby”. [8]

Personally, I would wait longer – I would wait to wash my baby at home. Commercial products used in hospitals are harsh and can be harmful on neonatal skin. You could bring your own baby wash and ask the nurse if you could give your baby it’s first bath. I think that would be ideal if you choose not to wait until you get home. 

Remember, there are no evidence-based guidelines relating to newborn skin care in hospitals and postnatally, vernix exhibits antioxidant, skin cleansing, temperature-regulating and antibacterial properties.[9][10]

Conclusion

Remember, you have every right to choose what will be performed on your baby.

Cautiously take into account what care options you have. If you have questions about a procedure for your baby-speak up and ask.

You are the number one advocate and the only voice your child has. Your responsibly is to him or her, not out-dated hospital policies.          

          

[1]Umbilical Cord Clamping. ScienceDaily. Retrieved October 10, 2012, from http://www.sciencedaily.com­ /releases/2008/04/080415194222.htm

[2]McDonald SJ, Middleton P. "Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes (Review)." Cochrane Database of Systematic Reviews 2008, Issue 2.

[3]Gina Eichenbaum-Pikser & Joanna Zasloff. Delayed Clamping of Umbilical Cord: A Review With Implications for Practice: Benefits of Delayed Cord Clamping. J Midwifery Womens Health. 5(4):321326.2009  http://www.medscape.com/viewarticle/708616_3

[4]Andreas Matussek, Jan Taipalensuu, Ing-Marie Einemo, Malena Tiefenthal, Sture Löfgren. Transmission of Staphylococcus aureus from maternity unit staff members to newborns disclosed through spa typing. American Journal of Infection Control. Vol 35, Issue 2. Mar 2007 http://www.sciencedirect.com/science/article/pii/S0196655306011898

[5]Annika Nelson, Kjell Hultenby, Éva Hell, Hilde M Riedel, Hjalmar Brismar, Jan-Ingmar Flock, Joachim Lundahl, Christian G Giske and Giovanna Marchin. Staphylococcus epidermidis isolated from newborn infants express pilus-like structures and are inhibited by the cathelicidin-derived antimicrobial peptide LL37.Pediatric Research. 25 Mar 2009 http://www.nature.com/pr/journal/v66/n2/abs/pr2009183a.html

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[8]Care of the Baby at Birth. Module 1Neonatal Divison, AIIMS, New Delhi http://www.newbornwhocc.org/enn/Care_at_Birth1.pdf

[9] Lynne Walker, Soo Downe, and Liz Gomez. Skin care in the well term newborn: Two systematic reviews. Birth. Vol 32 issue 3. Sept 2005 http://onlinelibrary.wiley.com/doi/10.1111/j.07307659.2005.00374.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false

[10]Johann Wiechers, and Bernard Gabard. Vernix Caseosa: The ultimate natural cosmetic? Cosmetics & Toiletries. Sept 2009 Cosmetics & Toiletries Sciences Applied

[11] Giving Birth Naturally Webpage: Routine Newborn Baby Care Procedures. http://www.givingbirthnaturally.com/newborn-baby-care.html