Tuesday, April 10, 2012

Delayed (or more correctly, physiologic) Cord Clamping

If you want to wait until the cord has finished its job and delivered all of your baby’s blood after the birth, you are going to have to be proactive.
First, do your research.  Here is a great blog post explaining how a cord works.  Really understand why you believe this is necessary so that you can communicate that effectively to your doctor (homebirth midwives routinely delay clamping).  Make sure this request is in your birth plan and you have discussed it thoroughly with your provider and partner.
At the time of birth, make sure your doula and partner remind the doctor NOT TO CLAMP.  Routinely, doctors clamp almost immediately after the baby is born, before it’s even on your chest.  It’s a force of habit to clamp fast, so someone needs to remind in the moment.
Then make sure your partner actually feels for the pulse of the cord.  This is easy to do.  He simply puts his fingers gently around it and feels for a pulse.  It’s safe to clamp AFTER there is no longer a pulse.  The cord will also look empty, clearer, and feel less rigid (because there is hardly any blood left in it at this point).  There is no reason, if the cord is truly done, to even clamp.  You could simply cut.  Your baby is now completely born.  The placenta will follow shortly.
cord-blood.jpg
Some doctors pay lip service to delaying.  I’ve seen doctors pinch off the cord with their fingers (down below where the parents can see) to stop the flow so that it “looks” finished.  I’ve also seen them say it’s finished and clamp when it’s obviously not finished at all.  Please notice in the above birth that the cord is full of blood, that the vial the doctor is filling is full of blood.  This doctor had said the cord was finished pulsing.  It could not have been.
Why????  They must be in a hurry.  Waiting for the cord to finish takes more time (not a lot, but some).   Do your research; you will find it is safer for your baby to wait, safer for you to wait.  I’ve seen doctors totally respect this request and just slow down too.  One local doctor says he delays clamping just to give baby and mother more time before nurses intervene with newborn assessments.
About cord clamping and cutting:
From an obstetrician:  Why do obstetricians and midwives still rush to clamp the cord?  11-10
a 12/10 review of the research about cord clamping
from BellyBelly.com, an article that outlines the benefits point by point, and answers why doctors don’t wait
an article from Dr. Sarah Buckley about 3rd stage
World Health Org on cord clamping
a science study about delaying
another from academic ob/gyn
5 good reasons to delay, from a homebirth midwife
Are doctors causing infant brain damage by immediately clamping the cord?

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