Time to change our Newborn Model of Care

Hi! Today, I am sharing with something that has been disturbing me for a while.

A little while ago, I was with a doula client* in a hospital. The baby required some medical attention. This baby was healthy, except for a few things that showed up in his blood test, and a traumatic birth. Now, I am not a doctor. This baby may have really needed that we intervened, and I am not able to pose a diagnosis or an opinion on that subject. But one thing is certain, the way things were done could have been different, and it would have made a huge difference for that baby and his mother.

My studies in pre-and-perinatal psychology have taught me that most modern newborn hospital protocols have been created under the belief that babies' brains at birth are too immature to realize what is happening to them, to remember it, and that they are not able to feel pain (physical or emotional).  Of course this belief has since been proved entirely wrong, as babies are sentient beings who are conscious of what is happening to then, have a wide range of emotions, and who feel pain even more strongly than adults do. That out-dated belief, combined with a total ignorance of the immense benefits of skin-to-skin, and a bad understanding of the workings of breastfeeding and of the absolute necessity never to separate a newborn from his mother, except in extreme cases, is often still what drives medical protocols on newborn care.

Now this baby, very close to term, who seems healthy, was breathing and pink, and was a champion breastfeeder, was separated from his mother to go under observation. They isolated him in a plastic box. All day long, he had to undergo physical exams, blood draws on every available veins on his little body (including on the scalp), and surveillance by a machine that beeps loudly if something is a little out of the normal (or more often, when the sensor moves). They put him on an IV. They even refused to bring him back to his mother who could not get up, because there wasn't enough nurses on staff to be able to go with him. So they told the mother to pump her colostrum so that we could give it to the baby with a cup.

Never was the baby in a critical state. He did not need assistance to breathe, was not premature, and was not sick. And even if the care he received was necessary, the IV and all, ALL of these interventions could have been done in the room with the mother. An IV? A saturometer? A machine that goes beep to count his heartbeat and breathing? Why can't it all be dont in the room with the mother? Instead of a plastic box, this baby could have been kept warm by being skin-to-skin with his mother, which incidentally also regulates the breathing and heart rate. That way he would also have had the nipple available to eat when he wanted to keep his blood sugar at a good level.  This mother could have been able to get to know and bond with her baby better, and feel more competent in taking care of him and seeing how he was doing. The blood tests could have been done while the baby was breastfeeding, as suckling on the nipple helps reduce pain, instead of being put on a table under a neon with a gloved finger in his mouth.

Of course it is easier to put all the babies in the same room to watch them all at the same time. It saves staff, and makes it faster for all the check-ups. I know the nurses and medical staff do the best they can with the tools that were given to them. But I think it is time to change. It is time to put the discoveries of the last 30 years into work for an entirely new, modern and gentle way to care about babies.

Why is it still acceptable to separate babies from their mothers? Why, with all the microchip techonologies we have now can't we come up with a device that gives a full blood test with a single drop? Or even better still, through the skin? Why do we still make the mothers feel incompetent when it comes to caring for their own offspring? Why do we rely more on the machines than on our eyes to assess the state of a newborn? So many questions and so few answers...

Stories like this one, there are dozens, and a lot of them have undergone even more painful procedures, like a spinal tap for example. And very often, the parents don't have a doula with them to keep the baby company and reassure him until they are able to come take over. As I was keeping this baby company, I looked at all the other babies in the nursery, most often they were left alone for longs periods of time. I thought I was in the 50's. A nurse even said, nodding to a screaming and distressed baby, something like « his brain is too immature to know what is happening, he doesn't know what he want». In the eyes of the babies, you could read incomprehension, sadness, questioning: Where is my mom? What am I doing here?

I got out of this birth shocked, sad, and angry. Angry at the ''modern'' medical system who wasn't able to welcome and protect this baby as it ought to have done. I also got out with my heart full of love and compassion for this mother and her baby, who had a more than trying day. I hope I was able to help a little bit to dim the negative impact of the hospital protocols on that baby. I hope some day things will change, that we will treat the babies as we ought to, and without separating them from their mothers. As a matter of fact, I had a few ideas to improve neonatal care, but this will be the subject of a future post. 

* I have the permission of my client to relate this story

Sources: 
CHAMBERLAIN, David, Windows to the Womb, 2013, North Atlantic Books, California, 225 p.
ODENT, Michel, The Baby is a Mammal, 2007

VERNY, Thomas, with KELLY, John, The Secret Life of the Unborn Child, 1981, Dell Publishing, New York, 253 p.
APPPAH
http://www.kangaroomothercare.com
What Babies Want, film by Debby Takikawa Dc., 2004


Studies:
Early skin-to-skin contact for mothers and their healthy newborn infants
The importance of Skin-to-Skin contact



Have a nice day!


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