Midwives, like hospitals and pediatricians, offer newborn screens to their clients. Typically, these state mandated tests are performed on the second postpartum visit in the family's home within the baby's first week of life. The procedure is to poke the baby's heel and fill five circles on a lab slip with the baby's blood. Now it appears as if more than just the blood is being scrutinized by the state as the above CNN report details.
It is not a fun test to perform. Often the baby is a little dehydrated as the mother's milk may not be in yet, or just coming in. This means less blood, and more squeezing and often re-poking the baby's little heel. The test is a screening test, not a diagnostic test, so if anything comes back positive, the baby requires further testing. Most of the fifty disorders tested for, if caught early enough can be prevented through various treatments, hormones, dietary changes, nutritional therapies, etc.. The March of Dimes provides a list of the diseases and disorders being screened.
Informed consent is a cornerstone of midwifery care. In this case, it means not only offering the newborn screen to our clients, but informing them of the risks and benefits of the test. We also must offer them the opportunity to decline the test. Each state offers a form for refusing the test. Everyone's circumstances and health history should be considered when making the decision about the newborn screen. But from now on, I hope that all care providers inform moms and dads what really happens to the baby's DNA in the decision making process. I know I will.
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