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How to get newborn screening after a home birth

  • Last month I wrote about newborn screenings and the resources you can find on Baby's First Test. Typically, the newborn screenings (heel prick, hearing test, and in some states/hospitals, pulse-ox) are done after birth while still at the hospital. That makes it pretty easy! You can check what your state tests for specifically- you may have to ask for the pulse-ox if it's not done routinely.

    So what if your baby is born at HOME?

    Rebecca was born at home in February and I knew I needed to get her newborn screenings done. I'll share with you how my experience was and what I know about your options, but want to clarify that every state is different and I'm not an expert.

    First, I asked my midwife! She's a licensed professional and I knew she'd have the answers or could tell me where to look.

    Pulse-ox: I asked about this in our initial interview. I wanted to know if she had her own pulse-oximeter. They are pretty pricey, but some midwives do have their own and it's a non-invasive and simple procedure. However, my midwife did not.

    As I neared my due date, I called our new family practitioner to remind them that my baby would be coming soon and to make sure I'd be able to get in for an appointment shortly after birth. No problem, they said! Just call after she's born! It was important to me to be seen after the first 24 hours, but within the first few days... that's when pulse-ox is most important, as well as a number of other tests.

    I made sure to ask over the phone- "Can my baby receive a pulse-ox when I come in after the birth?" They said yes, of course.

    What happened? The pulse-oximeter they had was for adults only. You know, the kind that clips on your finger. It's way too big for a newborn and it results in inaccurate readings. I was beyond disappointed. They tried it on her anyway, only to receive readings around the 85 range. I warned them never to do that to another mom because that'd be enough to send any mom into a panic (if she thought the numbers were accurate). Heck, it worried me quite a bit! They tried multiple times and did get a reading of 95 at one point... but I knew I needed a newborn pulse-ox for a trusted reading.

    Hearing Test: there are only certain hospitals or clinics that offer the newborn hearing screen. I called my local hospital and they told me they couldn't do it (small town). I had to drive 45 minutes away to have it done. But once I was there, we were in and out, Rebecca passed with flying colors no problem.

    Also, I asked on the phone before I went if Rebecca could have a pulse-ox there. I mean, it's a hospital! And it's the special care area for newborns! They said, "sure, but ask the tech when you get here."

    So I did. And her reply? No, you can't get that done here. WHAT?! And then she told me that if I were to get one, anywhere in the hospital, I had to have a doctor's note. Really? I mean, I suppose, but have you seen a pulse-ox? It takes 2 seconds, it's non-invasive, it's as easy and simple as can be. And why couldn't they have told me that on the phone? And why didn't my family practitioner know that when I left her clinic? Sigh.

    Heel Prick: my midwife told me she could do this one for me, but I opted to just have it done by my family practitioner during our first visit when Rebecca was just a couple days old. If you haven't seen the form, there are 7 little circles (in IL... other states may only have 5 circles; it varies) and each circle has to be completely full and saturated with blood. Poor Rebecca's foot just squeezed out one tiny drop at a time so it took foooorrreevveerrrr and she cried through the whole thing. But this is a super important life-saving screening that tests for many complications.

    Fast forward at least an entire month and I get a phone call that the test didn't work. They didnt have enough blood. WHAT?! They said I had to do the test again and that I'd have to pay again, which confused me because it was not my error, but ah well. Note that the heel prick test is pretty time sensitive- you do it right after birth to catch some very serious disorders in time. I feel lucky and am very grateful Rebecca did not have any of these issues or we would have been late in the game.

    This time, I went to my midwife and had her do the test. And this time, it worked. Free and clear.

    OVERALL: you can certainly still have all your newborn screenings after a homebirth, but it does take planning! You DO have to know what to ask for and where to go, unlike a hospital where they just take your baby and do it all for you. When Ryan was born (in a hospital), I don't even recall when he had the heel prick or hearing test. The pulse-ox, however, I do know about because I asked for it.

    So... call ahead of time, make those appointments, figure out where you need to be. CLARIFY on the phone that the clinic/hospital/whatever has the newborn pulse-ox attachment. Ask if you need a doctor's note. I do believe I had a run of bad luck with my screenings, but that it won't typically be like that! Especially because you just ready my post and know what to expect!

    I am always here if you have any questions and please do check out Baby's First Test and their section on homebirths!

    Thanks for sharing your experience, Emily! We are so glad that you were able to get all of the necessary newborn screens to help keep Baby Dickey happy and healthy. Be sure to check out Emily's blog to learn more about her adventures!

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