The Cord and the Clamp

Vying for importance at the last moment of birth, the cord and the clamp face off...

So, I'm reviewing the information on neonate resusc. and other procedures that may be pertinent to neonates the other day (as is my custom to do every once and awhile) and I am again struck by the idiocy of current and routine medical practice... why the heck are we still clamping and cutting prematurely???

I have this 'delightful' (hear the dripping cynicism) movie called Navy Obstetrics Video which I purposefully don't show to too many clients... given it is old, but many of the practices are still in effect. There is a particularly disturbing theme in most of the births on this video, which, I chillingly see often in hospital births were the family has not made their wishes completely known and enforced.. early cord clamping and cutting.

The same scene - a baby is born, clamped, cut away from the mother - then whisked away to resuscitate because baby is in distress for not breathing!!! WTH??? Sorry for my cyber-french. But, why, why, why are we cutting off oxygen supply and blood flow when breathing has not have been initiated yet??? If a babies sole oxygen flow is still being maintained through the cord, and we cut that line, we are saying 'breath on your own now or else!'. Until that cord is cut or stops pulsing on it's own, a baby can take as long as he/she wants to start breathing.

There is some credible research out there that suggests, and common sense seems to agree, that birth while squatting may even help to establish independent respiration sooner... It makes sense, as the baby is born below the placenta, which, in turn, helps it to drain more quickly, delivering blood and oxygen to the baby.

Think of it, common sense people: clamping the cord at birth causes asphyxiation till breathing effort takes over (forcefully rather than naturally - potentially causing distress and/or trauma). There is nothing good and every bad to be served for the purpose of 'cutting the baby free' of mother prematurely. What harm is there in allowing baby to stay attached to the cord until the placenta is born? I tell you what harm - the doc has to sit patiently until the placenta is born as they can't 'traction' the cord to pull the placenta free, they cannot hasten the 3rd stage, and they cannot get baby under the heating lamps and one more thing crossed off their to-do list.

I digress, I know I sound angry - but more than that, I am simply frusterated and fed up.

How in the world can obstetrical practice be so unscientific? Yet another example of how we set the mother/baby up to fail, then swoop in with our heroic efforts to "save" them. Pshaw!

I really really recommend that, any woman preparing for her birth, go to this site and read the essay "Why Babies Cry" by George Malcolm Morley. It only takes a moment, but let's try changing things for the better, one birth plan and OB at a time... and throw those mideival torture devices called 'clamps' in the trash.


J Matt Miller said...

I completely agree and loves the bluntness that you wrote with. I love the beautiful design of our God given bodies and birth is one of the moments when we can witness His perfect design so clearly. I also enjoyed the link you posted. Reading material like this makes me feel like marching into every OB/GYN in American and forcing this info into the doctors hands.
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Jillian said...

Yep yep yep, I'm right there with you.

I'm just trying to figure out if Jonathan wasn't breathing because of

a) the epidural (double shot) or
b) immediate clamp-n-cut


I'm converted. Just promise you won't make me drink placenta tea afterward. :)

Jenny Nash said...

My son was born about 4 weeks early and developed a pneumo­thorax upon delivery. While most babies born with a pneumo­thorax can heal relatively quickly and without medical intervention, my son's condition quickly deteriorated and he was rushed by ambulance to the closest NICU where he was intubated and on a vent for 10 days.

I wonder if his condition could have been resolved sooner had he not been clamped so soon?

L. Janel Baby Keeper said...

Great article. Thank you.

Thought you might like to read my thoughts on the placenta and cord clamping.



sara r. said...

Last week I had the opportunity to doula for a couple that I met for the first time when the mother was in early labor. She had been sent home from the hospital and my husband suggested to her fiance that I might be able to help. I was too late to talk her out of the epidural (that she didn't need! Labor was actually going great and fast for her!), but I did explain the benefits waiting for the cord to stop pulsing before cutting it. They immediately "got it" and said that they were going to make sure to delay it, and they did. I was really happy that even though we had just met, they changed their minds and made an intelligent decision for their baby.

I totally agree, this is one of the stupidest and least evidence-based practices in obstetrics. My sister and I were born at 31 weeks, immediately clamped, and then given blood transfusions to make up the difference. Would we have needed those if the cord had been left intact? Who knows, but maybe not. It's almost like a form of bloodletting.


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