removing clamp from mother's cord end?

[weegift333]

I am confused about something that I heard as an old trick to encourage the placenta to come out, which is to remove the clamp from the mother's end of the cord while the placenta is still partially or completely attached.

Is this a prudent move or does it create a risk to the mother of bleeding out if the placenta has not detached yet?

It seems odd to me to remove the clamp from the mother's cord for any reason before the placenta has been delivered, but I would appreciate any clarification on this...

TIA

weegift333

[Reha]

The best way to encourage the placenta to detach normally is to not clamp the cord at all until the placenta is born.

But, as to your question, if you open the clamped and cut cord to let it drain, it is NOT the mother's blood. It is the baby's blood, and most of it would normally be in the baby's body is the cord is not clamped at birth.

[nashvillemidwife]

Right. The placenta is not directly plugged into the mother's blood stream. It forms little capillaries that spiral around the mom's blood vessels and nutrients and waste pass directly back and forth through the vessel walls. Mom's blood is not flowing into the placenta.

[mwherbs]

as Nashvillemw has said, think of it more like velcro (not a perfect analogy but will work)
any how if the cord is clamped and there is some blood pressure being held in by the clamp then letting the blood drain out will encourage those vessels to let go- it is theory and I have tried it as well, could not say that it definately works or if it just buys time giving a provider something to do while waiting...
having strong contractions and change in positions, emptying mom's bladder, breaking vacuum on an already detached placenta by following the cord up to the cervix, sometimes holding onto/giving counter pressure on mom's rectum so she can push well without feeling like she is going to turn inside out .

[nashvillemidwife]

The analogy I was going to go with was mold - it sends out tiny tendrils to attach itself to whatever it's growing on, then you wipe it clean off.

[weegift333]

why clamp mom at all, then?

Thank you all for these explanations...so my next question is why does mom's side of the cord get clamped in the first place, if bleeding from the cord while the placenta is still attached is the baby's blood and therefore not a threat to mom's blood loss?

weegift333

[doctorjen]

If you wait until the cord is white and empty, you don't have to clamp the mother's side, really. If you haven't waited, I think we clamp mom's side to prevent blood dripping all over the place and making a mess (or to be able to harvest cord blood.)

[maxmama]

Originally Posted by weegift333

Thank you all for these explanations...so my next question is why does mom's side of the cord get clamped in the first place, if bleeding from the cord while the placenta is still attached is the baby's blood and therefore not a threat to mom's blood loss?

weegift333

Mess would be my guess. If you don't strip the cord before clamping and cutting, for example, it looks like a slasher flick.

[mwherbs]

so others have said why to clamp- my take on it when people cut a still pulsing cord and it isn't clamped on both sides the blood actually sprays . I think we clamp both sides to keep dripping to a minimum, have something to hold onto when guiding the placenta out (if it isn't out yet), and to help define the space to be cut for who ever in the family is cutting the cord.

[weegift333]

hearing two different theories

What I have heard from an ob/gyn is that in hospital births, for example, the cord is double-clamped to be cut; then the mother's clamps are sometimes undone for about 15-20 seconds or so while they attend to the baby, and then re-clamped until the delivery of the placenta. This doctor said that if the cords were left unclamped indefinitely, with the placenta still attached to the uterine wall, it is like an "open tap", and though the blood remaining in the cord is the baby's blood, leaving them unclamped before the placenta has detached begins to take from the mother, since the placenta is sort of like the "sponge" between mother's body and baby's body, delivering what the baby needs, etc. And in this case, the mother would be losing *her* blood...

I guess this is still confusing me (sorry), since I feel like I had heard two very opposite things -- that the woman can bleed out from unclamped cords before placenta detachment/delivery, and that she can't bleed out, because anything that comes from the cords or the placenta is all the baby's...? I wonder if what I've heard from the midwifery circle has been advised under the impression of complete placental detachment?

I'm trying to understand the physiological facts and feel like I am getting conflicting information. Anyone who can clarify for me, I'd really appreciate it. :-)

[Reha]

This is complete nonsense. Especially since one 'trick' to help get a placenta quickly detached (that I have heard CNMs use in hospitals often) is to go ahead and remove the clamp on mother's side once the cord has been cut to let it drain fully. Mother's blood isn't going to begin pouring out of the cord. The only way I could possibly think this may happen is if the membrane separating mom and baby's blood is for some reason broken during the birth/postpartum.

I think there is so much misunderstanding on this point. I have even heard a nurse say that in the cord and placenta, mom's blood is flowing to the baby in the umbilical vein, and baby's is in the umbilical arteries. HUH???? No, no, no. Not true at all. But, this was a nurse who works for one of the biggest OB practices in town.

[Jane]

The idea is that you unclamp the mama's end to let any (Baby) blood in the placenta run out to make the placenta as small as possible to encourage it to peel away and easily pass out the cervix.