Waiting For The Cord To Stop Pulsating Before Cutting

[Deejoy17]

Hi Girls

Could someone please let me know the benefits of waiting for the cord to stop pulsating before cutting it, I`m still unsure what to do here but need to make my final decision soon so my caregivers know what I want.

Take Care

Dee

[christy]

I'm sure Kelly will have more info on this, but have you read this article on the main site? It talks a bit about clamping the cord & reasons & natural benefits.

We are planning on leaving the cord until it finishes pulsating. Our decision is to get that cord blood into our little baby to get all that goodness in from the very beginning of life. With Matilda, having an emergency c/s we were unable too, but the plan is to try for it this time.

[hannanat]

I agree with Christie. Also, there are no harmful effects and the only reason that the cord should be cut immediately is when the placenta is still inside the mother and the baby needs emergency attention from what I've read. So my motto is if it definitely helps and cant cause any harm I'm going to do it.

[MantaRay]

I went to a discussion on Childhood Nutirician run by a nutricianist/dietician with tonnes of qualifications. She said that if the cord is left until it stops pulsating that the baby's iron stores last for longer. This means that if bub is slower to take to solids it won't matter so much as they won't get iron deficient in the meantime.

I will be interested to hear the other repsonses.

Melanie

[Trish]

We left Tehya's cord attahced until it stopped pulsating approximately 20 minutes after her birth. While the cord is still attached there is no immediate need for baby to breath so if bub is alittle slow to start all is good as it is getting oxygen still through the pulsating cord. Basically cords are cllamped in hospital as a mater of convenience to the Dr's pretty much the same as the oxytocin injection. She was quite pink for the few days following her birth due to the extra blood butof course other than that she had no reactions or problems from it. I figure that if they need this blood so badly for other babies, how good must it be for mine. Afterall it is HER blood

The baby, the cord, and active management
Adaptation to life outside the womb is the major physiological task for the baby in third stage. In utero, the wondrous placenta fulfills the functions of lungs, kidney, gut and liver for our babies. Blood flow to these organs is minimal until the baby takes a first breath, at which time huge changes begin in the organisation of the circulatory system
Within the baby’s body, blood becomes, over several minutes, diverted away from the umbilical cord and placenta and, as the lungs fill with air, blood is sucked into the pulmonary (lung) circulation. Mother Nature ensures a reservoir of blood in the cord and placenta, that provides the additional blood necessary for these newly-perfused pulmonary and organ systems.
The transfer of this reservoir of blood from the placenta to the baby happens in a step-wise progression, with blood entering the baby with each third-stage contraction, and some blood returning to the placenta between contractions. Crying slows the intake of blood, which is also controlled by constriction of the vessels within the cord (Gunther 1957) – both of which imply that the baby may be able to regulate the transfusion according to individual need.
Gravity will affect the transfer of blood, with optimal transfer occurring when the baby remains at or below the level of the uterus until the cessation of cord pulsation signals that the transfer is complete. This process of "physiological clamping" typically takes 3 minutes, but may be longer, or can be complete in only one minute. (Linderkamp 1982)
This elegant and time-tested system, which ensures that an optimum, but not a standard, amount of blood is transferred, is rendered inoperable by the current practice of early clamping of the cord- usually within 30 seconds of birth.
Early clamping has been widely adopted in Western obstetrics as part of the package known as active management of the third stage. This comprises the use of an oxytocic agent- a drug that, like oxytocin, causes the uterus to contract strongly- given usually by injection into the mothers thigh as the baby is born, as well as early cord clamping, and ‘controlled cord traction’- that is, pulling on the cord to deliver the placenta as quickly as possible.
Haste becomes necessary, because the oxytocic injection will, within a few minutes, cause very strong uterine contractions that can trap an undelivered placenta, making an operation and ‘manual removal’ necessary. Furthermore, if the cord is not clamped before the oxytocic effect commences, the baby is at risk of having too much blood suddenly pumped from the placenta by the over-zealous contractions.
While the aim of active management is to reduce the risk of haemorrhage for the mother, "its widespread acceptance was not preceded by studies evaluating the effects of depriving neonates [newborn babies] of a significant volume of blood" (Piscane 1996)
It is estimated that early clamping deprives the baby of 54 to 160 ml of blood, (Usher 1963) which represents up to half of a baby’s total blood volume at birth. "Clamping the cord before the infant’s first breath results in blood being sacrificed from other organs to establish pulmonary perfusion.[blood supply to the lungs].Fatality may result if the child is already hypovolemic [low in blood volume]." (Morley 1997)
Where the baby is lifted above the uterus before clamping- for example during caesarean surgery- blood will drain back to the placenta by gravity, making these babies especially liable to receive less than their expected blood volume. The consequence of this may be an increased risk of respiratory (breathing) distress- several studies have shown this condition, which is common in caesarean-born babies, to be eliminated when a full placental transfusion was allowed. (Peltonen 1981, Landau 1953).
The baby whose cord is clamped early also loses the iron contained within that blood- early clamping has been linked with an extra risk of anaemia in infancy. (Grajeda 1997,Michaelson 1995).
These sequellae of early clamping were recognised as far back as 1801, when Erasmus Darwin wrote:
"Another thing very injurious to the child is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a part of the blood being left in the placenta which ought to have been in the child" (Darwin 1801))
In one study, premature babies experiencing delayed cord clamping-, the delay was only 30 seconds- showed a reduced need for transfusion, less severe breathing problems, better oxygen levels, and indications of probable improved long-term outcomes, compared to those whose cords were clamped immediately. (Kinmond 1993).
Some studies have shown an increased risk of polycythemia (more red blood cells in the blood) and jaundice when the cord is clamped later. Polycythemia may be beneficial, in that more red cells means more oxygen being delivered to the tissues. The risk that polycythemia will cause the blood to become too thick (hyperviscosity syndrome), which is often used as an argument against delayed cord clamping, seems to be negligible in healthy babies. (Morley 1998)
Jaundice is almost certain when a baby gets his or her full quota of blood, and is caused by the breakdown of the normal excess of blood to produce bilirubin, the pigment that causes the yellow appearance of a jaundiced baby. There is, however, no evidence of adverse effects from this. (Morley 1998). One author has proposed that jaundice, which is present in almost all human infants to some extent, and which is often prolonged by breastfeeding, may actually be beneficial because of the anti-oxidant properties of bilirubin. (Gartner 1998)
Early cord clamping carries the further disadvantage of depriving the baby of the oxygen-rich placental blood that mother nature provides to tide the baby over until breathing is well established. In situations of extreme distress- for example, if the baby takes several minutes to breathe-this reservoir of oxygenated blood can be life saving, but, ironically, standard practice is to cut the cord immediately if resuscitation is needed.
The placental circulation acts, when the cord is intact, as a conduit for any drug given to the mother, whether during pregnancy, labour or third stage. Garrison (1999) reports that Narcan, which is sometimes needed by the baby to counteract the sedating effect of pain-relieving drugs such as pethidine (demorol), given to the mother in labour, can be effectively administered via the mother’s veins in third stage, waking up the newborn baby in a matter of seconds.
The recent discovery of the amazing properties of cord blood, in particular the stem cells contained within it, heightens, for me, the need to ensure that a newborn baby gets its full quota. These cells are unique to this stage of development, and will migrate to the baby’s bone morrow soon after birth, transforming themselves into various types of blood-making cells,
Cord blood harvesting, which is currently being promoted to fill Cord Blood Banks for future treatment of children with leukaemia, involves immediate clamping, and up to 100 ml of this extraordinary blood can be taken from the baby to whom it belongs. Perhaps this is justifiable where active management is practiced, and the blood would be otherwise discarded, but, unfortunately, cord blood donation is incompatible with a physiological (natural) third stage.

This information comes from the Birthsong Childbirth Education Support Services site.

[BellyBelly]

If you do a search Dee I have posted a few articles in this section already about it being left alone to stop pulsating and being linked to lower anaemia rates and other things - lots of benefits

[chocolatecatty]

Deejoy, whatever you decide, make sure your midwife/ob knows about it before hand....I mentioned it to my midwife at a checkup and she immediately went on to tell me why it should be cut blah blah so I presume it's not the done thing?
If they give you the syntocin injection can you still wait until it stops pulsating or not? My midwife ended up saying as long as the baby is above the placenta, it's ok to let it stop pulsing naturally before clamping it. She said something about too many red (or white!) bloodcells entering bubs if bubs was below the placenta?

[BellyBelly]

That sounds a bit strange, I will consult my sources

[SuzL]

I'd never even thought of this before. I always just assumed it was cut straight away and that was that. It has been very interesting to read about the options!

[BellyBelly]

This is from Diane Gardner, who does HypnoBirthing and others midwives agree with her:

Here is a site to go to that is very informative about cord clamping. http://www.cordclamp.com

There is no reliable research that proves babies being more suseptible to jaundice if they receive all their cord blood. Also the lower lobes of the lungs do not inflate until after birth so extra blood is needed to do that otherwise where is it taken from. Nature designed it perfectly. So are we saying that nature was wrong in its design that has birthed babies for thousands of years. Who has it wrong? I remember once that Dr Spock once had all the answers too. Hmmmmmm

The cord contains up to 150mls of blood, where do you think it was designed to go? Whether the baby is inutero with the placenta at the top or the bottom or holding the baby up or down after birth, the placenta still keeps pumping to the baby. I have felt pulsing cords with mumns sitting with their babies up on their chests. Blood flows to and from the baby until it starts to breathe then it becomes a one way operation not a two way one.

You have to ask yourself why nature designed a cord that connects from a mother to a baby until it breathes on its own and then when it's job becomes defunct it stops supplying oxygen and blood,and the placenta then releases from the uterus. How we have interferred in nature. When a cord is prematurely clampled how is the signal that the baby is breathing on its own transmitted to the placenta? BY AN INJECTION!! No wonder PPH often occurs after a "perfect" birth because the placenta doesn't know its job is completed, there is still pressure from the placenta to the clamp.

In the cultures where the cord and placenta is left attached the cord is never clamped. Eventually the cord just shrivels up and releases from the navel.

Imagine the poor baby who has suddenly had it's oxygen supply prematurely cut off and is forced to breathe to survive. I have seen some terrible instances of having to rub and jiggle babies to make then breathe or I have also seen babies that born peacefully, gently start to breathe, gradually getting stronger and the cord gradually slowing down and then after some time the cord stops pulsating and is then cut.

What have we as this so called advanced society done.

Sorry but this is a subject I feel very strongly about and Michel Odent has supported this for more years than I can remember. I know medical science is needed in some instances but not EVERY birth.

regards
Diane Gardner

[Tobily]

I love this site I'm learning so much

This all makes perfect sense to me but hearing of others experiences trying to actually get this to happen makes me despair of ever getting any say in my birth in a hospital setting
Ugh it can be so disheartening.

[Rouge]

Yeah I have to agree with both Di & you Kelly I think leaving the cord to pulsate has to be a good thing. Think of how many people that want to get their hands on the cord blood, cord blood is prescious, and therefore I made sure it went to the person it was intended for. Like Imogen Seth was awfully pink for a while after as well. And I also noticed that Seth's cord healed quicker and fell off quicker than Paris' did too.. wonder if there's a link with that?

*hugs*
Cailin

[Katey84]

from the article on the main site -

Choosing to forego preventative oxytocics, to clamp late (if at all), and to deliver the placenta by our own effort all require forethought, commitment, and that we choose birth attendants that are comfortable and experienced with these choices.

does that mean that it is unlikely that midwives/doctors in public hospitals (ie not ones you choose yourself or pay for their services) would 'let' women do this?.. I'm a bit scared about hearing other people's experiences with this, it's almost as if it is discouraged...?
or is that quote more to say 'you have to really want to do it and make it known' - and the birth attendant being supportive of it is more to do with them being your voice when incapacitated...?

I guess in my thoughts I had kinda resigned to not being too concerned about whether I could have a natural 3rd stage or not, just because it looked like so much of a struggle..
It seems like such a great thing to do however, so I'd really like to try when the time comes, if it seems realistic.
My other reservation is not having any idea how hard it is to birth the placenta? how long it takes? etc... I have a stupid fear that my time with my newborn child will be interrupted by another hour of pushing to get the placenta out...
anyone with experience want to make me feel better about this? I really have no idea as I've never given birth (!) but I want to fill my mind with knowledge so I have a solution for every problem that comes up..
Plus it gives me something to do while I'm losing weight in prep for ttc.
(Please don't laugh at how far ahead I'm thinking! )

Thanks

[Trish]

Kate, there really is very little pushing involved in getting the placenta out and after you have given birth the birth canal is already open, it's not some thing that hurts to push out. Thankfully

[hannanat]

Yes TMI WARNING ___ it just kind of feels like a 'plop', lol....

[Trish]

LOL Nat, you are so right though, or in my last births case a splash

[christy]

I am going to a public hospital and will request on my birth plan this choice. The first time I expressed that I wanted it, but it wasn't possible at the time. I think they wouldn't suggest it to you, but if you know what you want, you can discuss it with the midwives & they "should" support you in that decision.

[*Rae*]

Wow - i have never even heard about this ...always just heard about cord blood being donated. It does make sense to let those good nutrients flow into bub! I'll definatley consider this with baby #2