By Elizabeth Chuck
As interest grows in alternative birthing options, such as water births, consumption of placentas, and deferral of vaccinations for newborns, physicians should advise expectant parents of the risks these decisions could pose. suppose for babies, according to a new report.
The clinical report was published online in Pediatrics, the peer-reviewed journal of the American Academy of Pediatrics, and examined seven emerging birth trends.
[This young woman made it a point to give birth at home: “I brainwashed myself on the internet.” The result was tragic]
Little or no clinical studies have been conducted on some of the trends covered in the report, such as so-called lotus births, which involve leaving the umbilical cord and placenta attached to a baby until the cord falls off naturally, in instead of cutting it when it is born.
But the document referenced incidents where these non-traditional movements resulted in medical emergencies.
Lotus births, according to the paper, had no clear benefit and, in rare cases, led to sepsis, an extreme response to infection, in newborns.
Dr. Dawn Nolt, lead author of the report, said the goal was to educate pediatricians on how to advise families considering these practices and to make pediatricians more aware of how to evaluate and treat a child who may have developed an infection such as result of these birth choices.
"I think this report fills a gap," said Nolt, a professor of pediatrics in the division of infectious diseases at Oregon Health and Science University.
"We really hope families feel comfortable enough to discuss these practices with their provider."
The report also revealed:
Water births, which involve making childbirth more comfortable by immersing the pregnant woman in water, have been shown to be beneficial during the first stage of labor.
However, there is no benefit for the second stage of labor or delivery, and there is a potential for serious waterborne infections, according to the report.
The report also cited cases of drowning or near-drowning of babies born underwater.
[Why 2022 will be a “dramatic” year for abortion rights in the United States]
The practice of a trend known as vaginal seeding, which involves applying fluid from the mother's vagina to which babies born vaginally are exposed, is still not considered safe.
A small pilot study suggested this could be beneficial for the baby's microbiome, according to the report, but cautioned that studies are ongoing and this practice should not be done outside of a research setting.
An unexpected birth in the air: a woman gives birth on the flight to Hawaii
May 3, 202101:19
According to the report, consuming placenta - a practice that has gained popularity for its purported benefits for the mother, such as increased energy and increased breast milk production - has not been shown to provide any boost.
However, one case report identified a newborn sickened by bacteria from placental capsules taken by her mother.
[FDA authorizes abortion pills to be mailed]
The report advises against delaying the dose of hepatitis B vaccine that is recommended for all healthy babies for 24 hours after birth.
It also found no reason to delay giving the eye ointment that prevents gonococcal ophthalmia, an infection that can cause blindness if left untreated.
There was a trend in births that the report welcomed: delayed bathing, that is, not giving a newborn a first bath until several hours into its life, unless the baby has been exposed to HIV, to genital lesions or other infection.
Many hospitals have already integrated this practice.
Dr. Alison G. Cahill, chair of the Clinical Consensus Committee — Obstetrics at the American College of Obstetricians and Gynecologists, praised the report for the “plenty of guidance” it offers doctors talking to expectant parents.
“While all providers try to take advantage of opportunities to individualize the experience of pregnant women and their families when it comes to the birth experience, we want to do it within the limits of safe clinical practices,” said Cahill, who is also a professor of women's health at the University of Texas Dell Medical School at Austin.
However, the president of the American College of Nurse-Midwives, Catherine Collins-Fulea, said she viewed the report as "somewhat one-sided" and suggested that anecdotal case reports about birth options should not be generalized.
So you can identify if your child is facing emotional problems
Jan. 20, 202204:35
Many aspects of childbirth cannot be well studied in clinical trials, but that does not necessarily mean that childbirth options cannot be safely presented to expectant parents.
"I really think it comes down to maternal choice, when we don't have strong evidence one way or the other," he said.
[A Canadian girl was kidnapped by her father to avoid being vaccinated]
Both Collins-Fulea and Cahill said they have seen an increase in inquiries from expectant parents about many of the trends listed in the report, particularly vaginal seeding, as the rate of C-sections in the United States has increased.
Although the report does not endorse vaginal seeding, Cahill said it could eventually be accepted as beneficial within the medical community if more research proves it.
"But again, there are so many infectious concerns that it's something we strongly discourage, unless it's in a research setting where the patient has consented," he said.
A reaction against “too medicalized” births
According to Cahill, the interest in new birthing options stems from a combination of factors: Expectant parents receive information about labor and delivery from a variety of sources, including social media and celebrities, and there is growing skepticism about traditional medical practices.
[Family of man stabbed decades ago by pig heart patient questions operation]
“I think there is a concern in some communities that the experience of birth and childbirth is, if you will, too medicalized, or too Westernized,” she said.
Collins-Fulea, for her part, noted that there are proven benefits associated with less extreme versions of some of these trends.
Although leaving the umbilical cord intact for days after birth has no documented benefit, delaying cord clamping—or not cutting the cord for at least 30 to 60 seconds—is recommended to increase hemoglobin levels in babies.
Nolt suggested that parents might gravitate toward the more radical options outlined in the report because they believe these practices could improve the mother's health and comfort, improve the baby's health and comfort, or give her an edge in the world.
But unproven birthing methods aren't necessarily the answer.
“We know that there are good practices: prenatal vitamins, good nutrition, rest for the mother.
And for the baby, just being in tune with her needs,” Nolt explained.
[Colorado Woman Denied Transplant Because She Wasn't Vaccinated]
Cahill encouraged all expectant parents to ask their healthcare providers questions.
"There is too much at stake in medicine to follow a path in which there is no evidence," he recalled.