Have any of you seen evidence of a connection between cutting the cord and abnormal detachment of the placenta? I'm trying to think logically why that might be, but don't know enough about the chemistry of the process to figure it out."I, personally, hope to have my clients squat but I have yet to see a client who was willing to get back up after she has laid down!"
In my case, this was because psychologically I had given the birth over to the midwife -- I was exhausted from being micromanaged every step of the way, so she could damn well take care of the placenta too! lol. But really, it felt very very anti-climactic, and I felt very put upon to have to do more
work after I'd just birthed the baby. I was on reclining, so I had to push *hard* to get it out while they applied cord traction. If I'd been told that with squatting there would be little or no more hard pushing from me, you bet I would have made the effort to get upright.
With my second birth, I was still of the mindset that "I've done all the work, I'll relax, now the midwife can take care of the rest." I really hadn't educated myself about third stage at all. So it was just sheer luck that after an hour with no placenta (and a nervous midwife, despite the fact that I felt GREAT) the midwife's assistant suggested that I squat. I had to get up to go pee eventually anyway, so at that point it was really not all that big a deal. And voila!, the placenta slid right out.
My third was unassisted so there was no feeling like somebody else ought to be taking care of this or that for me. I waited about half an hour (felt great, again, so was really not concerned) then handed the baby to my husband and got up on my haunches. I waited a few minutes, then had that same urge to push that one has when having a bowel movement, and again it slid right out. I'm a big, big fan of squatting, obviously.
I think, in dealing with clients who do not seem to want to get up after the birth that a few things might help. First, explain to her before
the birth how much easier squatting makes the expulsion. Second, if the mother has not actually given birth in bed, have her rest on a couch or recliner instead of going to bed immediately after the birth. It is much easier to maneuver into a squat position from either than it is from a nice little cozy nest in bed. Third, leave her completely alone after the birth so that she has a chance to go through that stage that Pam spoke of, where she is connecting to her infant. If she is allowed to go FULLY through that, with no pressure to cut if off prematurely, it's likely that at some point she will wish to be physically seperated from the baby via the cord (assuming it has not been cut yet) and will of her own accord set about figuring out a way to facilitate that -- that might be the best time to ask her if she needs help squatting.