Delayed cord clamping rebuttal from OB - Page 2

[Super~Single~Mama]

Originally Posted by mambera

That is because most veins are specially constructed with valves that prevent backflow.

Why would the cord be any different? Baby isn't always going to be "below" the cord! And why would it pulse if it wasn't constructed in a way to get the blood into the baby?

[triony]

Originally Posted by KGB

. She said that when a baby is placed on the mother's chest, gravity would end up forcing the blood in the cord from the baby back to the mother.

Hopefully the OB didn't actually say "back to the mother" since you are right it is a closed system. Baby and mom do not share blood. Blood could flow back to the placenta I suppose, barring any naturally occurring methods that I assume nature put in place to avoid exactly that.

I think most doctors these days deal with people that don't do what you are doing: going out and research the Dr's responses afterwards. Most of the folks I have spoken to in real life just accepted whatever their OB said and that was that.

Heartfelt thanks and appreciation for mothering.com and every single person who posts here!

[mamabadger]

A secondary issue: the studies I have seen compared "immediate" cord clamping (within a few seconds) with "delayed" cord clamping (two minutes). Would a longer delay make a difference? Two birth centres I know of do no cord clamping, and only cut the cord an hour or so after delivery of the placenta. There seems to be no blood left in the cord at that point - or is it that the Wharton's jelly prevents further blood flow? Does all the placental blood eventually go to the baby if given enough time?

[honeybee]

I had the opportunity to listen to a lecture by Dr. Morley -the delayed chord clamping expert researcher. It was so fascinating. He does actually recommend leaving baby below mom for a time right after birth to get maximum chord blood to the baby, if baby is slow to oxygenate (perhaps due to chord compression during birth). Optimal is mom in an upright position, and baby resting below her. With a baby that pinks up right away, this isn't really necessary, and the pulsing of the chord will get the blood to the baby on mom's chest. Valves will ensure that no blood drains out of the baby through the chord. That's pretty much impossible.

After a few minutes, the chord stops pulsating and valves seal off the chord in baby, and the baby doesn't receive any more of the chord blood. So, delayed chord cutting is really beneficial, and it only requires a few extra minutes. I don't know why the OB community is so resistant to the idea.

[KGB]

Originally Posted by triony

Hopefully the OB didn't actually say "back to the mother" since you are right it is a closed system. Baby and mom do not share blood. Blood could flow back to the placenta I suppose, barring any naturally occurring methods that I assume nature put in place to avoid exactly that.

I think most doctors these days deal with people that don't do what you are doing: going out and research the Dr's responses afterwards. Most of the folks I have spoken to in real life just accepted whatever their OB said and that was that.

Heartfelt thanks and appreciation for mothering.com and every single person who posts here!

Thanks Triony. She may have said "back to the placenta"... I don't remember exactly, but she basically meant away from the baby.

My wife has started giving me a hard time about all the "research" I've been doing. She's a nurse and has talked with doctors that have agreed with what her OB said. I debated it with the things I've heard on MDC and she mentioned she doesn't put much trust in people not in the medical field. So I followed lots of links I found on MDC and read her medical journals to support delayed cord clamping ad nauseam. My wife is all for delayed clamping, but she still believes there's no benefit to waiting until it stops pulsating. Well, you can't win em all I guess.

Oh, here's a great quote from a book I'm currently reading about people's blind faith in medical professionals:

"Anyone working to improve the childbearing experience and help women avoid unnecessary intervention can fill in the blank on a long, frustrating list that begins, 'But the doctor said ...,' where the doctor was wrong. And while the evidence in the medical literature is solidly, often unequivocally, against whatever 'the doctor said,' without access to that evidence the pregnant woman is quite reasonably going to believe her doctor, who she presumes is the expert."

[AllieFaye]

Nicholas Fogelson, MD has an interesting point of view on this topic.

[Gena 22]

Originally Posted by AllieFaye

Nicholas Fogelson, MD has an interesting point of view on this topic.

That is truly awesome!!! Thanks for the link!

[gemasita]

It's a miracle that we have survived as a species given the millions of years we spent on this planet before clamps and scissors were invented. A true miracle...

[MsBlack]

Originally Posted by gemasita

It's a miracle that we have survived as a species given the millions of years we spent on this planet before clamps and scissors were invented. A true miracle...

Quite!

[Bellabaz]

Her answer makes no sense to me. I would still go ahead with your plans. Esp since she is willing.

[prancie]

From all the stories I've heard here and from ICAN meetings I can only think that most obstretricans base their care on cultural medical practices and not evidence based practices. They assume that the culture is evidence based so we sound like freaks when we want something different.

For example, a couple of nursing students came to our last ICAN meeting. They described how in class the teacher talked about the lithotomy position saying that it is not optimal for mom and baby but the best for the doctor, and the other nursing students were just studiously taking notes and no one seemed to think that was weird at all. They are being indoctrinated into a culture.

[mambera]

Originally Posted by prancie

most obstretricans base their care on cultural medical practices and not evidence based practices. They assume that the culture is evidence based... They are being indoctrinated into a culture.

Absolutely spot on.

[mwherbs]

Originally Posted by rainbowmoon

um, how would one have a lotus birth during a cesarean Wouldn't you bleed to death?

so I wanted to reply to this because I really don't know how fast they get placentas out during a c-section- and if there is any benefit to delaying clamping- the thing is that c-section babies could very well end up being held too far above the placenta to do much good- on the other hand here was a study published in the Green Journal- in 07 on placental drainage/cord stripping in order to prevent Rh- sentization and they waited 3 minutes to drain the placenta on average and that drastically reduced the Rh+ exposure in the group of women they studied.

"The incidence of feto-maternal transfusion, as detected by the primary outcome variable of a positive Kleihauer-Betke test, was significantly lower in the drained group (3 of 44, 6.8%) than in the not-drained group (14 of 42, 33%) (P=.003; relative risk 0.20, 95% confidence interval 0.065-0.65). On the basis of these data, we needed to treat four patients with placental drainage to avoid one feto-maternal transfusion (95% confidence interval 2.34-9.60)."

you can read the full text here--
http://journals.lww.com/greenjournal...arean.12.aspx#

[SeekingJoy]

Originally Posted by KGB

Oh, here's a great quote from a book I'm currently reading about people's blind faith in medical professionals:

"Anyone working to improve the childbearing experience and help women avoid unnecessary intervention can fill in the blank on a long, frustrating list that begins, 'But the doctor said ...,' where the doctor was wrong. And while the evidence in the medical literature is solidly, often unequivocally, against whatever 'the doctor said,' without access to that evidence the pregnant woman is quite reasonably going to believe her doctor, who she presumes is the expert."

I LOVE this quote. What book did it come from?

[billikengirl]

Is your OB opposed to delaying cord cutting in any and all circumstances?

When my baby was born, he was pink/nice heart rate/adequate blood sugar level, but was not immediately interested in breathing on his own. So the midwives left his cord alone (aside from checking that it was still pulsing), let him continue to get oxygen from me, and worked to stimulate him to breathe. It worked great for him and he started up just fine with the help. I know anecdotes aren't evidence, but I can't help but be grateful that my midwives know better than that OB