How to get newborn screenings after a homebirth

Last month I wrote about newborn screenings and the resources you can find on Baby’s First Test. Typically, the newborn screenings (heel prick, hearing test, and–in some states/hospitals–pulse ox) are done after birth while still at the hospital. That makes it pretty easy! You can check what your state tests for specifically–you may have to ask for the pulse ox if it’s not done routinely.

So what if your baby is born at HOME?

Rebecca was born at home in February and I knew I needed to get her newborn screenings done. I’ll share with you how my experience was and what I know about your options, but want to clarify that every state is different and I’m not an expert 🙂

First, I asked my midwife! She’s a licensed professional and I knew she’d have the answers or could tell me where to look.

Pulse ox: I asked about this in our initial interview. I wanted to know if she had her own pulse oximeter. They are pretty pricey, but some midwives do have their own as it’s a non-invasive and simple procedure. However, my midwife did not.

As I neared my due date, I called our new family practitioner to remind them my baby would be coming soon and to make sure I’d be able to get in for an appointment shortly after birth. No problem, they said! Just call after she’s born! It was important to me to be seen after the first 24 hours, but within the first few days… that’s when pulse ox is most important, as well as a number of other tests.

I made sure to ask over the phone–“Can my baby receive a pulse ox when I come in after the birth?” They said yes, of course.

adult pulse ox on a newborn–wrong!

What happened? The pulse oximeter they had was for adults only. You know, the kind that clips on your finger. It’s way too big for a newborn and it results in inaccurate readings. I was beyond disappointed. They tried it on her anyway, only to receive readings around the 85 range. I warned them to never do that to another mom because that’d be enough to send any mom into a panic (if she thought the numbers were accurate). Heck, it worried me quite a bit! They tried multiple times and did get a reading of 95 at one point… but I knew I needed a newborn pulse ox for a trusted reading.

Hearing test: there are only certain hospitals or clinics that offer the newborn hearing screen. I called my local hospital and they told me they couldn’t do it (small town). I had to drive 45 minutes away to have it done. But once I was there, we were in and out, Rebecca passed with flying colors no problem.

Also, I asked on the phone before I went if Rebecca could have a pulse ox there. I mean, it’s a hospital! And it’s the special care area for newborns! They said “sure, but ask the tech when you get here.”

So I did. And her reply? No, you can’t get one here. WHAT?! And then she told me that if I were to get one, anywhere in the hospital, I HAD to have a doctor’s note. Really? I mean, I suppose, but have you seen a pulse ox? It takes 2 seconds, it’s non-invasive, it’s as easy and simple as can be. And why couldn’t they have told me that on the phone? And why didn’t my family practitioner know that when I left her clinic? Sigh.

Heel prick: my midwife told me she could do this one for me, but I opted to just have it done by my family practitioner during our first visit when Rebecca was just a couple days old. If you haven’t seen the form, there are 7 little circles (in IL… other states may only have 5 circles; it varies) and each circle has to be completely full and saturated with blood. Poor Rebecca’s foot just squeezed out one tiny drop at a time so it took foooorrreeevvverrrr and she cried through the whole thing. But this is a super important life-saving screening that tests for many complications.

image from USAF Photographic Archives (by Staff Sgt Eric T. Sheler)

Fast forward at least an entire month and I get a phone call that the test didn’t work. They didn’t have enough blood. WHAT?! They said I had to do the test again and that I’d have to pay again, which confused me because it was not my error, but ah well. Note that the heel prick test is pretty time sensitive–you do it right after birth to catch some very serious disorders in time. I feel lucky and am very grateful Rebecca did not have any of these issues or we would have been late in the game.

This time, I went to my midwife and had her do the test. And this time, it worked. Free and clear.

OVERALL: you can certainly still have all your newborn screenings after a homebirth, but it does take planning! You DO have to know what to ask for and where to go, unlike a hospital where they just take your baby and do it all for you. When Ryan was born (in a hospital), I don’t even recall when he had the heel prick or hearing test. The pulse ox, however, I do know about because I asked for it.

So… call ahead of time, make those appointments, figure out where you need to be. CLARIFY on the phone that the clinic/hospital/whatever has the newborn pulse ox attachment. Ask if you need a doctor’s note. I do believe I had a run of bad luck with my screenings, but that it won’t typically be like that! Especially because you just read my post and know what to expect 😉

I am always here if you have any questions and please do check out Baby’s First Test and their section on homebirths!

~Disclosure: this is the second of a 2-post series brought to you by Baby’s First Test. All opinions and experiences are my own!

13 comments to How to get newborn screenings after a homebirth

  • Kelley Johnsen

    Wow, great to know. I have had my four in the hospital and it never was a thought as too how those that do home births do the screenings. Rebecca is beautiful, Congratulations.


  • I really want to have a home birth the next time around. I am saving this post for future information, thanks!


  • We had a homebirth planned for our son, but lost it when I ended up with severe preeclampsia. Thankfully, the hospital that we went to was very respectful of our wishes to deny most of the interventions/screenings. We did the PKU, but that was it. For our next child, we will plan for another homebirth and also only do the PKU. Thanks for sharing.


    Kristine Reply:

    Thanks for sharing your experience. The “PKU” test actually tests for over 29 conditions in most states–so we don’t call it the PKU test anymore. I highly suggest you research heart screening, or pulse oximetry. It’s extremely non invasive. In many cases, you can even feed the baby, and it could have saved my baby’s life. It’s a vital sign, and on par with getting the baby’s temperature taken.


  • Thank you for this post, I’ll be sure to ask my midwife about it at our prenatal check up next week!


  • After just coming back from BlogHer and following Kristine and her mission with Cora’s Story I was thrilled to see you writing about this. As an RN, I am appalled they tried to use that adult pulse ox on a child, let alone a NEWBORN. Good for you for educating them and everyone planning for their baby’s birth!!


  • I love that you shared your experience to educate other Mamas. It is hard to know exactly what to expect and to when to ask for it the first time so thanks for sharing!


  • Tazim

    Wow – I didn’t know about any of these. I don’t children, though – but I’m glad to know more before the day comes.


  • I never thought about that aspect of home birth, thank you for sharing your experience and tips!


  • This was good to know. I’m not having a home birth but birthing with a midwife at a birth center. I know with my last one they did the hearing test and heel prick but no pulse ox. I need to ask her if she can do the pulse ox for me with this baby.


  • Chrysa

    Very informative. This will be helpful to lots of home-birthing mamas.


  • […] Now Available For DownloadMiniaturized wireless sensors can save lives of wounded soldiersHow to get newborn screenings after a homebirth .recentcomments a{display:inline !important;padding:0 !important;margin:0 […]

  • […] You may need further testing for your baby depending on the results. You may do further testing and find out that their is NOTHING wrong with your baby. I know this aggravates some mothers because they subjected their baby to further testing when it actually wasn’t needed. I completely understand that point of view but in many of the cases it’s a better safe than sorry situation. You will never regret making sure your baby is as healthy as he/she can be. You will regret something negative happening to your baby because you decided to forgo testing. Want to see what these tests look like while being done? Having a home birth and not sure how you’ll get your screenings done? Check out little Rebecca at Baby Dickey getting her newborn screenings. […]

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