The core difference in the midwifery model regarding vaccinations—for the parent during pregnancy (like Tdap or flu) and for the newborn (like Hepatitis B)—is the emphasis on client autonomy and the time to choose.
The goal is to move the conversation from mandatory compliance to educated decision-making.
New Traditions Midwifery & Choice: New Traditions Midwifery operates on a principle of informed consent and refusal. They provide the most up-to-date, evidence-based information regarding all recommended vaccines, but the ultimate decision rests entirely with the parents for themselves and their child.
What Informed Consent Means in this Context
Informed consent (and refusal) is a legal and ethical right. To make a decision truly “informed,” the care provider must ensure the patient understands:
- The Nature of the Procedure (Vaccine): What it is, how it works, and how it is administered.
- The Risks: What known and potential risks (side effects, adverse events) are associated with the vaccine.
- The Benefits: What protection is provided by the vaccine (for the mother and the baby).
- The Alternatives: What other options exist, including delaying the vaccine or choosing to decline it entirely, and the consequences of those alternatives.
A midwife’s job is to facilitate this understanding, not to coerce a specific decision.
The Midwifery Approach to Newborn Vaccination
Midwives recognize that the birth environment should be reserved for bonding and stabilizing the baby, not for routine procedures unless medically necessary.
- Delaying Routine Procedures: The first routine newborn vaccine, Hepatitis B, is typically administered in the first 12 hours of life in a hospital. In the midwifery setting, especially for a healthy, low-risk newborn, this is usually delayed or declined by the parents, and the midwife supports this decision.
- Focus on Postpartum Health: If parents choose to delay vaccinations, the midwife may connect them with pediatricians who are vaccine-friendly or who support alternative/delayed vaccination schedules, ensuring continuity of care.
- Texas Law on Exemptions: Texas state law explicitly allows for Conscientious Exemptions (including religious or philosophical reasons) from required immunizations for school. This legal context further empowers parents who choose to delay or decline the standard schedule, and midwives fully honor this choice.
The Contrast with the Hospital Model
The key difference lies in the setting and the pressure:
- Hospital: Procedures like the Hepatitis B shot are often presented as routine and sometimes administered with minimal discussion shortly after birth, potentially disrupting the Golden Hour.
- Midwifery (New Traditions): These decisions are discussed during prenatal care, well before the birth, giving the parents time to research, discuss, and solidify their choice, which the midwife then honors at the time of birth.
In summary, the midwifery philosophy supports the freedom to be unafraid of making a non-standard choice, because they are informed by evidence and supported by their care provider, regardless of whether that choice is to vaccinate, delay, or decline.
