Saying No, Part I

Sometimes I think my "green" and "crunchy granola" personality gets hidden behind societal norms and my personality traits of "frugal" and "cheap-skate."  It's actually quite convenient that the two go hand in hand so often (except, sometimes, when buying organic groceries).  But I really have been motivated on saving our planets resources since I was a little girl.  I remember doing science experiments at home to see how long it would take rubber bands to rot away due to bad stuff in the air and having celery soak up food coloring to discover about how our plants are affected by what's in the water and the soil.  Did anyone else own this book: 50 Simple Things Kids Can Do to Save The Earth?  I think the cover's changed a few times since I was in elementary school.  But I will never forget that book.

So along with having to say no to myself about all sorts of things I want to buy, but don't, as we're trying to get out of debt, I am aware that saying no as a mother will be important too.  And I think it starts long before one's child is old enough to do something naughty.  As babygirl Warren grows and kicks more, I've been thinking about labor, delivery, and child birth and all of the things I might want or not want to be a part of that process.  You know I've been working with a midwife and my goal would be to have as natural of a birth as I can safely manage (though Ben swears at least one of us will be drugged for the process).  I'm not opposed to pain killers, epidurals, pitocin, IVs, fetal monitors, or even c-sections if my midwife thinks these are necessary to keep myself and my little one safe, but I'm not going to pursue them as "the standard" like many American women do.

Along with that, there are a variety of medical interventions that Americans perform/do/provide to their infants within the first few hours of life that I am wondering if I should say no to as well.  I had a chance to talk with my midwife about these at Thursday's appointment.  And I'll be honest, even though I knew I was working with a "crunchy granola" midwife, I was pleasantly surprised at how quickly she told me it was okay to say no.

The first one she said I could say no to was really more of a "maybe," which I think is fair.  It is: VITAMIN K.  In the US (and many other western countries) babies are given a shot of Vitamin K during the first few hours of life to help with blood clotting.  I was concerned, though, because I believe the research that outlines how you want to minimize traumatic experiences as much as possible with little ones, especially brand-new-day-one little ones.  A shot, no matter how routine, is a traumatic, painful event.  So I wanted to look into the whats and whys of vitamin K shots-- to determine if it's really necessary.  Here's my own brief summary of what I learned:

• Vitamin K shots became common in the 40s (when "twilight sleep" labor was common) when most women were so knocked out that they had to use forceps to deliver the baby and therefore, head traumas were very common.
• Vitamin K literature is skimpy with regard to what the "right" dose should be -- it's never been thoroughly tested
• The only reason they give it by shot (rather than by mouth, which has been shown in the literature to be effective as well) is to "ensure that the baby actually gets it."  Really?
• Babies often "loose" or "miss out" on 40% of their blood volume at birth by clamping and cutting the umbilical cord immediately after birth (rather than waiting until it stops pulsing, about 5 minutes).  
• The reason people clamp and cut so early is so that they can take the baby across the room, away from mom, to perform other interventions... many of which have to do with being in distress because there's not enough blood (do you start to see the circular reasoning here???)
• Vitamin K is passed to the baby better in breastmilk/colostrum than it is through the placenta.  However, many babies aren't nursed immediately and miss out on the early doses of colostrum which are high in Vitamin K.
• Vitamin K uptake is reduced/limited when mothers or babies are exposed to antibotics during 3rd trimester or labor/delivery

I read a lot of websites and articles, but I won't bother siting them all here.  My favorite one was at gentlebirth.org if your curious to read it in someone else's words.  But if you're really considering saying No yourself, I'd also encourage you to look at something with evidenced based citations, which that site is missing.

So, when I asked my midwife about skipping out on vitamin K, her response was that it was reasonable if I don't have a traumatic birth (aka, if I don't need a c-section, forceps or vacuum delivery, lose a lot of blood, baby immediately in distress, etc-- all those things that I am hoping not to need anyway).  She said that Mount Auburn would administer it (if we consented) after the baby was taken to the nursery for her exam and bath and Ben went with her, so Ben would have to know what our plan was.  I thought that was all quite agreeable. 

Having researched it now, my hope (but not expectation.  I know I can't expect perfect) about vitamin K is that 

• I have an easy, natural birth without trauma,
• Baby is well enough that she can stay with me for at least the first 5 minutes until the cord stops pulsing before we cut it,
• Baby is well enough to stay with me for the first 2 hours in the labor/delivery room so that we can start nursing ASAP,
• and therefore we'll be able to decline the vitamin K shot.

On a related note, I also found conflicting information about ways that mom can consume vitamin K to best help baby.  A couple places talked about how vitamin K isn't passed well through the blood, so there's not much I can to do help.  But a couple other places talked about how increasing my vitamin K could help.  One source discussed a small study in ?Norway where they tested vitamin K levels during the 3rd trimester, which were gradually dropping in all of the women, presumably because the baby was taking the vitamin k that he/she needed, leaving low levels for mom.  

Now I'd say, even if the vitamin K doesn't pass through my blood to my baby, I still don't want low vitamin K levels for myself... I need good clotting too, right?  I mean, first of all, I've always bruised easily, second of all, I'm gonna have a lot of blood loss during labor/delivery, and 3rd, it can even contribute to silly little things like increased gum bleeding when I floss!  Thus, I want to keep my vitamin K levels high, if I can.  So the first thing I did was look at my prenatal vitamin... not a single drop of vitamin K in it!!!  I was stunned!  If we're in such a rush as a society to give it to baby immediately after birth, why aren't we, as a society, trying to pump it in during pregnancy?  That led me to looking for other, more natural ways to get vitamin K. And really, if I'm eating well, I should be getting plenty of vitamin K. Take a look at this list of vitamin K rich foods:

"Excellent sources of vitamin K include parsley, kale, spinach, Brussels sprouts, Swiss chard, green beans, asparagus, broccoli, kale, mustard greens, turnip greens, collard greens, thyme, romaine lettuce, sage, oregano, cabbage, celery, sea vegetables, cucumber, leeks, cauliflower, tomatoes, and blueberries."

Again, I won't bore you with ALL the links I looked at, but this site seemed to be a pretty good summary of what vitamin K is, what it's helpful for, how to get it, etc.


What vitamins and minerals are you most on the look out for in your diet???


p.s., next post - eye ointments and hep B shots for newborns... stay tuned!