What did you do/should be done after an accidental UC?

[lovebeingamomma]

I was going to homebirth but now am faced with not having any homebirth options.  I found a great supportive midwife (my former hospital midwife), who is supportive of me staying home til I'm practically pushing.  I don't plan on having a UC, but I see it as a real possibility so I want to make a mental note of what to do.  So if I suddenly HAVE to push and can't get in the car to go (I push my baby's out in about 10 min's), what do I do?  Call 911 so they can cut the cord and bring me to the hospital?  Have sterile scissors/clamp on hand and do it myself and stay home?  And just bring the baby to the ped?  Not sure the best course of action.  I'm not too concerned for myself, unless I'm having severe bleeding I recover really well from birthing.  But for the baby...what to do...

I just thought of this, did anyone consult with a midwife after their UC?  Like I could describe to her how the baby is doing, and see if she thinks there's any reason to come to the hospital?

[Tumble Bumbles]

((((not medical advice, just sharing of common sense info by having done lots of research))))

No need to call 911 to cut the cord! If you happen to have your baby at home unassisted, you quite simply bring baby to your chest for skin to skin contact, make sure baby is breathing, leave the cord in place, and keep yourself and baby warm. Never pull on the cord obviously, this can make placenta detach prematurely causing a hemorrhage.

 Many babies who come into the world gently outside of the hospital don't cry right away, don't appear to be breathing right away, and sometimes take a bit (30 seconds or so) to even breathe. Holding baby face down in the crook of your arm (not upside down but laying along your arm only faced down instead of typical cradle hold) can help mucus drain but this typically happens while the head is out and babe is naturally upside down anyway. You can also manually remove mucus from baby's mouth either by gently sucking it out (with your mouth or a bulb syringe but typically it isn't necessary), or with your finger. Basic newborn "resuscitation" includes rubbing baby's back, tickling baby's toes, or blowing in baby's face gently. Mamas instinctively do these things :) In the vast majority of cases, baby responds to this right away. If not, I would call 911 after about a minute (unless you can see baby's chest rise and fall and know they are breathing. Some babies are just naturally chill and won't cry or move about a lot at first but follow your gut.

You can also wipe baby's face with clean cloth to also remove fluid/debris from his/her mouth/nose.  As long as the cord is still pulsating (it pulsates at your baby's heart rate) it is giving baby oxygen -- so no need to cut it until long after it turns white and limp and stops pulsating. Try to bring baby to breast as soon as possible to encourage your uterus to clamp down to stop bleeding and to help expel the placenta. If baby doesn't want to latch, that's fine, the skin to skin contact will help a lot.

Try to have some warm, salty broth on hand or a drink such as emergen-c or powerade to replenish fluids and electrolytes to help you feel less worn out/tired/woozy. You can cover both of you with a blanket but the skin to skin is very important so I personally wouldn't wrap baby up, but rather, but a blanket or robe over the both of you to keep warm.

Once the cord is white/limp, not pulsating,  you can choose to cut it about 4 inches from baby's belly button. I would tie it off just to be safe but at that point all the blood should have drained. So you would tie it off with sterile (boiled) shoelace or cord clamps and cut with sterile (boiled or kept in rubbing alcohol) scissors. Typically placentas deliver within 30-45 minutes but can take up to an hour or more. If your placenta hasn't delivered in an hour or so, I would evaluate carefully how you're feeling. If you feel fine, you can wait a bit but a retained placenta can quickly turn into something serious. Gently massaging your tummy/uterus can help expel it, as well as changing positions (such as sitting on the toilet if you feel sure-footed enough).

I would call your midwife though once it happens so you can just make her aware of the situation. 99% of the time there will be no emergency, no need to call 911 or rush to the hospital right away. If you have severe tearing, retained placenta, heavy bleeding which is not slowing. or baby hasn't "pinked up" within a couple minutes of being born (most babies are born somewhat blueish upon being born but should begin pinking up pretty quickly), I would seek medical attention pretty quickly.

There are lots of resources, that was just the very basic off the top of my head. I think if you are in tune with your body/intuition/instincts, a lot of time that is the best indicator of what you should do in any particular situation.

[Mamatoabunch]

Not much needs to be done and what does need to be done you can do yourself! I birth baby, leave cord attached until it stops pulsating and then cut the cord w/ boiled scissors. It is much, much less complicated that we are ever led to believe.

[lovebeingamomma]

you don't tie it off just cut it's limp?

[Mamatoabunch]

Originally Posted by lovebeingamomma 

you don't tie it off just cut it's limp?

I have done both. I have almost always delivered the placenta before cutting. I have cut, after the placenta was delivered, and of course it was then white and limp. Once blood came out from baby's side so we tied it off on baby's side, usually though once you wait until limp and white tying off is not necessary.

[Almi]

What I did for the birth of my twins:

First baby came, I held her to my chest.  A few minutes later, the second twin's water broke, and she was out maybe two minutes later.  I cradled both twins in one arm and covered us with a towel, keeping them skin to skin.  The placenta came out maybe five minutes after they were born.  I don't recall either of their cords pulsating, not even the first twin's.  The cords were also really short.  We clamped their cords a few inches from their body with some cord clamps that we ordered online, and cut them with a scissors, which my partner sterilized.  Then we began our babymoon!  We took them to a pediatrician a week after birth.  The only time they've seen a hospital is when I went for my postpartum checkup. :)