In this third post in my Making Babies series, I discuss some specific medical protocols and how, sometimes, they might just be obsolete...
Did you know that within an hour after a baby is born, doctors and midwives are required by Health Canada to put a antibiotics in babies eyes (poor little guys!). This outdated practice, as pretty much every progressive health care practitioner agrees, is completely unnecessary, intrusive, and ineffective. Check out this two minute video for a briefer on the subject:
These eye drops are meant for mothers with STIs like gonorrhea or chlamydia to prevent them from passing these infections on to their newborn and potentially causing eye issues. The thing is, they aren't very effective, nor does every mom have these sexually transmitted infections, and there are other, more effective ways to treat these STIs. Read more about this here and here.
Thankfully, parents now have the choice to decline these antibiotics. You simply inform the medical staff that you don't want erythromycin, and they will give you a waiver to sign.
This outdated practice highlights a little problem in our medical system: obsolete yet standard medical protocols.
Although this antibiotic eye drop protocol has been repeatedly challenged by front line medical professionals, as well as parents, the procedure still continues. I guarantee that in 5-10 years they will no longer be routinely administering these antibiotic eye drops, but this change has simply not yet happened.
Standard medical protocols are dictated by government, which can be slow to change, so sometimes protocols get "stuck".
These protocols generally were the best line of treatment for a specific time period, but in light of new evidence have been proven not to be. Medical knowledge evolves but new protocols are sometimes slow to get approved and implemented.
I've come across a few other standard medical protocols that I, personally, think could use some review, which I will list below.
Some people totally don't mind just following protocol and that is fine, but me, I like to avoid any unnecessary medical interventions & thought I'd share the things I'm most likely opting out of. You have the right to as well!
Of course, it is important to discuss these topics with your medical provider and figure out what is best in your particular case. If you have a health condition or your baby isn't thriving, these medical protocols could save you -- that is what they are intended to do. Always be wise!
Medical Protocols that might be overused/unnecessary:
Stretch and Sweep
Besides being the grossest, most alarming possible name of something that someone is going to do in your vagina, this common procedure is said to aid in helping move along labour by manually separating the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may kick-start your labour. It often causes cramping and bleeding, and is described anywhere between unpleasant to painful.
If you have a complication like high blood pressure or just really want the baby out, this is perhaps something drug free to try and tip the scales and start the cascade of hormonal events that trigger labour. That being said, I am of the school of thought that the baby will come when it is ready and this might just be an uncomfortable and unnecessary addition to the waiting game. Read more about stretch and sweeps here.
Labour Induction with Synthetic Oxytocin
I will be discussing this more in depth in a future post, but put very simply:
Due dates are just estimates and healthy natural labour can start anywhere from 38-42 weeks.
Standard medical protocol in Ontario is that at 41 weeks and three days you will routinely be induced by synthetic oxytocin. The iffy part of this is that on average, a first time mother will naturally go into labour at 41.3 weeks. If the estimated due date is inaccurate by, let's say 5 days (which even the best ultrasound techs say is the closest they can guarantee), or the mother had a longer menstrual cycle and ovulation was later than a textbook case, we could be routinely inducing women with artificial hormones earlier than the estimated '41 weeks and 3 day' marker.
This isn't a big huge deal because babies are totally viable after 37 weeks, however, induction with synthetic hormones generally causes a more intense and painful onset of contractions, a higher likelihood to request an epidural and require the assistance of a vaccuum. Women who are induced are also at a significantly higher risk for c-sections. Something to consider.
Routine IV set up
It is standard practice in most hospitals in Canada that when a woman checks into the hospital she is given an IV for fluids and "just in case" they need to administer other things. If you have someone there to make sure you drink and eat enough & you are low risk, I'd opt out of it. Most modern medical practitioners don't mind, just say you'd rather not have the IV.
I, personally, think it is more comfortable for women to not be hooked up to an IV and if a woman is more comfortable, the labour will be easier. There are situations where an IV is necessary. Please, again, talk to your medical practitioner about it.
Vaginal Exams (every 2 hours)
As I am writing this I am two days overdue. I saw my doctor yesterday, who works on a teaching team so when I go in, I see her and an intern. The intern informed me that when I check into the delivery ward I will be getting a vaginal exam every 2 hours to make sure "things are progressing".
Um, A VAGINAL EXAM EVERY 2 HOURS? Pass. Hard Pass.
I told my doctor I'd prefer minimal vaginal exams and she agreed every two hours is excessive and unnecessary. Each exam opens you up to potential infection and, as everyone is probably aware, is rather uncomfortable.
Of course, if there are signs of trouble or it's been a while and nothing is happening I'll re-examine my stance on this but to just routinely check every vagina every 2 hours seems...a bit much. According to the World Health Organization, every 4 hours is sufficient and even then it isn't clear how much these help.
Take a look at this study which states, "It is surprising that there is such a widespread use of this intervention without good evidence of effectiveness, particularly considering the sensitivity of the procedure for the women receiving it, and the potential for adverse consequences in some settings." I concur.
Again, these are simply things I think aren't always needed medically and thought I'd share.
Maybe a vaginal exam every couple of hours provides comfort to some women to know that they are being monitored well and perhaps labour induction sounds awesome to a women who just wants to get the party started.
I don't think my way is everyone's way. Please see my post on non-judgement.
As always, take only what serves you.