The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Why I Wear Gloves At a Birth

I feel strongly about some of these glove issues:

Yes, I always wear gloves at a birth, for lots of reasons:

1. To protect myself:  I practice universal precautions and would never take more risk just because I felt a client was less likely to be carrying HIV.  People can carry all sorts of things that I wouldn't want to catch and that I feel professionally obligated to protect other clients from.
2. To protect the client from my germs:  If a client's skin tears under my hands, I don't want to introduce infection with my germs. Ideally, gloves that started out sterile will have only the mom's germs on them, and she'll have a much better chance of fighting off infection.  This is especially important if there's some kind of emergency that requires you to perform invasive maneuvers, e.g. a shoulder dystocia, where there's a large chance of incurring some tearing.
3. To protect the client from other clients' germs: Routinely catching bare-handed turns a midwife into a great vector for spreading disease.  I find myself wondering whether midwives who catch bare-handed get informed consent for this.  Do they tell clients that this practice theoretically exposes them to all the germs of every other client this midwife has ever attended as well as the clients of any other midwives who might previously have attended any of these clients?  The disease-potential principles are no different from those of unprotected sex.
4. To protect my profession.  Midwifery is an underdog in the U.S. I think we need to do everything we can easily do to present ourselves as professional and responsible. Someone else wrote about her feelings about seeing a photo of a newborn, where the midwife's gloves seemed glaringly out of place.  I don't get this. When I see a birth photo of a bare-handed midwife, I just pray that the date on that photo is pre-1985. I am grieved and aggrieved when contemporaneous birth stories posted on the web show a bare-handed midwife. I think they do a dis-service to the profession by providing fodder for the cultural prejudices that midwives are dirty and uneducated.

I think it's my obligation to minimize handling of the newborn during the immediate postpartum, anyway, while the baby is imprinting on family faces and voices, but when I do touch the baby, I've got gloves on my hands.

I do not offer a bare pinky for a newborn baby to suck on to calm them.  A moment of fussiness while we wait for a family member to offer a knuckle is well worth avoiding thrush. Is there any midwife out there who truly believes she doesn't carry yeast under her fingernails?

Others have commented on the intimacy of touching a woman's genitals without gloves and the potential for this being a form of sexual abuse if done without consent.  I agree.

Like consensual sex, if a client and a midwife understand the issues involved and both agree that they don't want the midwife to wear gloves, then all they need to do is get the baby's consent and they're all set.

It's easy to wear gloves, although I, too, sometimes have a really bad glove sensitivity.  I don't wear latex anymore. Some days, even the unpowdered vinyl gloves make my hands unhappy.  But I still wear them rather than compromise the care I provide my clients.

But maybe I'm missing something here.  Are there substantial benefits that accrue to the mother and baby in having a midwife not wear gloves?  Do these benefits outweigh the risks?