Worms and Germs Blog
Dogs in the delivery room?
Don't get me wrong. I'm all for pet therapy and animal visitation in hospitals - when it's done logically. I've been involved in research in the area, helped develop international guidelines and am chair of the medical advisory board of one of the largest pet therapy groups in the US. Animals can do great things in hospitals and we need to support good visitation programs. But that doesn't mean I check my brain at the door and think that all animals in all hospital situations are a good idea.
A colleague sent me a link to a Medscape News article entitled Woof! Does Fido Belong in the Hospital Delivery Room?
- My first thought was... not a chance. (My second, third and fourth thoughts were no better.)
The situation in the article isn't that clear cut though, since the English woman who wanted her dog in the delivery room had a trained therapy dog that helped her with an anxiety disorder. So, if this was truly a trained therapy dog (some people unfortunately make that claim just as an excuse to take their dog everywhere, and compromise people that truly need these animals), it would be justifiable since this is a service dog, not a companion, and we need to support access of service dogs.
However, it raises questions about whether this will open the door to requests for pets to join in the birthing process, now that we've moved from the era when dad paced outside the room to a time when half the family may be present, live-streaming the event to the internet and posting on Twitter.
What are some issues here?
A delivery room is a busy environment. Things can be nice and happy and relaxed. There can also be yelling (personal experience there), lots of activity and other things that might scare or upset the dog. I'm not worried about the dog's feelings here, but what a startled or upset dog might do (e.g jump, bark, bite, pee, try to run away).
Not all deliveries are smooth and things can go from good to bad quickly. The last thing that's needed is another distraction (e.g. the aforementioned dog jumping, growling, barking, peeing, etc.) when medical personnel are dealing with a life-threatening delivery complication.
A newborn is a high risk person for infectious diseases. Every dog is shedding multiple microorganisms that can cause disease. Usually, the risk is low. However, when you have a highly susceptible person (or persons, including the mother here to a lesser degree since post-partum infections are a concern), we don't want them exposed to pathogenic bacteria if we can avoid it. Yes, it's an ever-present risk in a hospital, but why add to the potential risks? It would seem illogical to have delivery personnel in full protective gear (e.g. gowns and gloves) with a dog potentially aerosolizing bacteria nearby through breathing, coughing, barking, shaking, and tail-wagging. People would also likely contaminate their hands often by touching the dog. Yes, medical staff can be to told to avoid contact with the animal and wash their hands, but we know from previous research that hand hygiene by medical personnel after animal contact is very (very!) uncommon.
Also, we know that a baby's first bacterial encounters have a major impact on its developing bacterial microbiome (that is, the composition of normal bacterial populations at various body sites, something that's important for good health and development). Babies born by C-section have much different microbiomes for a long period of time compared to those born by vaginal delivery. Do we really want to confuse the picture more by having some of the first bacteria encountered being Fido's bacterial flora? It's not going to make the baby start barking, but I'd rather the baby not be exposed to various bacteria from a dog seconds after it's born.
In my opinion, visitation is more important the longer the person is in hospital, the more lonely they are and the more upsetting or depressing the situation is. Delivery is typically a short-term, happy hospital stay. What's the real benefit here for your average dog owner?
Personal pets in any hospital situation is a controversial area. Unlike dogs that are part of proper visitation programs, these dogs tend not to have any health screening, behaviour screening or other type of assessment. There's also no handler training. You might say "well, the dog's just visiting its owner so that's not a big deal." However, the dog has to go from the parking lot to the room and back again. What are the odds that the dog's not going to encounter lots of other people in the process, let alone potentially distracting or scary situations. Do you want your elderly immunocompromised relative to ride (or be stuck in!) a hospital elevator with an aggressive or otherwise high risk dog? Or to have you child that just had surgery step on a pile of dog poop? There are clear screening, training and supervision criteria for hospital visitation dogs, and they are there for a reason.
Back to the article. Dr. Arthur Kaplan, the author, sums things up nicely:
"I think there are risks, and I think the risks are pretty significant. I am not sure that we should open the door to every barnyard creature we could think of to be present at birth, even when the mom-to-be says that she would like to have her pet there. But at the same time, I think there are arguments that, for some people, such as the woman in England who has a special relationship with her pet, or perhaps a woman who is blind, a case can be made."
University of Guelph
Guelph, Ontario, N1G2W1, Canada.