Delayed cord clamping, dangerous? - Page 2

[NSmomtobe]

I managed (through great effort) to get my doctor to agree to delayed clamping as long as there were no contraindications during the birth.

When I arrived in the delivery room, I told the nurse on duty that I wanted delayed clamping and she told me it wouldn't be possible because there was meconium staining in the amniotic fluid, so my baby would need to be suctioned immediately by the NICU team.

She actually didn't call my doctor in time for the delivery, so the cord was clamped and the placenta was pulled out by the on-call doctor before my doctor even arrived.

[Marissamom]

Originally Posted by NSmomtobe

I managed (through great effort) to get my doctor to agree to delayed clamping as long as there were no contraindications during the birth.

When I arrived in the delivery room, I told the nurse on duty that I wanted delayed clamping and she told me it wouldn't be possible because there was meconium staining in the amniotic fluid, so my baby would need to be suctioned immediately by the NICU team.

She actually didn't call my doctor in time for the delivery, so the cord was clamped and the placenta was pulled out by the on-call doctor before my doctor even arrived.

why the hell do they need to cut the cord to suction! I had mec and they suctioned before cutting the cord. they are supposed to have the suctioning stuff in easy reach of the bed, so there's no reason to have to take the baby away from mom and no reason to need to clamp the cord. I'm not sure how long the doc on call actually delayed clamping the cord because everything was a blur, but she did wait until it has stopped pulsing according to her. I really wish I had had a Dula present, because DF and I were so wrapped up in other things neither of up was paying attention to what all she was doing down there at that point. I think she may have tugged to get the placenta out faster, it did feel like she was in a complete rush to be done with me.

[Mrs.Music]

Originally Posted by Mommal

Ah, those amazing vampire placentas- they faithfully nourish the baby for 9 months, but the instant the baby is born, they suck the blood right out of him.

Nothing to add, since I have had 2 preemies and never really had a chance to think about what to do or not to do with the cord. I think I will discuss this with my MW at my next appt.

[elanorh]

mOxxie, if you can talk to the charge nurse on the L&D floors while you're touring, *her* reaction (and advice) when you tell her you'd like to delay cord clamping should give you a good feel for how supportive the nursing staff would be (which in many cases could be helpful if the random doctor who's caring for you is not so supportive).

When I knew I wanted delayed cord clamping and AAP procedures followed for dd2 for breastfeeding initiation (I didn't know as much about them with dd1, and assumed that's how hospitals did it, and when they didn't, with Ina, I figured that they must have had a reason. The reason was that I hadn't told them I wanted that, therefore they did what was most convenient for them, which was whisk baby away to do their thing with her immediately rather than letting me initiate breastfeeding skin-to-skin before she was bathed etc.). Anyway, the charge nurse there told me that OF COURSE they'd follow my birth plan, of course they do the AAP policy for breastfeeding, just be clear with the nurse about the birth plan and what we wanted when we arrived, etc. She acted offended that I even thought either would be an issue. So that reassured me; I knew I'd be bucking the norm but at least the charge nurse was supportive and knew what I was asking for was reasonable.

I've heard that at larger hospitals, the L&D nurses will often try to angle for their favorite type of patient - so a mother who is having a natural birth, or wants one, might get a nurse who is more supportive of that. Maybe. Worth letting them know clearly when you first arrive! People here can help with your birth plan, too, incidentally.

I'd also look into a doula, as pps have suggested.

ETA: In practice, however, we did have a little issue. My OB had to stop the nurse from coming in to give the pitocin for active management of third stage of labor (placental delivery) - which would have meant that I couldn't do delayed clamping of the cord. Our OB was awesome, he stopped her in her tracks, told her I didn't want pitocin, that I'd noted that in my birth plan, that he hadn't asked for it, and to take it out of the room to dispose of it and it had better not show up on my bill either. In her defense, I'd been at the hospital for about 20 minutes at that point and she hadn't really had time to look at my birth plan.

[nia82]

Oh I didn't see you were with Kaiser. I switched to private insurance at 18 weeks. I initiated care in Hayward. But I heard the best things about the hospital in Redwood City (the Kaiser one close to Jefferson blvd). They have midwives on staff and the lowest c-section rate around.
Since the obgyn comes at the end only to catch the baby, I would distribute my birth plan to the nurses, put it up with Scotchtape to my room door, the wall, anywhere. Bring a doula and drill your partner to hover over the obgyn right at baby when born to enforce no cord clamping, cutting, milking etc.
Yes, there are nurses who like natural birth, request one once you come in (nicely, of course).

[karen1968]

The first time I heard about "vampire placentas" (love that term, BTW ) was from a surgeon last week. I have an anterior placenta and placenta previa (as of 3.5 weeks ago, anyway) and will need a c-section in 2 weeks if it doesn't clear. I assumed the potential of blood loss to the baby would be due to the placenta being cut and bleeding itself. Has anyone heard of that? I do wonder after reading this thread if instead he doesn't just have a misinformed position.

How surprising that article was from so long ago! I this quote though:

The carefree manner in which the newly born infant is "disconnected" from his mother, concludes the report, "is in sharp contrast to the meticulous care with which the thoracic surgeon separates his patient from the heart-lung machine."

[erin_brycesmom]

Suctioning shouldn't be done in the case of meconium stained amniotic fluid any how (unless baby is non-vigorous).

[Catherine12]

Originally Posted by WifeofAnt

Eh, I've only seen kittens born and they all came out in pretty much the same pattern. Kitten first, placenta about a minute or two later (still attached to the cord), repeat until all kittens are born. Then once they were all out she started eating the placenta and severing the cord. Maybe my cat was just odd but all 8 kittens followed the same pattern.

I used to breed dogs (have delivered about a hundred puppies) and this is about how it goes for them too, except the mom eats each placenta right after the pup is out (even if not all her pups have been born yet). My observations are that in dogs the cord stops pulsing quite soon after birth, which is good, since the cord usually gets severed pretty soon due to the placenta being eaten.

A few times I have seen the cord break during delivery, but this is rare and not a good thing (though not a disaster). The pup does lose some blood when this happens - not enough to be hazardous to an otherwise healthy pup, but I don't like to see it. Also, when this happens the placenta is often not delivered promptly - it can stay in the uterus and block the way of the next pup (I once saw a pup born with its sibling's placenta around its neck - fortunately it was ok but this did slow the delivery). Or the placenta might be retained entirely (fortunately not as dangerous in dogs as in humans).

All of which has absolutely nothing to do with human birth... I just find it interesting.

[lexapurple]

After reading in this thread that in Germany delayed cord cutting is a norm I asked my midwife if it was so (I am seeing a group of MWs at birth center in Bremen, Germany) she said that it was and looked at me like I had two heads when I asked if it was a common practice in the hospitals here as well because in US hospitals people have to fight for it. She said that it was and there is absolutely no need to cut them right away and proceded to explain that they usually wait until cord stops pulsing and then cut it while the baby is still on moms chest nursing.

[gemasita]

Nature wouldn't hand us a widespread situation that has the capacity to destroy the species such as the baby 'bleeding back' and expect us to last very long.

Love this.

[mamabadger]

Originally Posted by elanorh

My OB had to stop the nurse from coming in to give the pitocin for active management of third stage of labor (placental delivery) - which would have meant that I couldn't do delayed clamping of the cord.

Why would Pitocin rule out delayed cord clamping?

[NSmomtobe]

Originally Posted by erin_brycesmom

Suctioning shouldn't be done in the case of meconium stained amniotic fluid any how (unless baby is non-vigorous).

I was told I had no choice in this matter and since I was already at the pushing stage, I wasn't in the mood to argue. My son was taken across the room by the NICU team for a few minutes after he was born.

I asked during prenatal care whether they could wait to see whether the pitocin shot was necessary before giving it, and I was looked at as if I was suicidal for making such a request. But my doctor (the one who didn't get there in time) said that they could delay the shot until after the cord was clamped. This turned into a non-issue because the meconium staining "necessitated immediate clamping." Still, I have no recollection of getting the pitocin shot. I actually thought they had forgotten until I asked my doula and she said I had gotten it.

Clearly I am still bitter about this, but everything leading up to the delivery was 100% natural.

[erin_brycesmom]

Originally Posted by NSmomtobe

I was told I had no choice in this matter and since I was already at the pushing stage, I wasn't in the mood to argue. My son was taken across the room by the NICU team for a few minutes after he was born.

I asked during prenatal care whether they could wait to see whether the pitocin shot was necessary before giving it, and I was looked at as if I was suicidal for making such a request. But my doctor (the one who didn't get there in time) said that they could delay the shot until after the cord was clamped. This turned into a non-issue because the meconium staining "necessitated immediate clamping." Still, I have no recollection of getting the pitocin shot. I actually thought they had forgotten until I asked my doula and she said I had gotten it.

Clearly I am still bitter about this, but everything leading up to the delivery was 100% natural.

I totally feel you. Hugs mama!! Ds2 had immediate clamping and was whisked away for suctioning because of meconium staining as well. The birth was also completely natural...I didn't even have an IV or even a heplock so I really do know how you feel. This led me to do a lot of research and I found out that it's completely non-evidence based to suction and that no medical body recommends suctioning for meconium staining....it also goes against the NRP. The only exception is if baby is born non-vigorous and the airways need to be cleared for resuscitation. Ds3 also had meconium staining but this time, no suctioning (homebirth). So *finally* with my third baby, we did delayed cord clamping for the first time and it was also the first time out of three that I was able to hold my baby right away.

Oh and they did give me a shot of pitocin in my thigh with that hospital birth. I didn't have the energy to fight it because they told me I was having massive bleeding and I was scared to death of what was going on with my baby across the room. boo.

[elanorh]

Originally Posted by mamabadger

Why would Pitocin rule out delayed cord clamping?

Well, from what I read in the research and discussed with OB, the pitocin in the third stage could cause stronger contractions of blood (rushes of it) into baby's system in an out-of-ordinary way (or something like that and I'm sure the terms are wrong in my description). Basically what I read said that you should have a natural, non-pit third stage with delayed clamping so that it works right.

It's been a few years since I was researching it, though, the information I found might be out of date by now?

....And, I didn't want pitocin for the third stage anyway. I had been really upset when I realized it had been given to me after dd1's birth ("hospital protocol").

[AlexisT]

I believe that pit alone, rather than a full managed 3rd stage, is done by some UK midwives. It would certainly be worth researching if you were at risk for PPH.

[CBEmomma]

Here is a study from the Chochrane Collaboration. It suggests that it doesn't help with PPH, but it may help with higher iron stores for baby.

http://onlinelibrary.wiley.com/o/coc...074/frame.html

And this study also from the Chochrane Collaboration suggests that delayed cord clamping for preterm babies improves their health.

http://onlinelibrary.wiley.com/o/coc...248/frame.html

The AAP also had an article with the same findings, but you have to pay to see the full text.

[Banana731]

Originally Posted by erin_brycesmom

Suctioning shouldn't be done in the case of meconium stained amniotic fluid any how (unless baby is non-vigorous).

This has been the reecommendation from ACOG since a practice bulletin in Sep of 2009, if I recall correctly!

Though that pp was in Canada...

[MegBoz]

I absolutely wouldn't birth in a hospital in your situation without a doula!!

Originally Posted by elanorh

ETA: In practice, however, we did have a little issue. My OB had to stop the nurse from coming in to give the pitocin for active management of third stage of labor (placental delivery) - which would have meant that I couldn't do delayed clamping of the cord.

Needing pit for 3rd stage doesn't have to mean you can't do regular ('delayed') cord clamping. My MW waited until the cord had stopped pulsing & turned white before clamping & cutting. In my case, it seemed like that happened very quickly (less than 5 min maybe.) AFTER that was done, she was a bit concerned about my bleeding (I think she said there may have been some amniotic sac retained - after she examined the placenta.) At that point, she wanted DS to nurse or she'd give me pit. She waited to see if he'd nurse, but he wasn't interested, so I had a shot of pit.

[Adaline'sMama]

OP,
My OB told me the exact same thing. Its strange too, because she was so excited about my desicion to have a natural birth, with a doula. She was super positive about my entire birth plan, even letting DH catch the baby. But when it came to the delayed cord clamping, I got talked out of it. I wish Id done more research.

[smeep]

I'm sure that others have given you all the info, but I want to reiterate... delayed cord clamping does NOT cause any problems. There is no excessive dangerous blood flow to mother or baby (resulting in excessive blood loss from the other), and it is not affected by position (though, theoretically, if baby is well above or well below mother gravity would affect how long before the cord stopped pulsing).

Just ask her, "If delayed cord clamping is so dangerous, how do other mammals survive? They don't do any kind of clamping and wait to sever the cord until well after it has stopped pulsing." Duh...because it's SUPPOSED to be that way. I honestly don't know where doctors get this information or how on earth their common sense doesn't kick in to tell them how absurd it is.

Also you may want to look up the study done on delayed cord clamping and iron. It found that babies who had delayed cord clamping (1-3 minutes before the cord was clamped) had increased iron stores. Mind you, 1-3 minutes is a FRACTION of the time it takes to stop pulsating. If I remember correctly, it generally takes 30-60 minutes to stop. That's WAY more time than was given in the study and, therefore, we could easily theorize that iron (and other) stores would be much higher if allowed to stop all on its own.