Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Immediate skin-to-skin contact with unstable newborns improves survival chances

medlifestyle.news

Post reply on HN
Print view View original

181–190 of 236 posts

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#181

Post by yupper32 »

gffrd wrote: post #171
yupper32 wrote: post #170

Earlier quoted context omitted.

According to a recent study reported by Reuters, child birth in a hospital setting is far safer: https://www.reuters.com/article/us-health-homebirths-newborn... Skin-to-skin contact immediately after birth is pretty common in hospital settings now. You shouldn't care about it all being a "lovely" or "natural" experience. You should care that everyone gets out safely. Birth can be a brutal and deadly affair.

What's wrong with it being a lovely experience? Couldn't we assume that OP's hierarchy includes the "everyone gets out safely" box having been ticked? This is like saying cars should not be enjoyable because they exist purely to move us around.

> What's wrong with it being a lovely experience?

It shouldn't be a priority. At all. If it happens to also be a lovely experience, that's of course fine. But it's not something to plan around when it significantly reduces the chance of everyone being safe.

> Couldn't we assume that OP's hierarchy includes the "everyone gets out safely" box having been ticked?

They didn't have a hospital birth, so no. It's not a box that was sufficiently ticked.

> This is like saying cars should not be enjoyable because they exist purely to move us around.

This is like buying a two seater sports car and putting your child's car seat up front. It might be more enjoyable for you, and it'll probably be fine most of the time, but it's significantly more dangerous for your child.

My post might sound harsh, but continuing to spout the "benefits" of a home birth is just plain dangerous when the facts don't support safety. I feel the harshness is appropriate.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#182

Post by vlovich123 »

baby wrote: post #172
yupper32 wrote: post #170

Earlier quoted context omitted.

According to a recent study reported by Reuters, child birth in a hospital setting is far safer: https://www.reuters.com/article/us-health-homebirths-newborn... Skin-to-skin contact immediately after birth is pretty common in hospital settings now. You shouldn't care about it all being a "lovely" or "natural" experience. You should care that everyone gets out safely. Birth can be a brutal and deadly affair.

Country A infant mortality rate in 2021: 2.86 deaths per 1000 births. Country B infant mortality rate in 2019: 5.75 deaths per 1000 births. Guess which country is which.

Intra country results can be challenging as who chooses a home birth & who goes to the hospital is already a likely biased population. Maybe the pregnancy is already known to be an at-risk factor, thus biasing things. Or choosing one vs the other may be a confounding socioeconomic factor.

If it's this hard for intra country comparisons, why would one expect inter country comparisons, where one country has socialized medicine & the other doesn't, to meaningfully reflect the specific policies around child birth vs the larger differences between societies?

I don't know the answer, but I don't think simply comparing mortality rates can be used to conclude "natural home birth is safer".

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#183

Post by nthnclrk »

reacharavindh wrote: post #33

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s…

This is almost exactly reflective of our experience here in Australia, too.

The midwifery service was genuinely amazing and our midwife also positioned childbirth as a natural thing, not a "medical event" (by default anyway).

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#184

Post by missedthecue »

OJFord wrote: post #131
doggodaddo78 wrote: post #65

Earlier quoted context omitted.

I just watched the Frontline episode on the Healthcare Divide where US safety-net hospitals (accept anyone hospitals of last resort) have been closing or being sold to vulture investors who buy, trim costs, and sell them at the cost of reduced care. For-profit healthcare should be like for-profit prisons: illegal.

I'm not sure about that, I live in the UK with public healthcare and optional private for-profit; I think that's fine. Non-profit replacing the public is an interesting idea though, I've never heard that suggested before, people usually just argue about public being available or not. (And invariably quite pointlessly since neither side will budge!)

Most Americans don't know this, but in the US, most people have healthcare insurance through a non-profit such as BCBS or Kaiser or Wellmark. Additionally, 2/3 of the hospitals themselves are non-profit.

The non-profit model is more prominent than the for profit model in the direct care area of healthcare.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#185

Post by jac241 »

souprock wrote: post #144
tootie wrote: post #142

Earlier quoted context omitted.

Lol, you know epidurals only last as long as they're administered right? As soon as the baby and placenta are out, they stop the flow and feeling starts coming back pretty quickly. The doc can also adjust the level of meds on the fly to allow enough sensation to facilitate pushing. And mom just stays in a hospital bed until it's safe anyway.

It's not just about injury after the birth. It's about injury during the birth. As soon as the baby and placenta are out, it's too late to avoid injury during childbirth. It is no longer possible to let pain be guidance for minimization of injury. The chance was missed.

"Epidural analgesia had no impact on the risk of caesarean section or long-term backache, and did not appear to have an immediate effect on neonatal status as determined by Apgar scores or in admissions to neonatal intensive care." - Cochrane meta analysis: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD....

Have you seen a childbirth, and one without an epidural? There's so much pain that it's not going to be guiding anything. Physicians monitor the status of the infant via fetal heart rate monitoring and monitor the progression of the delivery.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#186

Post by acuozzo »

pedroma wrote: post #174
gambiting wrote: post #50

Earlier quoted context omitted.

Wait, you have to pay to have a baby in the US? The wealthiest country in the world cannot even pay for the birth of its own citizens? I can understand arguments for private healthcare etc....but making people pay to give birth is insane.

Why should I pay for other people's kids if I'm never going to have kids? The only people that should have to pay for those services are the people who actually use those services. For things that are unplanned like injuries (or even unplanned pregnancies), payment can be deferred if necessary and wages deducted straight from the paycheck to pay back for those services. Ideally, roads are that way too. People license…

> Why should I pay for other people's kids if I'm never going to have kids?

Medical Debt Up => Poverty Up => Crime Up => Incarceration Up => Paying for their imprisonment instead.

You're protected by prisons, so you are a user of the service provided by them and must therefore pay under your model.

> Ideally, roads are that way too.

How would this work for e.g. Montana with seemingly-endless lengths of highway and a very low population density?

…

Let's take things a little further. Do you believe only private schools should exist?

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#187

Post by jac241 »

economusty wrote: post #129
pumaontheprowl wrote: post #126

Earlier quoted context omitted.

2.8 million people die during childbirth every year. It's absolutely a medical condition. And you should absolutely have a doctor there.

Thanks for saying this, most do it in the hospital because if something goes wrong we want to have the best chance of saving mom and child.

It's wild that on a site that educated people use that you're seeing people advocate for homebirths. I'm guessing that next to nobody on hacker news have seen a delivery go south and need an emergency C-section. If you're at home, the ambulance is going to be way too late to prevent serious harm to the baby (hypoxic brain injury) or the mom (hemorrhage, hypotensive shock). There's a reason why OB/Gyns don't have their babies at home - it's because they have seen it go wrong.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#188

Post by tenfourwookie »

I received the opposite care. Was delivered by C-section, no contact with anyone while in incubation for several weeks. My mother would often tell the story of how she was unable to touch me for weeks after my birth.

45 years on and I haven’t a single bond, not with family, not with friends, not even with animals. Like a ghost floating through the world with no attachments and seemingly no compelling interest in them. Active avoidance is on point. But don't be sad for me. It's just the way I developed. And the lack of bonding, skin-to-skin contact with my mother is one possible reason.

They’ve tried to make a number of diagnoses fit, from autism to Schizoid Personality Disorder, Bipolar to Asperger's. Nothing. Nothing fits. There's nothing wrong with me except that I don't bond, at all.

One of the more disturbing experiences was watching what happened to chimpanzees when their mothers were taken away from them after birth (or were denied bonding entirely). They rock back and forth with anxiety; they grapple for the nearest comfy thing; more rocking. It was like watching myself. I'm typing this 45 years later holding a pillow for comfort. You'll rarely see me seated without one. I rock all the time. The pillow, the rocking. They fill a hole. It's protective somehow. I'm sure a shrink would say it reminds me of the womb that was stolen from me.

And I know I'll live the rest of my life like this, without bond, alone, and not really sad because of it, just totally missing what compels others towards their own kind, to bond.

So, yeah, more skin-to-skin sooner. No more lost people like me. Again: not sad about it, but life without others (and very much not wanting them) can be a severe challenge. You have only yourself.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#189

Post by jac241 »

hahahasure wrote: post #127
hallway_monitor wrote: post #93

Earlier quoted context omitted.

We did it in the hospital too but there's nothing stopping you from using a midwife at home right? Another thing that seems to be pushed a lot is epidurals. They expect everyone to get one and are very surprised when someone does not want it.

The epidural costs $6000. A 10 minute procedure. I saw my wife before and after an Epidural so I could not dispute it's effectiveness. But I generally can't see a reason why we need to spend 12 years in school to learn how various needles and rules of thumbs work. Only the US has such an education burden, and only does the US have such a strong physician cartel to mandate it.. Edit, and even with midwives you will be…

The training length for physicians is pretty much the same in all countries. In the US to become an anesthesiologist: 4 years undergrad, 4 years medical school, 4 years residency. Total: 12 years. In the UK to become an anesthesiologist: 6 years medical school, 2-3 years of general postgraduate training, 5 years specialty training. Total 13-14 years. Why did you not look this simple fact up before saying it authoritatively on here?

There's more to it than you think, and it's easy to think that it's a simple procedure whenever you don't know what can go wrong, why things can go wrong, and how to fix things if it does go wrong.

Also, the doctor isn't why it's expensive. Doctors don't set the prices, hospitals and health insurance companies do.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#190

Post by souprock »

jac241 wrote: post #185
souprock wrote: post #144

Earlier quoted context omitted.

It's not just about injury after the birth. It's about injury during the birth. As soon as the baby and placenta are out, it's too late to avoid injury during childbirth. It is no longer possible to let pain be guidance for minimization of injury. The chance was missed.

"Epidural analgesia had no impact on the risk of caesarean section or long-term backache, and did not appear to have an immediate effect on neonatal status as determined by Apgar scores or in admissions to neonatal intensive care." - Cochrane meta analysis: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... . Have you seen a childbirth, and one without an epidural? There's so much pain that it's not goin…

Your study does not address all types of injury.

I have seen more than a childbirth. I have 12 kids.

The most miserable and painful birth was in a hospital. That birth featured pain medication, fetal heart rate monitoring, beeping machines, and a prison-like situation with doors that locked us in. My wife was in pain for months afterward. We learned our lesson and didn't do another hospital birth.

The other 11 births were definitely not "so much pain", but pain did guide my wife to be careful. She was always up and about right afterward, without pain. One time she walked around town doing errands the next day.

Post reply on HN