In Texas, there is a law that requires that all newborns receive eye ointment in the hours immediately following their birth.
Texas State Rule 97.136 Prophylaxis against Ophthalmia Neonatorum
(a) A physician, nurse or midwife or other person in attendance at a childbirth shall apply or cause to be applied, to the child’s eyes a 0.5% ointment in each eye within two hours after birth. If this ointment is not available due to the disruption in the distribution or manufacturing, a physician, nurse or midwife or other person subject to this section shall apply or cause to be applied to the child’s eyes and alternative treatment included in guidance issued by the Department of State Health Services or the Center for Disease Control and Prevention.
(b) Failure to perform is a Class B misdemeanor under the Texas Health and Safety Code.
| Ophthalmia neonatorum (ON) is a conjunctivitis (ie type of pink eye) that can be contracted during vaginal birth. The two main causes of ON are chlamydia or gonorrhea. ON is not caused by Hep B, Step B or HIV. If the mother does not have chlamydia or gonorrhea, then the newborn cannot contract it. While ON can potentially lead to blindness (and that was a common problem before the advent of antibiotics), ON is treatable and blindness would only occur if an infected newborn did not receive antibiotics. In most states though, antibiotics in the form of eye ointment or drops are administered prophylactically to avoid an initial infection on every single baby that is born regardless of the mother’s chlamydia or gonorrhea status.
Why would a parent even want to decline the eye ointment treatment? There could be any of a number of reasons. The ointment is irritating to some babies eyes, most babies are taken to the warmer for the administration of the ointment so baby is taken away from mom during the initial bonding period and the ointment may then also interfere with the baby’s sight during that time. However the most common reason may be that most parents do not want to give unnecessary medication to their children and from a societal perspective the use of unnecessary antibiotics contributes to the growing problem of antibiotic resistance. Even C-section babies are required to get the medication and, particularly if their amniotic sac was intact prior to surgery, there is almost no likelihood of an infant acquiring an ON infection – even if mom is positive for Chlamydia or Gonorrhea. Given the numbers of babies being born surgically, that means just by method of birth alone, upwards of 60% of babies are receiving unnecessary antibiotics within moments of their arrival. That’s quite a welcome!The Texas state law as seen above requires that every baby have the antibiotic erythromycin within 2 hours of birth and the law is written so that it is a misdemeanor for the care provider to not to so (though there are provisions for midwives that I have not listed). In practice, many hospitals provide a waiver for parents to opt out as patients should always have the right to decline any medical care that they choose. However, a number of big hospitals do not have any opt out and those hospitals typically call CPS if mom and dad decline and often will administer the ointment against a parent’s wishes. So where does that leave expecting parents?
*** Maria Pokluda has been a doula serving expecting families in Dallas and Ft. Worth since 2008 and has helped hundreds of |
