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
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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
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.
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.
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
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 :)
This information comes from the Birthsong Childbirth Education Support Services site.:
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.
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 :)
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?
That sounds a bit strange, I will consult my sources ;)
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!
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
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.
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
from the article on the main site -
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...?:
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.
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 :)
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 :)
Yes TMI WARNING ___ it just kind of feels like a 'plop', lol....
LOL Nat, you are so right though, or in my last births case a splash ;)
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.
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 :)
From ABC website:
Better not clamp the umbilical cord
25 July 2006
One medical tradition that maybe heading for the dustbin of history is clamping the umbilical cord immediately after a baby is born. It may be depriving infants of lots of good things, especially iron. The reasons relate to fears that the mother might be at increased risk of haemorrhage. And then there’s the desire to put the baby on the mother’s abdomen as soon as possible.
But more and more research is showing that in un-distressed babies, leaving the cord open for a couple of minutes with the baby on the bed rather than up on the tummy improves iron stores in the first six months – which in turn could mean better brain development. The babies are no more likely to become jaundiced or have too much blood on board and the risk of bleeding in the mother seems unaffected.
A lot of the research in this area is in poorer countries where babies are more at risk, but there’s little reason to suspect that delaying cord clamping won’t benefit all infants.
For reference
Chaparro CM et al. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomised controlled trial. Lancet 2006;367:1997-2004
Mercer J and Erickson-Owens D. Delayed cord clamping increases iron stores. (Editorial) Lancet 2006;367:1956-1958
Can't they put the babies on the mothers tummies unclamped Geeeezze! Thats what we did... sillllly!
*hugs*
Cailin
Yeah, that bit confuses me...? I think I'd find it really hard not to pick up my child straight away..
Oh and thanks Trish and Natalie for the 'plop' info lol.. I'm not so worried now.. :)
This is sooooo interesting. I had absolutely no idea about the cord pulsating etc. I feel terrible depriving my son of these things having had a cs.
I have heard of some caesareans where they have let the cord stop pulsating. You just have to choose the right Ob. Unfortunately not many women are informed about the cord stuff before they have the baby or that they have the option to have this happen. There are hospital *policies*, but no laws... remember that when you are making decisions for your baby's birth :)
Thanks Kelly. I really need to read more, and aim to be much more prepared for my next preg/birth. Do you know of any educational preg/birth type videos that explains everything that happens to your body and baby during the birth process?
With my first preg/birth, we werent taught much at all at the ante natal classes, which only went for 3 nights. And i figured the less i knew, the less i would worry. I am thinking the opposite now.
Yes unfortunately the way things are these days that if you want something specific, you have to ask or fight for it, which is not something you want to do in labour hence the need for good birth support people. I see dad's reduced to tears all the time, because it is so hard sometimes to understand and be able to know what to do and say for their partner. Like I always say to everyone, it's up to you to inform yourself and get that birth you want - it's often not going to be served on a plate for you and often it's the strong who survive!!! So start with a carer you trust and acknowledges and supports your birth intentions (get them to sign it!), a place of birth which has good birth philosophies, GREAT pre-natal education - forget the hospital, it's only going to be based around their need for management, and great support. I am not sure of some pre-natal education in Adelaide, will see what I can find out.
For birth videos, if you just want to see births, there is a huge collection on the ACE Graphics website, Capers website etc but if you mean something else let me know. I think just seeing lots of homebirth/waterbirth DVD's are great as it gives you all that power and confidence that it can be done without interventions and it can be done well when things are undisturbed.
Consider having a Doula / Birth Attendant. After every birth I have been to, they all say to me that they couldn't have done it without me. And while I always reply, 'Hey, you were the star of the show - it was all you,' it just goes to show you how much that extra support has meant and been helpful - plus you get the benefits of the things a Doula brings including all that lowered rates of interventions and the little things that she can remind the doctors - e.g. 'Wait - she's asked that you wait before cutting the cord,' when mum and dad are so exhausted and overwhelmed with emotion holding their baby, and they just don't notice what else is going on. I also love taking those 'right-after-birth' photos that dad can't take because he is getting to know his new baby :)
I'm in Adelaide and just had my intensive ante-natal class at Modbury Public. I found it really good - the midwife was clearly pro active-labor and we talked a lot about the positions which help relieve labor pain, we even watched a video about these positions. The only time we talked about drugs were after we'd passed around clip-boards with words like 'epidural', 'pethidine', 'gas' etc. and written what we knew about them, and when they were collected the midwife went through refuting or confirming what we'd written. Nothing more was said about drugs, which I thought was AWESOME!
In saying that, at my last visit (24 weeks) I mentioned I would like the cord to stop pulsating before it was clamped and the midwife I had immediately set about telling me how it wasn't that great....which was annoying. I'll just take in a printout of its benefits next time and get them to write me a paper in response to it, would be easier!
PS: we also watched a birth video (first time mum having a natural birth) and it was really encouraging....she did so well!
Thanks for your Info Kelly, and great advice :) You are totally right in what you say. I was naive in the sense that i did think that the Drs were in control of the birth, but in the end, it is my birth, my body and my baby. I think watching some birth dvd's may help put my mind at ease. As i have always feared birth, and i know that this is not a healthy way of thinking. A doula definately sounds like a great idea too, my DH was too busy looking after me during my cs, and missed out on the birth/photos/video etc.:(
Ally - I felt that way with #1 as well, so your not alone. I`ve learnt a lot with this pregnancy, hence different OB.:
Kelly - thanks for the info, I`ve decided to go ahead with no cord clamping until it stops pulsating :) Just need to tell this boy to get a move on out into the big wide world, everyone`s waiting to meet him.
Take Care
Dee
Dee, good to hear that you've made a decision. Does your OB support this??
I think it's time your little man started paying board hey. Come on little man, mummy and daddy are waiting for you :)
HI All,
It is so true that the cord should be left to cease pulsating until severance. Their is at least one exception I don't think has been mentioned yet however and that is during a waterbirth. The ambient temp approx 37 celsius delays cord ceasation and we used to severe after a reasonable time a min or two.
Another consideration is the babies position in relation to the placenta to assist or inhibit bloodflow too and from baby (important when considering Bilirubin breakdown etc later on.
Blessings to all
Nigel
Nigel, my last birth was a homewaterbirth and we left the cord attached until it stopped pulsing roughly 20 minutes or maybe more. We had no problems at all with this. ALso Tehya did have slight jaundice for about 2 weeks but again nothing that isn't out of the norm anyway.
Found one of the articles, I will re-post it here:
:
Trial finds delay in cord clamping protects babies
(as reported in the Courier Mail recently)
A 30 second delay in clamping a premature newborn's umbilical cord protects against bleeding in the brain and infection, groundbreaking new research shows.
The study, which involved 72 babies, could prompt a reassessment of the standard practice of clamping the cord immediately after birth.
Delayed clamping has been shown to increase the volume of blood transferred to the baby from the placenta.
Researchers from the University of Rhode Island, in the US, followed 36 babies assigned to immediate cord clamping and 36 assigned to delayed cord clamping.
All were less than 32 weeks gestation and their prematurity meant they were at increased risk of brain haemorrhage and infection.
In the weeks after birth, 36 percent of the immediate group had suffered bleeding into the brain, compared with 14 per cent of the delayed group.
Nine of the immediate group but none of the delayed group developed infections while in the intensive care.
"It may be that the small amounts of additional blood preterm infants obtain by delaying cord clamping helps to stablise cerebral blood flow and provide additional stem cells to establish adequate immunocompetence" says the report in this month's America Pediatrics journal.
I know this is a really old thread but,
I have already agreed to donate the cord blood as i was unaware of this information.. I had no idea that the cord clamping could be delayed or of its benifits. Am I able to change my mind now or is it set in stone now that ive agreed?