Banning early C-sections is a very interesting headline…I am not sure how hospitals in Oregon are going to actually enforce this hard line control on early, elective Cesarean sections.
Having a c-section for other than true medical necessity is never a good idea…the baby is still developing during the last weeks of pregnancy. Certainly it is not a great thing for a newborn to be shuttled off to the NICU for respiratory problems due to an early elective c-section…not to mention the added cost of the NICU care.
- After delivery if a baby is in the NICU the bonding that is so important is difficult because mom is dealing with her own post-op pain and restrictions.
- Breast feeding then becomes more difficult as well and cannot be established as early in the postpartum period as it generally is after a vaginal delivery.
It will be very interesting to watch how all this ‘plays out’ in Oregon and how it influences what is happening in other states as well.
Starting next week, many hospitals in Oregon will be taking a stand against early and elective Cesarean sections, MSNBC.com reports. C-sections have become commonplace, and federal statistics now show that surgical deliveries account for more than 30 percent of all U.S. deliveries.
However, Oregon officials are now working toward the goal of giving “babies more time for important development and to reduce costly complications after birth,” MSNBC reports.
Seventeen Oregon hospitals (including all nine birthing hospitals in the Portland area) are implementing a “hard stop” on these elective procedures, says the March of Dimes’ Oregon chapter, as quoted in the MSNBC report. According to a 2009 study published in the New England Journal of Medicine, about 1 in 3 C-sections is performed before 39 weeks (37 to 41 weeks is considered full term).
via Oregon Plans Ban on C-Sections – Parenting on Shine.
There is a new recommendation from the American Academy of Pediatrics and the American College of Cardiology Foundation and the American Heart Association which calls for screening of all newborns for congenital heart defects.
Before newborns leave the hospital, they should receive a simple, pain-free test to check for signs of congenital heart disease, one of the most common types of birth defects, according to a recommendation by a federal advisory panel.
via Congenital heart disease screening recommended for newborns – latimes.com.
A congenital heart defect can be detected early but often goes undetected because newborns can appear normal in the first few days after delivery. The reason these newborns look normal is that fetal circulation may still be functioning somewhat and thus they do not turn ‘blue’ or have a signs of distress until after they are at home.
This is pretty scary stuff for parents. A simple pulse oximetry test can look at the oxygen in the baby blood. It is non-invasive and requires putting an electrode on the newborn’s toe. Although there may be many false positives with this test it can give an indication of whether the newborn is in any kind of distress which is not evident by listening to his/her heart sounds or by looking at his appearance which may indeed be pink and healthy looking.
The question here is what to do if the pulse oximetry is positive indicating that there may be a problem. This has not yet been worked out thoroughly. The newborns that have a positive pulse oximetry may be sent for further testing such as a cardiac ultrasound. Not all hospitals are capable of newborn follow-up so the baby may have to be sent to another hospital for these tests. Parents will be upset and anxious until the results are in…but it is a small price to pay to avoid a possible life threatening cardiac event in the newborn period.
I am not sure what the protocol will be concerning these new recommendations but each hospital will more than likely develop their own response.
Parents need to be aware of these recommendations and the reasons for them so that they can advocate for their newborns and make sure that their precious little ones get checked out thoroughly.