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Tuesday, November 23, 2010

Informed consent: Moms, do YOU want to be vaccinated after giving birth?

I wanted to give a heads up to moms who will be giving birth anytime soon in a hospital and possibly in freestanding birth centers. Several different moms have told me recently that after they gave birth in a hospital (two different hospitals), staff offered vaccinations to the mother. I'm not talking about the Hepatitis B vaccine typically offered to newborns. I'm talking about vaccines for mom.

One mom, in her post-birth blur, said that she was pretty sure that one of the vaccines may have been pertussis and she wasn't sure what the second one was (possibly flu?). She consented because the healthcare worker (I'm not sure whether it was a nurse, doctor, or other) rolled up her gown sleeve for her and told her that she *had* to have these vaccines. She did receive both vaccines, but she didn't feel that it was informed consent.

The other hospital did not present it falsely as a mandate, and the mother at that hospital declined the vaccines without any further struggle.

I'm not telling you to accept or decline any vaccine. I'm just here to give moms a heads up that they may need to make such a decision shortly after giving birth in an institution, so it's best to research your options and make your choices on available information instead of in a rushed manner, without having time to read product inserts or ingredient lists, and when they know that you're distracted with a newborn on your chest. Whether to accept or decline vaccines for mom is not something that most women think to include in their birth plans.

Links to CDC list of vaccine ingredients, PDF (US licensed vaccines)

Links to package inserts for US licensed vaccines

CDC page listing possible side effects of US vaccines

CDC list of vaccine contraindications (US vaccines)

VAERS (Vaccine Adverse Event Reporting System), co-sponsored by CDC, FDA, and US Dept. of Health and Human Services

National Institutes of Health/ Cochrane Review to "assess all studies evaluating the effects of vaccines against influenza in healthy adults." Conclusion: "Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.WARNING: This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding."

It's always a good idea to research ingredients and relative safety/risk of each vaccine vs. the relative safety/risk of each illness as well as the effectiveness (or lack thereof) of each vaccine. It seems that many people spend more time reading the ingredient list on the back of their cereal boxes than they do reading what is injected into their (or their children's) bodies.

14 comments:

  1. A friend of mine actually succeeded in achieving a local birth free from the common interferences, such as induction, pitocin, epidural, etc. The staff hated her, of course. However, at one point, she was verbally refusing to get a rubella shot, and the nurse actually jabbed her arm anyway!!!!!!!!!!!!!!!!!!!!!

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  2. I was offered Tdap after my almost 1 year old's birth. I had to sign a separate consent form to accept/decline.

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  3. I was offered the flu vaccine and the pertussis vaccine after I had my son. I politely declined both and wasn't given any hassle at all. =)

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  4. Yes, after the last two births I had in the hospital they tried to give me the Rubella vaccine claiming I'm not immune (I was vaccinated as a child, but apparently am not immune). They offered it over and over, saying I WANT it and NEED it. I kept declining, they got mad, but finally left me alone.

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  5. I got the rubella vax after my fifth and ended up constantly sick for the next 6 months! Pneumonia and all kinds of other issues. I truly believe it was from getting that vax when my body was already dealing with birth and my immune system just couldn't handle it! NEVER again.

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  6. Wow! Thanks for your input, ladies. Apparently, this is a fairly widespread situation. So, from what I'm hearing, new moms may be offered a flu vaccine, pertussis/DTaP vaccine, and/or rubella (in which form? MMR?). Perhaps this varies regionally.

    If moms are aware that this is a possibility, they can prepare and research then add their vaccine preferences (accept or decline) to their birth plan well in advance.

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  7. Good to know, I will warn my doula clients!

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  8. Thanks, Enjoy Birth, and I'd love to hear feedback from other moms about their experiences. What other vaccines (if any) are being routinely offered to new moms, and where (geographically)?

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  9. As a nurse at a hospital, we do offer both the influenza and tdap vaccines to postpartum moms. However they must sign a consent and are given information so they can make an informed choice. We do recommend the rubella vaccine if a patient is not immune because contracting it during a future pregnancy can have devestating results to the fetus. Here, too, there is written consent.

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  10. I reside in WA and after the birth of my 3rd child I was given a consent form for the DTaP (literally right after I'd been moved to a postpartum room!) and told they're giving it to all moms to protect their newborns. I was dazed from labor and still in that glossy-staring-at-my-precious-bundle phase and consented to the shot without asking any questions. I was jabbed in the arm right after I signed the form.

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  11. If ANYONE ever gave me a needle after I said no, I'd be filing a lawsuit! Aside from that, I only get tetanus shots every 10 years now.

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  12. There is currently an epidemic of pertussis in California. We have had 10 babies die from it! I do believe in informed consent however in all honesty - this is a problem in this state. Women should be vaccinated during their pregnancy, however many care providers are frightened to give the vaccine to women while they are pregnant because it is listed as category C (no harm shown, but unknown if safe). Also, it is suggested strongly that all pregnant women get vaccinated against the flu. Remember, getting vaccinated helps to protect your innocent newborn from contracting illnesses that can kill.

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  13. Debi Sandler, thank you for contributing your POV. I have no doubt that most L&D wards follow the correct protocol in obtaining the proper signatures from the patient on liability waivers and consent forms. I wouldn't argue that point. I would, however, challenge the assertion that it's truly INFORMED consent if the patient was unaware that such a decision needed to be made thus has not researched the potential risks and benefits, is hours (or less) postpartum and in a baby daze. "Patient cannot sue us" does not equal "informed consent."

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  14. Victoria, I appreciate that you took the time to read and comment. Have you read the articles reporting that fully 2/3 of the pertussis victims in CA's current epidemic were FULLY VACCINATED at the time they contracted pertussis?
    See here:
    http://www.kpbs.org/news/2010/sep/07/vaccinated-people-getting-whooping-cough-sd/
    and here:
    http://well.blogs.nytimes.com/2010/08/16/vaccination-is-steady-but-pertussis-is-surging/?ref=health
    Another confounding factor: "The bacteria that causes whooping cough has mutated, eroding the protection provided by the vaccine..."
    http://www.dailytelegraph.com.au/news/whooping-cough-strain-now-immune-to-vaccine/story-e6freuy9-1225828959714
    Considering that the CDC estimates that possibly only 10% of vaccine adverse reactions are reported to VAERS, and looking at stats for reported adverse reactions, I would NEVER take it upon my own liability to advise anyone to get any vaccine (nor would I advise to decline). It's important that everyone take responsibility for their health and RESEARCH as much as needed to make the decision. "Remember, getting vaccinated helps to protect your innocent newborn from contracting illnesses that can kill" does not qualify as evidence-based information, but rather as propaganda straight from Big Pharma posters I see in hospital hallways.

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