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suctioning and APGAR tests

Forum: Natural Childbirth


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May 7th, 2007, 11:28 AM
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I took a waterbirthing course this weekend with all the midwives, doulas and like-minded women on natural childbirth.. I was given lots of information and was wondering your thoughts on how necessary it is to have your baby taken away within the first one minute to 5 minutes for the routine tests of suctioning and Apgar tests? The more information I was given, the more I felt that the Apgar tests aren't really needed and the suctioning was unnecessary, even harmful with the normal development of baby's respiratory and neurological systems. Any thoughts?


No Benefit Seen With Suctioning During Birth of Meconium-Stained Neonates SAN FRANCISCO (Reuters Health) Feb 11, 2003 - Suctioning during delivery of infants who present with meconium staining apparently does not prevent meconium aspiration syndrome. These findings, presented at the meeting of the Society for Maternal-Fetal Medicine, contradict current practice guidelines.
Lead study author Dr. Edgardo Szyld, of the Hospital Diego Paroissien in Buenos Aires, Argentina, believes that "we should consider revising the current recommendations" of suctioning these infants during delivery.

A total of 2514 infants with meconium-stained amniotic fluid were randomized to oro- and nasopharynx suctioning or to no suctioning just before delivery of the shoulders. Of those infants suctioned, 3.5% developed meconium aspiration syndrome (MAS), as did 3.6% of those not suctioned. Five newborns died in the suctioned group, and three in the group not suctioned.

No differences between the two groups were observed in the frequency of thick meconium, C-sections or need for resuscitation.

A single study back in the 1970s was the foundation for the recommendation of suctioning when meconium staining is evident, Dr. Szyld said. Recommendations to suction, set forth by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists (ACOG) makes the practice "widespread--and it's done around the world."

However, he said, the current study shows that suctioning before the shoulders are delivered does not prevent meconium aspiration or its complications.

"The data presented by Dr. Szyld's team provides convincing evidence that suctioning probably does not" alter outcomes, Dr. Laura E. Riley, chair of ACOG's Committee on Obstetric Practice, told Reuters Health.

"Because suctioning has been beaten into clinicians for so many years, I'm not sure the current findings are really going to change clinical practice," Dr. Riley said. "Still, I think the findings may provide some reassurance to clinicians that when meconium aspiration syndrome occurs it probably didn't have anything to do with how adequately the infant was suctioned."

While Dr. Riley believes that the researchers succeeded in showing that suctioning is probably unnecessary, she said they didn't address "whether suctioning may actually have harmful effects, such as causing facial trauma."

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May 7th, 2007, 03:49 PM
*:Onei*Chan:*'s Avatar Platinum Supermommy
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Thanks for the info! I didnt have my baby suctioned out.... I just rubbed on him and loved him. He cried in his own time, his cord was intact so I didnt see the need. He took two minutes to cry so his "apgar" was low. No one really worried about it. I knew that he was fine, he just wasnt ready to holler yet!

I JUST noticed that you changed your SN, when did you do that?
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May 7th, 2007, 04:22 PM
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THis weekend I got it changed.

Duh.. I didn't even think about the pulsating cord. It all makes so much sense now.
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May 7th, 2007, 05:11 PM
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Jenni will be on my tummy the minute she is born and will stay there for...well, until I feel like putting her down, which may be never, lol. I don't see the point in suctioning her, and I have no idea what the point is in the APGAR tests, my baby is and will be perfect, I don't need a test to tell me that.
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May 7th, 2007, 09:23 PM
LaLa's Avatar Platinum Supermommy
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Well, we didnt suction either & only reason we would have would be if there was a problem but in vaginal births there is rarely a need.

As for Apgar - I see no reason that it cant be done on mommas tummy if they just feel it HAS to be done. We did it - and her scores were just great, even with no suctioning


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May 9th, 2007, 12:08 PM
Pure Innocence
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No there isn't usually a need. Kailey was planned to be on me and breastfeeding before being taken away and having the cord cut. But when she came out and was laying on me she was getting purple because she couldn't breathe so they had to suction her. In normal circumstances...no, it's not needed.
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May 9th, 2007, 08:09 PM
Alison79's Avatar Platinum Supermommy
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With my last birth my daughter was given right to me and remained there for over an hour (this was in the hospital). I don't think she was suction, she pretty much came out screaming! After that hour I got up and took a shower and DH gave her a bath and then they weighed and measured her. I wouldn't have it any other way after that! Our next birth will be a home birth and baby will stay with me
Alison - Mom to: Emmeline (7/14), Augustus (2) Maximus (4) Eleanor (5) Reid (6) Evelyn (8) Lucas (13) Christopher (14)

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May 11th, 2007, 11:59 AM
outnumbered's Avatar Platinum Supermommy
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I've req'd that my baby be put right on my chest immediately after delivery and that whatever they feel they need to do is done right there in front of me. That's the only thing they did with my last son that I didn't like, they took him away and he cried through the entire thing.
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