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The Third & Fourth Stage of Labour Labour doesn't end with the birth of the baby - it ends with the third stage - the birth of the placenta! So if you have any questions about anything third stage, for example cord blood, cord clamping, vitamin K injections or the 'fourth stage' of post-birth bonding, post here!


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Old May 19th, 2008, 05:39 PM
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The thing that the midwives explained to me about the vit k is that the oral dose is actually 3 or more times higher than the injection.

As far as vaccinations, I have conscientiously objected for all of my kids so far, and signed all of the forms when booking into the hospital. Of course, you still get certain medical "professionals" questioning your decision (I even had the local early childhood nurse begging me to reconsider, for the safety of the other children they come into contact with!) My kids are all healthy and the only childhood disease they have picked up has been chicken pox (which isn't on the immunisation schedule anyway! Or should I say, not that I know of - it wasn't up until the birth of my last, but I haven't checked recently!)

I really do think it's all personal choice though, and I am glad to have that choice!
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Old May 19th, 2008, 06:05 PM
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We didn't have any hassles declining. It was in our birth plan so the midwives just brought us the right forms to sign. We ended up deciding to give him the vit k by injection though as he had a pretty big bruise on his head. We were happy with that as a case specific decision.
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Old May 19th, 2008, 07:17 PM
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I'm glad they didn't pressure you to vax ren.

Coming a bit late but we decided to take the Vit K vaccine (in the UK they don't offer anything else until 2 months). I took the view that because DD wouldn't see a paed (homebirth, she saw the GP on day 2 or 3 i think) i'd rather obliterate the risk of Vit K deficiency right away. It's a very personal decision but for us we felt the fact we'd had a homebirth meant we'd minimised one kind of trauma and would thus feel ok about allowing the injection. When my SIL had her DD#1 she got the Vit K while lying alone and naked in a plastic cot under a bright light with MW's and Obs talking over her in loud voices while trying to get SIL's BP up and temp down (epidural complications). DD got hers in a dimmed, hushed room, lying skin-to-skin with me, breastfeeding. So that meant I felt ok about the circumstances around the injection.

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Old May 19th, 2008, 08:14 PM
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We declined vit K and Hep B at birth with DS Hep B because we had no risk factors for Hep B so didn't see why we should introduce foregin matter at birth and vit K because after doing the research I didn't think the risk factors were worth the "welcome to the world, stick you with a needle" We got a lot of lectures about giving oral Vit K however our paed was much more supportive after he saw that we had followed up all three doses - apparently he sees a lot of people who don't follow through

However... DS was born at 36wks (induced) had little suck reflect and developed severe jaudice so when we had DD we decided to get the injectable Vit K as we read that it helps with jaundice and although she did suffer from slight jaundice it was no where near as bad as DS. We still declined the Hep B and there is now a revised schedule for people who refuse at birth whereas when we did it with DS there was a lot of confusion over if there was a catch up or not
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Old May 20th, 2008, 07:17 AM
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Oh poor bubbies- I didn't know they jabbed some babies unsupported. Our son didn't have his needle (and routine checks like weighing) till sometime in the afternoon (he was born at 7.30am) and with us right there with him.
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Old May 20th, 2008, 07:42 AM
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Ren i was the birth assistant with SIL's #1 and it was my primary motivation for a homebirth. The VitK was like icing on a big medicalised doctor-centred (rather than baby or woman-centred) interventionist cake. Classic cascade (induction for EDD+10, gels, painful pre-labour, AROM, sinto drip, morphine, vomiting, epidural, posterior baby, slow dilation, low BP, fever), she was lucky to avoid forceps (though the Ob came in with them in his hand after she'd pushed on her back (she'd been given the epidural at 3cm and bubs was still posterior 9 hours later, a stint on her side finally allowed rotation anterior but then caused random decelerations so she went back on her back to push) for 40 minutes waving them above her, in litho (basically right at her vagina, between her feet which were velcro'd into the stirrups so she couldn't move them should her epi wear off a bit) and saying "If you don't get the baby out i'll use these and you and your baby don't want that!"). It was truly awful. Seeing her baby come into the world was wonderful but it was like watching people flush a miracle down a toilet. She was totally disempowered, her baby was not treated with respect by all the staff (needle-sticker being the worst offender) or even talked to when handled, and the two took a long time to bond. In fact they still obviously struggle compared to her #2 who she had with one shot of peth, a few sucks of gas and a lot of bouncing on a fit ball in the shower.

It was the most beautiful and saddest thing i had ever seen.

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Old May 20th, 2008, 12:08 PM
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A bit off topic but Caty got her chicken pox (varicella?) vax last week. Obviously it's not compulsary though.
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Old May 21st, 2008, 03:53 PM
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Can anyone please help me I am not sure how you would know if you are a high risk for hep B?

When i had my daughter over 6 years ago I don't remember saying yes she can have the hep b needle? Which I know she did have because I just checked her blue book.

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Old May 21st, 2008, 05:44 PM
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I *think* high risk groups are certain racial groups (not sure which), and perhaps those in a very low socio-economic bracket? I think perhaps that's why everyone gets the Hep B at birth, cos you can't say to someone, 'you have to get the hep B because you're Nellanese', in case that's seen as discriminatory, or racist or whatever. And also I think it's given at birth because perhaps some of those groups don't go to follow up appts or get other immunisations done.
(I could be way off track here, because I don't remember who told me that, a midwife, doctor, or a lady in the checkout queue...could have been anyone :P).
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Old May 21st, 2008, 06:46 PM
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i believe the reason it is given at birth or in infancy is because this is the best time to immunise. if parents decide they want to immunise their children then they tend to stick to the schedule and get it done. it has nothing to do with racial or socioeconomic groups, that is a very presumptious statement to make, and suggests that poor people, or poeple from a certain ethnic group are more likely to participate in high risk behaviours. obviously bub won't however no one knows what they will choose to do when they are older, so if the hep B is given in childhood and they are immune, it saves them contracting hepB, with all the associated problems that comes with it, passing it onto other people, and costing the health system lots of money.
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Old May 21st, 2008, 07:30 PM
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Hm, well why is it that in SA there's a few extra vax compared to Vic? Can't remember which one(s) exactly (Caty's blue book is in the car) but there's definately one or two more jabs that babies get over there. What else would the reasons be except socioeconomical, racial, whatever?

Just because it's not politically correct doesn't mean some babies aren't more at risk than others elsewhere in the country.

On a side note, lol at being Nellenese!
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Old May 21st, 2008, 09:00 PM
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Generally they vaccinate against Hep B if the parents are from a place where it is prevalent (2 or more % of the population have it) though since vaccinating everyone could eradicate it, many places are recommending it for everyone. There is a list on the CDC website here of the places where it is prevalent. It might be a good idea to vaccinate babies in areas where a significant proportion of the population has arrived in the last generation from the areas where the disease is prevalent.

Hep B is passed by blood and bodily fluids. It can be contracted through risky behaviours (needle sharing) or normal behaviours (from an infected mum at birth, from sharing the toothbrush of someone who you had PROTECTED sex with, from having unprotected sex with one's long-term partner who just happened to get it through unprotected sex in a previous monogamous relationship). Most people who work with drug users (my mum included) are offered the Hep B vaccine, and many medical professionals have had it.

Babies born to an infected mother should be vaccinated within 12 hours to protect them from contracting the virus. The vaccine has been shown to be effective for at least 23 years in studies. In the UK (where the government foots ALL the medical bills, for both vaccines and HepB treatments) all women are offered HepB testing during pregnancy and all babies born to HBV+ mums are vaccinated at birth.

HTH

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