Give that Baby some Oxygen!

A few years ago, I had a picture of Rixa Freeze PhD holding her newborn son on my website. I had the pleasure of attending her birth, so with her permission I wanted to share the beauty of that moment as a testimony to the relaxing nature of waterbirth.

Not too long afterwards, I received a concerned email fromRixa and Dio an obstetrician that recommended I remove the picture because it clearly demonstrated a depressed newborn in need of oxygen. I had to look again at the picture, as I didn’t remember distress.

Babies born at home into their mommy’s hands, aren’t typically frightened when they are born. They don’t often scream. They aren’t immediately separated from their pulsating cord. They aren’t cold and hanging from an obstetrician’s hands. They aren’t overwhelmed by noises or lights.

Waterborn babies born are welcomed into a buoyant environment that is similar in temperature to the womb, and can ease into breathing because they are supported by a cord that continues to oxygenate. They are alert and engaged, although often are blue at the onset. We have had a number of clients share that they didn’t hear a single cry for a day or two after their little ones were born.

As an NRP instructor, I appreciate that some years ago, a blue baby meant cyanosis and oxygen was immediately provided to “perk baby up.” In fact, I caught myself once more recently doing the same.

We had a post-dates mother birth a little six pound, baby girl who was slow to breath and had poor tone initially. We offered gentle stimulation, which was effective although she seemed to need a few reminders to continue her participation and we suctioned a significant amount of fluid from her lungs, then laid her on momma’s chest to find her way. She did well, although was working a bit initially to clear her airway and find her rhythm. In spite of being alert and having reassuring tone, her color remained blue.

True to the nature of every practitioner, I gave my nurses several more orders than they could manage simultaneously. Gretchen applied our pulse oximetry monitor and I remember feeling rather aloof. Honestly, how accurate will the reading be when clearly the little one’s body is sparing blood circulation to the feet to preserve more vital organs. My second assistant, Michelle, begins oxygen blow-by just as recognize a 93% reading on the oximeter. She pauses, and we all look at each other in surprise. “Well, tushay little lady. We will get that oxygen off of you and leave you alone with your mommy!”

waterbirth-blue-baby-300x200Homebirth midwives certainly aren’t those that struggle to eliminate interventions that lack supporting evidence, but admittedly, because I wasn’t convinced that pulse oximetry would be helpful in a baby that did not appear to be circulating to the lower extremities, I struggled to accept current recommendations.

Our team was reminded that prior to the initiation of oxygen, the pulse oximeter should be applied and baby should be given up to ten minutes to saturate in the 90s. A term, vigorous, and cyanotic newborn is not always representative of a baby in need of midwifery intervention.

Further discussion about the blue appearance of waterborn babies can be found on our waterbirth page.

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