Denis mentioned a birth center that doesn't check the temperature of babies
at birth. Would you be looking for fever? I think you will find very few
maternity units in this country that check babies' temperatures before they
are two hours old following normal birth to a non-febrile mother. We only
check maternal temperature if she mentions it or if we discover by touching
her that she feels unnaturally warm, or if there have been signs of
infection beforehand. At about two hours babies are checked to make sure
they are not hypothermic, a holdover from the time when babies spent a fair
amount of that first two hours in a cot. Mothers do not have their
temperatures measured again after normal birth unless they develop a fever.
Our tradition is to observe mother and baby very informally during the first
two hours, in the labor room. We watch them out of the corner of an eye
while tidying up and completing the labor record and if they ask for help
with anything we give it. We do keep an eye on maternal blood loss. After
the first two hours they are transferred to the post partum ward, still
together. Now they are usually in skin contact with their mothers the whole
time and it's rare to see a cold baby. More of our CS babies get cold going
through drafty corridors to reach their mothers for the first feed (we don't
usually do it in the operating room, at least not yet). But now we keep
them skin-to-skin with the mother's accompanying person, most often the
father, and they stay nice and warm, and besides, when they come to mother
they are much quicker to respond and latch on by themselves than if kept
swaddled until that first prolonged encounter.
A baby with a body temperature below 36 degrees C can be stripped and placed
skin to skin with mother, and warmed covers put over the two of them. We
check again in an hour or so to make sure the baby is maintaining normal
temperature.
If a baby is born more than 24 hours after ruptured membranes, we check its
temperature twice every shift for 48 hours, along with observations of other
vital functions, to watch for signs of infection. All temperature
measurements are done in the axilla. I hasten to add that these
observations are carried out by going to where the baby is, normally in
close proximity to the mother.
I don't think these particular measurements nor the things we do if the
measurements are outside the limits of what we accept, are especially
obtrusive or disrespectful of physiology. But I must admit I don't measure
the temperature of babies born at home when I am in attendance. I might put
a hand on their body, and see that it feels about right, but if the baby is
doing all the usual things babies do in the first few hours, I don't worry
about it. I weigh them, though, and not just because it looks bad to leave
blanks on the birth registration form, but because it allows me to quantify
weight loss in the first few days, which I feel an admittedly neurotic need
to do in assessing the effectiveness of the baby's feeding. Now that
initial weights are done after the undisturbed skin to skin time, most
babies have passed significant amounts of meconium before they get weighed
for the first time, so the drop from birthweight they experience over the
first few days is smaller :-)
Rachel Myr, hoping she has understood the 'question', in Kristiansand,
Norway
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