Could early cord-cutting cause pp bleeding?

[DoomaYula]

Baby had a tight nuchal cord, and after trying to remove it from baby's neck, doc just cut it and then seriously yanked the baby out. Mom had pretty heavy bleeding, needed pit and... something else that caused her to have explosive diahrrea. I'm just wondering if the early cord cutting could have caused the bleeding, or could the yanking have done it? Or are they unrelated?

[fishface]

I would think the yanking > early cutting would be a factor in the bleeding.

[Ackray]

I think it was pobably the yanking. What in the world did they give her that gave her diarrhea?

[DoomaYula]

I asked twice for the name, and the nurse told me but I don't remember. The doc ordered it IM along with a pit drip. I asked if it was meth, but no, it wasn't that. I am pretty sure it started with an H? Hep or Heb something?

But YEAH, seriously instantaneous, "Can you help me get up to go to the-- nevermind, I just crapped myself." Apparently the effects will last for about a day or two. I felt terrible for the mom. And the extremely nice nurse who kept cleaning it up.

[BeckiCNM]

Hemabate. Nasty stuff - causes horrific diarrhea. All our orders say to give an anti-diarrheal with it to try and help with the diarrhea.

[mamaverdi]

What is it for?

[DoomaYula]

From a rx website

HEMABATE is indicated for the treatment of postpartum hemorrhage due to uterine atony which has not responded to conventional methods of management. Prior treatment should include the use of intravenously administered oxytocin, manipulative techniques such as uterine massage and, unless contraindicated, intramuscular ergot preparations. Studies have shown that in such cases, the use of HEMABATE has resulted in satisfactory control of hemorrhage, although it is unclear whether or not ongoing or delayed effects of previously administered ecbolic agents have contributed to the outcome. In a high proportion of cases, HEMABATE used in this manner has resulted in the cessation of life threatening bleeding and the avoidance of emergency surgical intervention.

And apparently it's also used as a second tri abortificant.

Meanwhile, nobody at the hospital even MENTIONED an anti-diarrheal.

Back to my original q, any more thoughts?

[DoomaYula]

bump.

[MsBlack]

I don't know as early cord-cutting had anything to do with the pp bleeding...I do know that yanking babies out, does. Another typical mauling of birth in the hospital....

[mamallama]

I have researched this recently, but I haven't posted to this thread b/c I don't have the supporting link handy.

I think it's really hard to guess what caused the mom's pph...esp given that she had a managed birth.

It could have been the yanking. You didn't say, but if her labor was induced or augmented, it could have been that, maybe her hg/htc or clotting factors were low to begin with, big baby/fast labor, low blood pressure associated with epidural or narcotics....there are just so many things that are associated with (but don't always) cause/contribute to pph. Early cord clamping is suspected to be one of them.

I recently read an article about neonatal transitional physiology. One of the ideas was that early clamping causes the baby's blood to back up into the placenta, thus engorging it & causing it to detach before the uterus is ready to clamp down on the attachment site. I'd love to post the link, but I can't find it. Maybe it will come to me.

[Sweeney]

Here it is!
Link

My first initial thought was- how was that Mama treated as that was happening and immediately afterwards? I've heard stories of births where women are so freaked out and afraid that they hemorrhage. The 'fight or flight' response can interfere with clotting factor and the uterus' ability to clamp down.

But in general birth is a chaotic system. There are too many factors to count (especially in a managed birth like that), and they can have a huge impact or none at all.

That must have been difficult to witness

[DoomaYula]

Originally Posted by Sweeney

My first initial thought was- how was that Mama treated as that was happening and immediately afterwards? I've heard stories of births where women are so freaked out and afraid that they hemorrhage. The 'flight or flight' response can interfere with clotting factor and the uterus' ability to clamp down.

HMMMM, very interesting point. The mom had a totally med-free non-augmented labor, although she did ask to have her water broken when she'd been at 9cm for a long time. So the only managed part of the labor was the water. HOWEVER, when the doc grabbed the scissors to cut the nuchal cord while only baby's head was out, the mom FLIPPED OUT -- thinking the doc was going to cut an episiotomy. She absolutely did not want an episiotomy. So it could have been the fight or flight.

That must have been difficult to witness

At the time, it all happened really fast, but later I found it very disturbing. I've talked it through with my dh and my mw. I've really YET to see a birth in this particular hospital that WASN'T disturbing in some way. I'm really glad I don't have any more clients and I can just focus on my homebirth.