While it is too late to take advantage of these opportunities if you already have your child, you should know about them anyway, in the event that you plan to have another. If, however, you are reading this book in anticipation of the birth of your baby, this chapter will be of immediate importance to you.

The future well-being of your baby will be affected by choices you can make throughout your pregnancy. It can be affected by the attitudes of the obstetrician you choose. Then, when the long wait is over and the first pangs of labor appear, you may even choose to avoid the hospital and deliver your baby at home.

Please don't dismiss that choice out of hand. At first glance it may sound like radical advice, but I assure you that it isn't. A steadily increasing percentage of mothers are demanding home births for their babies, because they have examined both options and determined that home birth is the sensibly conservative choice.

What is radical – and dangerous for you and your child – is the arsenal of obstetrical intervention that lies in wait for you in the hospital, as well as the threats lurking in the hospital nursery that may damage your baby after he is born. There is ample evidence that the medical technology, drugs, anesthetics, surgery, and other obstetrical slings and arrows employed in most hospitals expose mothers and babies to needless risk. They have a frightening potential for inflicting severe, even life-threatening, damage on you and also on your child.

The classic family doctor of my own childhood "assisted" in the delivery of babies when, and to the extent that, his services were required. To him, childbirth was an uncomplicated natural process, and he did not interfere with it except in those rare instances when something went terribly wrong. If labor was prolonged, he didn't give the mother a shot of Pitocin so he could get to the golf course on time. He was content to give nature a chance and would sit with a laboring mother for hours until her body, not Parke-Davis Pharmaceutical Company, decided it was time for her to deliver.

What a contrast with the often irrational obstetrical behavior we see today! Contemporary obstetricians, for the most part, no longer "assist." They consistently interfere in a natural physiological process that they insist on treating as though it were a disease. In a shocking percentage of cases this medical interference with a normal bodily function adversely affects the physical or intellectual capacity of the child for the rest of his life. Sometimes it even ends that life before it really has a chance to begin.

If you have your baby in a hospital, you will be exposed to an array of obstetrical hazards so broad that I can't possibly describe them fully here. However, they were thoroughly documented in my previous book, Male Practice: How Doctors Manipulate Women, so if you want more information about the obstetrical risks to mothers, you will find it there. What I discuss in this and succeeding chapters are the secondary effects of obstetrical intervention on your child, and the primary damage that your doctor and the hospital's routine procedures may inflict on your baby after his birth.

Obstetricians, in defense of their own fouled nest, insist that a hospital is the only safe place for you to have your child. On occasion they even go to court to try to prevent mothers from using midwives and having their babies at home. There is no statistical or scientific evidence to defend their position; in fact, the available evidence proves them wrong. Meanwhile, observation of the iatrogenic (doctor-caused) damage to children, coupled with simple logic, is enough to demonstrate to any impartial judge that the safest place to have a baby is at home.

The reason is almost self-evident. Having your baby at home is less risky than going to the hospital because much of the most dangerous technology employed in hospitals is not available to doctors or midwives who deliver babies at home. This reduces the opportunity for needless, hazardous intervention and virtually assures that you will be permitted to have your baby naturally, as God intended that you should. Procedures such as ultrasound diagnosis, internal fetal monitoring, excessive use of sedatives, pain relievers and anesthetics. Pitocin-induced labor, and the temptation to resort to delivery by cesarean section, are largely avoided when you play it safe and have your baby in your very own bed!

Obstetricians who practice in hospitals decry home birth as reckless, because hospital facilities are not available in the event a complication arises. If those doctors, whose practice is limited to hospitals, were determining which mothers were appropriate candidates for home birth, and were then required to deal with any emergencies that arose, I would agree with them. They don't have the skill and experience to select the appropriate home birth candidates and to anticipate problems in other mothers. They also would be at a loss to cope with an occasional problem they did not cause and without the assistance and technology available to them in the hospital.

Home birth doctors and midwives are experienced in identifying mothers who can safely give birth at home and rejecting home birth for those who are not. They can also anticipate problems, but without the intervention that occurs in the hospital setting, these problems are few and far between, and home birth doctors know how to cope with those that do arise.

There are five distinct stages during which you should be alert to actions of your doctors that could result in the birth of a deformed, brain-damaged, or mentally retarded child. The first is the period prior to conception; second, the nine months of pregnancy; third, while you are in labor; fourth, during the delivery of your baby; and, finally, the period during which your child remains in the hospital for newborn care. Let's examine them, and the risks they entail, one by one.

The behavior of doctors can influence the health of your baby long before the thought of having one has even crossed your mind. The fact that you are reading this book suggests that it is too late for you to do anything about that, but it is not too late for you to take the precautions in the future that will protect your next child.

Fetal deformities and mental retardation may occur as the result of excessive exposure to x-rays throughout your life, and these radiation effects are a threat to the health of both men and women and the children that are born to them.

Among women, the consequences of excessive exposure to radiation are usually noted among those who have their first babies in their later years. That's because the effects of X-rays are cumulative, so the older you are, the more opportunities there have been for radiation to accumulate and take its toll. This increases the possibility that Down's syndrome, a form of mental retardation, will afflict your child. Nor is this form of X-ray damage limited to women. Fathers may also be responsible for offspring with fetal deformities and mental retardation if X-ray exposure has damaged their sperm.

This potential impact on fetal development is one of many reasons why you and your children should avoid X-ray exposure to the extent that you can, from the earliest age. You can expect your doctor and dentist to downplay the risks of X-ray diagnosis, which they will maintain are minimal. Your dentist will also insist that his X-rays are harmless because the dosage is very low. Don't be misled by these assurances. It doesn't make any difference how low the dosage is during any single exposure to x-rays if you accumulate enough during your lifetime to damage you or your child.

I advise my patients to reject all X-rays unless they are essential to the diagnosis of a potentially life-threatening disease. If you must submit your child to an X-ray, don't hesitate to let your doctor know that you are concerned, even if you feel uncomfortable doing so. Your child's health is more important than your doctor's feelings. Insist that X-ray examinations be conducted at the lowest dosage possible. Ask your doctor whether his technician has been specifically trained and whether the equipment has been inspected recently to assure that it delivers the appropriate dose. Observe whether the technician provides proper shielding for the reproductive organs of your child.

Never let yourself forget that X-ray machines can be lethal. Study after study has shown that a shocking number of X-rays are performed in the United States with defective equipment, operated by untrained medical personnel who don't know how to use the machine properly. To make matters worse, most of the time the x-rays weren't essential in the first place.

You face another major risk if conception follows too closely a period of contraception with birth control pills. This, too, can result in a deformed or brain-damaged child. Women who have used the Pill should allow several months to pass before they attempt to have a child.

The babies who are at greatest risk during the first days, weeks, or months of life are those born prematurely, before all of their organs are fully developed, and those who lack physical stamina because of abnormally low weight at birth. You can help assure that your child will develop normally if you eat an adequate, nutritious diet from the moment of conception until the day he is born.

When I was young, doctors were fond of encouraging mothers to do this by reminding them that they were "eating for two." Today's obstetricians are more likely to be preoccupied with the insistence that you restrict your weight. Not too long ago, the maximum weight gain that many obstetricians would tolerate was 10-15 pounds. More recently, the reins your doctor will try to place on your appetite have been loosened a little, but most doctors will still try to limit your weight gain during pregnancy to 20-25 pounds. That's more rational, but the limitation still doesn't make any sense. On the contrary, maternal dietary and caloric restrictions may lower your child's birth weight and threaten his development or even his survival.

The possibility that your doctor may try to subject you to excessive weight restrictions is very real. A federal agency reported that in 1975 one of every three pregnant women in the United States suffered from malnutrition – more than a million women a year. Obviously, some of them were malnourished because they couldn't afford proper food, or for cosmetic reasons of their own, but the overwhelming majority suffered from malnutrition because their obstetricians wouldn't let them eat. Don't let your doctor do this to you, because it is virtually inevitable that, if you are malnourished, your baby will be, too.

Your primary concern during pregnancy should not be with how much weight you gain but with how adequately and well you eat. If your doctor tells you to hold your weight gain to 15-20 pounds, he will probably insist that this is important because it will make your delivery easier. He may also tell you that it will forestall the possibility that you will develop toxemia, one of the most dangerous and sometimes fatal complications of pregnancy.

These sound like persuasive reasons to control your weight, and you obviously would be wise to heed them if they were true. You needn't, because all of the available evidence indicates that in terms of ease of delivery and the threat of toxemia the truth is the other way around.

If you are malnourished, your uterus may not function properly and labor will be prolonged or even stop. The obstetrician who restricted your diet has now turned that lemon into lemonade for himself by creating the opportunity to do a cesarean section. That's a bonanza for him but potential trouble for you and your child.

And so it also is with toxemia. Evidence has been accumulating for half a century that it is improper maternal nutrition, not excess weight, that causes toxemia in pregnancy. Because the proper nutritional elements are not present in your diet, your liver malfunctions, and your body's responses produce the symptoms that are associated with toxemia.

Many women find it difficult to adhere to the weight restrictions imposed by their doctors and find themselves nearing the outer limits during the final two months of pregnancy. If they take their doctors' instructions seriously, they go on near-starvation diets, cutting down their food intake at the worst possible time. This is the period when their child needs maximum nourishment, because he should be gaining the most weight. It is also the crucial period in the development of the brain. If you starve yourself to hold to some arbitrary, medically imposed weight restriction, you also starve your baby, endangering his life and health as well as your own.

My advice to expectant mothers – no matter what their obstetricians are telling them – is to exercise common sense about food intake and how much or how fast they gain weight. But don't lose any sleep over it if you find yourself gaining more than your doctor would like. You'll feel better about it if you remember that the chances that an underweight baby will die during the first month after delivery are 30 times those of babies born at normal weight. Because they have been denied the nourishment they needed to develop properly, some degree of mental retardation is found in half of the low-birth-weight babies, and their incidence of epilepsy, cerebral palsy, and learning or behavioral problems is three times that of babies of normal weight. That's a good reason for you to eat a well-balanced, nourishing diet, avoid starving yourself or your baby, and tell your obstetrician to go fly a kite if he fusses at you because you've gained 30 pounds.

Be equally firm in your refusal if he tries to put you on diuretics should your hands and feet begin to swell. Nearly all pregnant women display swelling due to water retention at some time during pregnancy. This is almost always a normal condition and a valuable one, because the stored fluid that produces the edema is needed to support the increased blood volume that you and your baby require.

Many doctors seize this condition as an indication of toxemia and prescribe a diuretic to eliminate the stored fluids. In most cases that's wrong, because it simply deprives you and your baby of fluids you need. The result can be catastrophic. The death rate of babies born to mothers without edema has been shown to be 50 percent higher than that of babies born to mothers who stored ample fluid. You are also at risk if you take diuretics, because these drugs can kill you by lowering your blood pressure and pushing you into hypovolemic shock!

Your doctor will almost certainly warn you sternly about the hazards of cigarettes, alcohol, and other mood-altering drugs during pregnancy. He should warn you about them, and you should heed his warnings, because there is strong evidence that even moderate use of these substances may have a negative impact on your unborn child. For the same reason, he should also warn you not to take any over-the-counter drugs during your pregnancy – aspirin, cold remedies, and the like.

Unfortunately, he probably won't warn you about the even greater risks present in some of the treatments that he may employ. Fetal damage can also be caused by prescription drugs, x-rays taken during pregnancy, ultra-, sound, and procedures such as amniocentesis, which is used to detect abnormal conditions of the fetus. I won't go into these hazards here, but you should inform yourself about them. Many books about the medical hazards of pregnancy are available, including my own book, Male Practice: How Doctors Manipulate Women.

At the beginning of this chapter I urged you to consider home birth for your child in order to avoid the greater opportunities for medical intervention that are present if you enter a hospital. Almost every form of obstetrical intervention in what should be a natural process of birth has the potential for causing brain damage and mental retardation. The risks of such intervention, and thus the consequences, are substantially reduced if you have your baby at home.

A few years ago Dr. Lewis E. Mehl, of the University of Wisconsin infant development center, studied 2,000 births, nearly half of which had taken place at home. The differences between the home and the hospital births were striking:

• There were 30 birth injuries among the hospital-born children and none among those born at home.
• Fifty-two of the babies born in the hospital required resuscitation, against only 14 of those born at home.
• Six hospital babies suffered neurological damage, compared to one born at home.

The extent of the intervention in the birth process that typifies hospital deliveries is appalling. True, some of the procedures that are used have merit when they are appropriately applied – situations in which the risks of doing the procedure are justified by the benefits it may provide. The menace to the mother arises from the syndrome "What can be done will be done," which pervades American medicine. Procedures developed specifically to deal with critical situations are used routinely on every patient who comes in the door.

The typical hospital delivery, in most hospitals, is characterized by one needless intervention after another. Again, because I have covered them in previous books, I will not go into the details here. Included, however, are internal and external fetal monitoring, intravenous feeding, analgesics and anesthetics, Pitocin-induced labor, episiotomy, and cesarean sections.

I do want to take the opportunity here to share with you emerging information about the risks of fetal monitoring through the use of diagnostic ultrasound. I do so only because it is not generally available to lay readers, nor is it information that is apt to be shared by your doctor. The use of ultrasound for fetal monitoring or any other diagnostic purpose raises some alarming questions that can't be answered by those who employ it. It is another way in which modern obstetrics violates the medical imperative, passed down by Hippocrates, "First, do no harm."

External fetal monitors consist of two bands that are strapped around your abdomen and connected to a monitoring unit that records the device's findings on tape. One band is pressure-sensitive and measures the strength and frequency of your contractions. The other employs ultrasound to determine the condition of the fetus. In most. hospitals doctors use fetal monitors routinely, although one study of 70,000 pregnancies found no difference in outcome between monitored and unmonitored patients, and other studies have shown that monitoring results in an increase in infant mortality among the patients monitored. This suggests that, at best, monitoring does no good, and at worst it may do harm.

There is, at this writing, no conclusive evidence directly linking ultrasound to fetal damage, nor is there any hard evidence that it will not cause damage. Unlike X-rays, which impart an electrical charge to matter through a process called ionization, ultrasound rays are nonionizing. Proponents of ultrasound seize this as proof that it is not dangerous, but there is no evidence that this defense is valid. In short, I can't prove conclusively that ultrasound may damage your baby, but the doctor who uses it on you can't prove that it won't.

Alice Stewart, a British epidemiologist who heads the Oxford Survey of Childhood Cancers, commented in mid-1983 on "very suspicious hints" that children exposed to ultrasound in the womb may be developing leukemia and other cancers in higher numbers than unexposed children. A World Health Organization report calling for extensive research on the hazards of ultrasound, and restraint in its use, had this to say about benefits versus risks (all italics mine):

Choosing end points for study [of ultrasound] is especially difficult in human subjects. Latent periods easily could be as long as 20 years in the case of cancer development, or the effect may not be seen for another generation.... Because the human fetus is sensitive to other forms of radiation there is considerable concern that it may also be sensitive to ultrasound....Animal studies suggest neurologic [sensory, cognitive, and developmental], immunologic, and hematologic possibilities for studies in humans. There is some evidence that if the exposure is within the period of organogenesis, congenital malformations may result from exposure to ultrasound in laboratory animals. In general, these end points in animal studies have been unexplored in humans and should be followed up wherever possible....

It is not clear at this time whether ultrasound fetal monitoring is beneficial to the mother or fetus in terms of pregnancy outcome and this, above all, should be examined closely; if there is no generally acknowledged benefit to the monitoring, there is no reason to expose patients to increased costs and possible risk.

If, despite the concerns that have been raised about leukemia, suppression of the immune response, congenital malformations of the fetus, and other possible effects of ultrasound, your doctor still insists on using it on you, what can you do? I suggest that you tell him you will permit it when he presents you with convincing scientific evidence that it is necessary, that you and your baby will benefit from it, and that it won't harm you or your baby now or 20 years down the road.

He can't very well object to your desire for this reassurance in your own behalf and that of your unborn child. He will also be unable to provide it, because such evidence doesn't exist. Perhaps that will persuade him to do what he should have done in the first place: forget about ultrasound and use his stethoscope instead!

If you have already given birth to a healthy, normal child, you need not be concerned with these prenatal risks until you decide to have another. If you are awaiting the birth of a child, I urge you to study the potential hazards that await you with great care. It is because of risks such as those I have described that I find home birth so appealing. That is why I was overjoyed when both of my own daughters opted to have their babies at home. My own beautiful, healthy grandchildren are now two, three, and five years old, and each of my daughters is due to present me with another. They, too, will be delivered at home.

If you're not ready to accept home birth as an option, and elect to have your child in a hospital, be on your guard. Make good use of what you have learned in this chapter, and in the other books that you read, and you should be able to avoid most of the risks to yourself and your baby that I have described.

Although competitive pressures have brought improvements in some hospitals, the probability remains that your baby will be whisked off to the nursery moments after he is born. He will be subjected to a number of procedures, some of them legally mandated in most states, and then compelled to lie there – probably screaming his head off – for at least four hours. Only then, and only once every four hours after that, will you be allowed to breastfeed your baby or give him his bottle, if that is the option you select.

Your obstetrician will waste no time in giving your new baby his first exposure to the chemicals that dominate medical practice in the United States. He'll squirt a few drops of silver nitrate into the baby's eyes. This treatment is predicated on the ridiculous presumption that all mothers must be suspected of having gonorrhea, which may have been transmitted to the baby during delivery. Doctors have, in fact, fostered legislation requiring this treatment in every state.

Doctors reject the argument that the mother could be tested for gonorrhea instead of inflicting silver nitrate on her baby, claiming that this won't do because the test is not 100-percent accurate. That defense is pure nonsense, because the silver nitrate isn't 100-percent effective, either. Whether one is more effective than the other is moot, because if your baby were to develop gonorrheal ophthalmia for either reason, the problem can and will be solved by using antibiotics to treat the disease.

The use of silver nitrate made some sense before antibiotics became available, but the price your baby pays because its use is continued today, when it is no longer needed, is not insignificant. Silver nitrate causes chemical conjunctivitis in 30 to 50 percent of the babies who receive it. Their eyes fill up with thick pus, making it impossible for them to see during the first week or so of life. No one knows what the long-term psychological consequences of this temporary blindness may be. The treatment may also produce blocked tear ducts, which necessitates difficult surgical intervention to correct damage done by a senseless procedure. Finally, some doctors – including me – believe that the high incidence of myopia and astigmatism in the United States may be related to the placing of this caustic agent into the delicate, tender membranes of your baby's eyes.

In some states doctors may now substitute antibiotics for the silver nitrate, although there is no evidence that this prophylactic use of antibiotics to prevent gonorrhea is effective. This does eliminate the immediate damage that may be done by silver nitrate, but it also provides the first example of indiscriminate use of antibiotics, which probably will be oft-repeated by your pediatrician and may cause problems for your child later in life.

In many hospitals a second example of indiscriminate use of antibiotics may follow on the heels of the first one. In an effort to prevent the cross-infection that threatens babies in hospital nurseries, many doctors are now giving routine injections of penicillin. Because every use of antibiotics contributes to the possibility of sensitization in later life, it should be avoided unless the treatment is appropriate and essential in dealing with a disease. There is also the risk, in some children, of an allergic shock reaction to antibiotics of all kinds.

When your baby reaches the nursery he will be bathed immediately, and there is a strong probability that the nurse will use hexachlorophene soap. It has been known for many years that hexachlorophene is absorbed through the skin and that it can cause neurologic damage in some children. Yet hospitals continue to use it, despite the risk to your baby, to try to avoid the onus of a bacterial epidemic in their germ-laden nurseries.

What makes this ridiculous, and even reckless, is the fact that hexachlorophene soap and antiseptic preparations afford no advantage over bathing with plain tap water. In five carefully conducted trials involving 150 newborns, 25 infants were bathed with each of four different antiseptics and 50 were bathed with plain water. Bacteriologic samples taken from each group following the initial bath and on the third and fifth days showed that all of the baths were equally effective.

Don't let the hospital expose your baby to a potentially dangerous chemical to reduce the danger of infection when plain water will work just as well!

Another beloved procedure that your infant child will be subjected to is the PKU (phenylketonuria) test. Legally mandated in most states, it is given to determine whether an infant is a victim of a rare form of mental retardation. The condition is caused by an enzyme deficiency, but it occurs in less than one out of 100,000 babies.

The PKU blood test itself is not dangerous, except that it does require insertion of a needle that will open a pathway for the bacteria that abound in every hospital nursery. The problem lies with the test results, which are notoriously inaccurate and result in many false positive findings. If your child is diagnosed as a victim of PKU, he will be placed on a restricted diet composed of protein substitutes that have an offensive taste, tend to cause obesity, and become terribly monotonous. There is disagreement among doctors on how long the diet should be continued. The range is from three years to life. Most doctors who diagnose PKU will not permit the mother to breastfeed.

It is ridiculous, in my judgment, to condemn children to an obnoxious special diet based on a test that may be wrong, for a disease that rarely occurs, when the prescribed diet itself raises serious questions. Seven years ago treatment centers in the United States, Australia, England, and Germany revealed that some children with PKU showed progressive neurologic deterioration "even though their disorder had been diagnosed early and dietary treatment had been promptly instituted." All of these children labeled as having "variant forms of PKU," which differed from the classic form, died.

Unless there is a history of PKU in your family, my advice is to avoid the test and breastfeed your baby, which I believe to be the best treatment anyway, even if he has the disease. If you can't escape the test, and the finding is positive, insist that it be repeated a couple of weeks later to assure that the first result was accurate. If it is still positive, make sure that the doctor determines whether the PKU is the classic or a variant form, and make certain that the diet your child is given is appropriate for its type. Finally, insist on continuing to breastfeed along with the diet, because that's the best overall health protection your child can have.

If the second test is negative, don't fret for years wondering whether the first one might have been right. One of the unfortunate consequences of all forms of indiscriminate mass screening is the emotional trauma parents go through when a false positive reading is given. I have had more than one mother ask me years later, "Do you think 'it' (late talking, late toilet training, etc.) might be PKU?" The same thing happens when a pediatrician tells a parent that a child has "a slight heart murmur." This sounds threatening, but unless there are other symptoms, they are simply an innocuous finding that does not signify disease.

The list of obscure diseases for which mass screening of newborns is required is steadily expanding, although the requirements vary widely from state to state. Doctors are the prime movers behind this legislation, and in my judgment they are also the prime beneficiaries. It is ridiculous to expose all children and their parents to the physical and emotional risks of screening for diseases that aren't seen more than once in a blue moon.

Also add to the dangers that await your child in the newborn nursery the possible use of bilirubin lights to treat infant jaundice. This is a common condition in newborn babies, and the chances are somewhere between 30 and 50 percent that your baby will be mildly jaundiced. How great that chance is will be determined to a large extent by the degree of obstetric intervention you experience in the delivery process.

It seems that every generation of doctors creates a new set of interventions that create problems that can only be resolved by further intervention. Most of the things a mother goes through when her baby is delivered in a hospital – the analgesia, the anesthesia, the induction of labor, all of the drugs – increase the chance that her infant will develop jaundice, because it is one of their side effects.

Many doctors routinely give vitamin K to newborn babies because they have been taught that infants are born with a deficiency of this vitamin, which influences how rapidly the baby's blood will clot. That's nonsense, unless the mother is severely malnourished, but most doctors do it anyway. Administration of vitamin K to the newborn may produce jaundice, which prompts the pediatrician to treat it with bilirubin lights (phototherapy). These lights expose the baby to a dozen documented hazards that may require still further treatment and possibly affect him for the rest of his life.

Bilirubin is the bile pigment found in the bloodstream, which your doctor will probably describe as a potential source of brain damage through transfer of the pigment from the bloodstream to the central nervous system. Actually, bilirubin is a normal breakdown pattern of the red blood cells. This breakdown converts them into bilirubin, which is what gives your infant the jaundiced, yellow coloring. The condition is not threatening except in rare instances when it is very high or rapidly rising on the first day of life. This is usually caused by Rh sensitization and requires treatment with bilirubin lights or exchange transfusions. The transfusion simply replaces your infant's blood with other blood that is not contaminated with bilirubin, while the bilirubin lights hasten its excretion. Light in the blue part of the spectrum, which can be supplied artificially in the hospital nursery, or naturally by the ultraviolet rays in sunlight, oxidizes bilirubin more rapidly so that it can be excreted through the liver.

If jaundice does not appear until after the first day of life, the risks of treating it outweigh the benefits. The bilirubin is normally excreted naturally, and the process of excretion can be hastened by exposing your child to natural sunlight, but it may take a week or two to get rid of all of it.

Despite the normal and non-threatening nature of most cases of infant jaundice, doctors usually insist on treating the condition with bilirubin lights, rather than permitting natural sunlight to do the job. Now your child's health is threatened by using phototherapy to treat a non-threatening condition! Responsible medical authorities have reported that phototherapy for infant jaundice may be responsible for increased mortality, particularly in very small infants. The higher risk of death results from lung problems (respirator distress syndrome) and hemorrhage. Infant deaths have also been reported from aspiration of pads placed over their eyes to protect them from the lights.

Although your doctor will probably assure you that treatment with bilirubin lights is completely safe, no one actually knows what the long-term effects may be, and plenty of short-term effects have already been identified. They include irritability and sluggishness, diarrhea, lactase deficiency, intestinal irritation, dehydration, feeding problems, riboflavin deficiency, disturbance of the bilirubin-albumin relationship, poor visual orientation with possible diminished responsiveness to parents, and DNA-modifying effects.

If, because of a misguided cesarean, excessive weight control during pregnancy, or for other reasons, you have a low-birth-weight baby, you will have to contend with the treatment he gets in the neonatal intensive care nursery. Doctors and hospitals take intense pride in these facilities and all of the technological wizardry they employ – an attitude that mystifies me, because there is no evidence that they benefit the children who are isolated in them.

They do, however, expose your child to additional risks. If your low-birth-weight child is sent to intensive care, he will be separated from you immediately after birth and placed in a radiant warmer. This involves some element of risk, because babies have been burned in them. The risk that should cause the greatest concern, however, arises when your child is given oxygen while he is in this incubator.

Failure of your doctor to limit the flow rate of oxygen properly can in premature babies result in a disease known as retrolental phibroplasia, the leading cause of blindness in children. To avoid this, the oxygen level in your baby's blood must be closely monitored, which means drawing blood, and that in turn can produce a condition known as iatrogenic anemia. One intervention continues to lead to another, and the baby may need a blood transfusion, which exposes him to the risk of acquiring serum hepatitis or AIDS.

If your child is placed on oxygen in intensive care, let your doctor know that you are aware of these risks and that they are causing you great concern. That may forestall any carelessness on the part of the medical personnel.

The odds are high that if you have a male baby your doctor will recommend that he be circumcised. About 1,500,000 circumcisions are performed each year. That represents about 80 percent of all the male babies that are born in the United States. If performed for other than religious reasons, it is a useless, unnecessary, and potentially dangerous procedure.

Every generation of doctors has found a new excuse for circumcision, despite the fact that even the American Academy of Pediatrics has advised that "There is no absolute medical indication for circumcision of the newborn." If your doctor suggests circumcision for your baby boy, ask him why he wants to expose the poor kid to the pain, the possibility of infection or hemorrhage, and the risk of death from surgery that has no medical justification.

Although it is not likely that they will be performed immediately after birth, you should also beware of two other surgical procedures for conditions that may exist at birth. The first of these is the umbilical hernia, a small defect in the abdominal muscle that permits the abdominal contents to protrude. The condition is quite common and can usually be expected to correct itself before your baby's first birthday. However, even if it doesn't, surgery should not be considered until your child is three to five years old, because there is still a good chance that the condition will correct itself.

Finally, there is the possibility that your baby may be born with an undescended testicle, and your doctor will recommend surgery to bring it down. The need to do so is dubious, at best. Some doctors maintain that it is essential because of the threat that cancer may develop in the undescended testicle. That reasoning may seem persuasive, but it shouldn't be, because the mortality rate from the surgery is higher than the potential mortality rate from testicular cancer. Consequently, it is safer for your child to leave the undescended testicle alone. It is another matter if your child has two undescended testicles. In that event surgery deserves serious consideration because sterility is almost inevitable if neither of your child's testes is in its proper place.