Viral births on the beach: a danger for mother and baby

On a beach a half-kneeling woman holds a rock. Seconds later she is holding the newborn that she has just given birth to. The video posted on Wednesday by a Twitter user who wrote in Catalan: “Wednesday. And the sea was her confidant. Keiko gave birth to her third child in the sea, off the coast of Japan. She chose a magical setting. A day after a typhoon and under a full moon.” What purports to be an almost mystical experience, adorned with bucolic piano music, actually poses a real danger, both for the child and for the mother.

Wilderness births are an apparently residual fad, for the time being. But they have a movement behind them, the free birth (free birth) that proclaims “a holistic delivery outside the medical system”. They are a more radical evolution of home birth and more dangerous than these, which already pose a risk when unexpected complications appear.

José Ramón Fernández, a pediatrician specialized in neonatology at the Santa Lucía Hospital in Cartagena, explains that on a beach there can be complications for both the mother and the child. He lists infections, hypothermia, pneumonia, breathing problems. “In short: all wrong,” ditch.

Handwashing during childbirth was a revolution for maternal and child health in the mid-19th century. “How have we gone back to this?” Fernández asks, pointing out that the sea is full of microbes. “Even in deliveries that take place in water in a hospital environment, there have been cases of pneumonia due to aspiration of germs that were in the water, either because disinfection is not done properly or because the mother defecates while she gives birth. There are cases of sepsis and even deaths, ”he explains.

Beyond the complications of any birth, the problems of giving birth at sea can come from infections and the transition that a baby undergoes at birth, from the controlled and warm environment that is the mother’s womb to one in which the creature has to start breathing. When a baby is born in a hospital, neonatologists answer three questions: Is the baby full-term (ie, not premature)? Does he breathe or cry? Do you have a good tone? “If all three are affirmative, routine care is done, skin to skin with the mother,” explains Fernández.

But what appears in the Twitter video is not exactly like that. “In the case of this baby, what you see is that he is born hypotonic: he is flaccid and his breathing is not normal, but irregular, he gasps. It is what we call breathing type gasping. In a case like this, in a hospital we would try to stabilize him with a thermal crib, which has a heat source, repositioning his head and surely with some type of respiratory support, such as a positive pressure mask that supplies oxygen so that the lungs open up. . All that does not happen on that beach”, summarizes the neonatologist.

The temperature of the water should also be checked, but it will surely be well below that of the uterus. Fernández explains that babies are unable to maintain their temperature on their own and that in such a situation they are likely to become hypothermic. “This favors hypoxemia (lack of oxygen) and makes it difficult to transition from the uterus to the newborn,” he stresses.

The video that the doctor comments on is not the only one of births at sea that has gone viral on social networks. Within this movement free birth there are other mothers who share this practice, which is an evolution of home birth, seeking a “more natural” delivery.

Something very natural throughout the history of the human being has been to die giving birth or lose life at birth. According to the World Health Organization, more than 800 women die in childbirth every day in the world, and in most cases it could have been avoided with adequate assistance. In the developing countries with the worst figures, one in every 100 live births still dies; in Spain the ratio is 250 times lower: 4 out of every 100,000.

Under highly appraised and supervised circumstances, home births can be safe. A 2015 study from the Netherlands that looked at 743,070 low-risk births found no increased risk for home birth. Of course, “the results can only be applied to regions where home births are well integrated into the maternity care system.” In the Netherlands, when home births take place, there is an emergency system at the door of the home to transfer the mother in case of need. It is something that obviously does not happen in births in the wild.

There are also studies that investigate the motivations of mothers to give birth outside the system, even with high risk. One was also made in the Netherlands and concluded that it is not usually satisfactory: “While for some women it was a positive choice, for the majority, the choice of a home birth in a high-risk pregnancy or an unassisted birth was negative. Negative choices were due to previous or current negative experiences with maternity care and/or conflict [con los sanitarios] about the birth plan.

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