One of the more infuriating aspects of Woman as Patient are the events that tend to unfold during and immediately following the birth. Just as during labor, the power dynamic is established early on, so too, is the establishment of “possession” of and entitlement to the newborn immediately following the birth.
I’ve explored in some detail in a prior post the power struggle that takes place during the birth. Here, I’ll focus on the events immediately following the birth, and how they serve to maintain woman as patient, thereby diminishing her confidence in her own intuition as a mother.
Announcing the Sex
Many parents choose to learn the sex of their baby midway through pregnancy, but for those who don’t this moment of discovery has been anticipated for many months. For mothers who are respected and quietly given their baby immediately, often this discovery takes place many moments following the birth, as she simply revels in the euphoria of this new life. I recall with my two youngest, this being the case. While exploring this new being’s beautiful body, it occurred to me to check, and it was I who whispered, “it’s a boy” each time. But for many, this experience is robbed. The detail is exclaimed for the entire labor ward to hear just as the gendered parts emerge.
Immediate Cord Clamping / Cutting
In the technocratic model, the cord is clamped and cut immediately following the birth. Some practitioners will wait a moment or so, but under this model, there is no room for waiting and variations – certainly not something as obscure and uncalculated as waiting for the cord to cease pulsating. (See here for details on the importance – with scientific support – of delayed cord clamping.) Not only does this pose risks to the baby, as noted in the article referenced above, but this practice has its roots in immediate and routine separation of the mother-baby dyad immediately following the birth.
The cutting of the cord is also very symbolic – representing the weaning of the physical connectivity of the pregnancy. An abrupt severing of this connection signals the imposition of quick transition, rather than one that is intuitive, gradual and loving. It reinforces the idea that baby is its own entity, separate and independent of its mother.
Immediately severing the mother-baby connection displays the institution’s sense of ownership over not only the process, but also the “product.”
Suctioning of the Newborn
Within seconds of the birth, baby will be suctioned – usually with a bulb syringe, and sometimes with deep suction via a tube down the throat. Baby usually objects, obviously. It is quite intrusive to have a rubber object forced into the mouth; even more so, the throat.
Most people don’t understand the concern over suctioning. After all we need to ensure that baby breathes well, right? Of course. But the assumption that baby will not do this on her own without outside intervention again communicates our complete disconnect from and mistrust in the natural process.
Intervening with immediate suctioning without waiting to see if baby needs assistance is not only disrespectful and intrusive, it potentially sets up breastfeeding difficulties, as baby’s first experience with something in her mouth is a rubber syringe, which she actively tries to push out during the experience. This first experience is now imprinted in her brain, and it can be a challenge to reprint when the nipple is introduced.
Separation of Mom and Baby
While most mothers today opt to remain with their babies (dubbed “rooming in”) rather than send their newborns to the nursery, there still does remain an initial separation for most mother-baby dyads following the birth. In the managed care birthing system, where birth is likened to a factory process, there are numerous items on the newborn’s chart waiting to be systematically checked off. While many practitioners have (finally) recognized the importance of placing baby immediately on mom’s chest following the birth, most still don’t get it.
Usually mom is allotted several moments with her precious babe before he is whisked over to the warmer, where he will be measured, weighed, injected, cleaned up, wrapped up and served back to mom in a neat little package.
Again, not only is this process disrespectful to a mother who has just completed the most difficult work of her life, but it disrupts a natural bonding process that has been facilitated by mom’s hormones, now surging with the purpose of ensuring attachment and love. The interruption leaves both mom and baby feeling confused, lonely and distressed. Additionally, it lends again to trouble breastfeeding. Studies show that initial separation interferes with baby’s ability to self-latch as much as a baby groggy from medication (Lancet, Vol. 336,1105-07).
In this routine interruption, we are reminded that hospital procedure and staff convenience trumps mom’s and baby’s experience.
Mothers experiencing managed care in pregnancy are tested prenatally for STI’s. Even if mom is found clean of any STI, baby is still expected to take the antibiotic eyedrops as a precautionary routine.
Even though it is essentially unnecessary antibiotic exposure in the first hours of life.
Even though mom is breastfeeding and providing heaps of her own perfectly concocted antibodies and immunities.
Even though it is completely unnecessary if there is no infection present in mom.
The message here is that a woman’s body is unclean, a potential harbor of germs and bacteria waiting to infect her newborn.
Babies are born with low levels of Vitamin K, which is why newborns receive routine Vitamin K injection at birth. The purpose is to prevent a very rare bleeding disorder, Hemorrhagic Disease of the Newborn.
The fact that newborns are born with extremely low levels of vitamin K should not automatically lead to the conclusion that all newborns are thereby “deficient” in Vitamin K. Our bodies work in very specific ways for very specific purposes. It is interesting to note that Vitamin K does not pass easily through the placenta, even when mom ingests large quantities, prenatally, suggesting that the fetus is actually being protected from high levels. On the other hand, Vitamin K does pass easily through breastmilk, which suggests that a gradual increase in levels following the birth is what nature intended.
Routine administration demonstrates the belief in the futility of the innate structure of the human body, and the superiority of human-made supplements.
The amniotic fluid residue and vernix hold very specific purposes following the birth, which is why it is important to delay washing the newborn. Vernix is a wonderful cold cream-like substance, holding wonderful benefits for the infant’s sensitive skin. The amniotic fluid contains the same smell as the secretions from the breast, which is why the fluid is referred to as the “path to the breast.” Cleaning it off can lead to …. can you guess?….. Ding! Ding! Breastfeeding difficulties. (I’m beginning to note a pattern, here.)
In the hospital, the baby is washed of the birth residue as soon as possible. It is equivalent to a bio-hazard. And really, why wouldn’t it be? Where hundreds of patients lie in one building, some with lingering bodily fluids all over them, of course it would behoove anyone to remove it in order to keep the place sterile and free from the spread of germs.
So, herein lies the deepest issue of them all. Birthing women should never have been brought into an institution whose mission is to tend to the diseased and injured. Laboring women are neither. Confining them in the same institution as the diseased and broken lays the groundwork for the way that they are treated.