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Let's Talk About NOT Cutting The Cord

post #1 of 66
Thread Starter 
It was a decision to ponder; but after awhile I chose to post in this forum because this discussion is one that may benefit all of us who are expecting a baby.

So, let's talk about NOT cutting the cord after the baby's birth (aka: Lotus Birth). Lotus Birth is the practice of leaving the cord/placenta attached until it dries and falls off (3-10 days). For those of you who don't know yet; there's a technique of salting it after 24 hours; wrapping the cord in silk or material and having a cloth (sometimes scented) bag to keep the rest of the placenta in.

I heard about this and have finally gotten around to doing some researching. As of yet, I've done little reading; but what I did read prompted some questions right away. I'd like to talk about it and get some imput.

This site has a pretty extensive write-up about Lotus Birth; and I was skimming through before I came to a screeching halt in the section that talks about harvesting cord blood. The practice of harvesting cord blood is what got me really wondering in the first place: If the blood is so beneficial to be harvested, might it be beneficial to the baby after birth?

According to the site...

Quote:
...'Banking' cord blood involves immediate, very early cord clamping to take a significant amount of blood (100mL on average) from the newborn...Cord blood banks receive from 80 ml to 180 ml of blood on the average amount of blood taken for CBC harvesting. The blood bank interests do acknowledge more blood is received if the cord is clamped "quickly", meaning in 30-seconds, or less...
So; the faster they clamp the cord; the more blood they get for harvesting. Which means that (logically speaking); the longer they wait, the more blood leaves the cord and ends up.... in the baby...? It appears so...

Quote:
...a 9-pound baby only creates 10 ounces of blood (300 ml). Therefore 180 ml is actually more than half this baby's blood supply...
That's alarming to me. Logically speaking; when the baby is in the womb; the cord is their means of nourishment and survival. His (/her) blood is travelling through the cord; gathering nutrients from the mother; and then travelling back to nourish the baby. That being said, the typical umbilical cord is 2-3 feet long...which is a lot of blood in baby terms (as the quote said, around half the blood)!!

So; if they gather more blood by clamping the cord quickly; then logically speaking, the longer the cord is left attached, the more blood ends up in the baby.

I just wanted to make a quick side note for those of you who don't have time to read the rest of the information on the site; because I think it's important to consider...

Quote:
...the neonate has a right to their own blood when they most need it: in the vulnerable hours and days of the first year of life, from which we measure infant mortality. Many well-intentioned parents-to-be, misled by aggressive banking business marketing, do not realize that the blood 'harvesting' creates an extreme systemic deprivation for their little one, as well as the shock and trauma that goes with it - because at birth, a child is considered anemic if deprived of even 20 to 50 percent of blood, and only 20 percent blood loss can cause shock....Other disorders associated with low blood volume are autism, cancers, brain tumors, leukemias, liver, kidney, holes in the heart, hormone deficiencies, imbalance of enzymes...
So; as a whole, the longer you leave the cord attached; the more blood end up in baby (I assume that as the cord dries out the blood is pushed into the baby); and the less likely the baby is to have any blood loss related problems.

Now, personally speaking - I'd rather not keep the cord attached until it falls off. It's considerably out of my comfort zone in terms of the bigger picture (ie: I'd worry that it would get pulled accidentally and hurt baby, etc). So, in wanting to find a 'happy medium' and do what's best for my baby; how long would be 'good enough'? I figure, based on the way I've interpreted the information from the site; and the logic I've put into it; even an hour or two can only do good; right? I mean, when you look at either keeping it attached for an extra hour, vs clamping and severing right away; out of the two the most logic for benefit goes to the leaving it alone option.

Your thoughts?
post #2 of 66
I've always been very interested in Lotus Birth's and we will most likely be having one (assume everything goes well with the birth and I don't change my mind last minute or anything).

I've read into lots about lotus births and also eating the placenta, seeing if I can manage the best of both worlds, and in short, I don't think I can. Giving my baby its blood is more important than myself consuming it, so I came to that decision.

If you aren't comfortable with a lotus birth, why not just delay cord clamping until 24 hours PP. It is very easy to apply a clamp and cut the cord yourself after 24 hours or so. You get the assurance of your youngster getting ALL it's blood (assuming you know to keep the placenta above the babies heart) and you don't need to bother with the salting and wrapping of the cord (although, so so beautiful).

post #3 of 66
Thread Starter 
Quote:
Originally Posted by Hesperia View Post
...seeing if I can manage the best of both worlds, and in short, I don't think I can...
Well, you could; if you kept it attached for 24 hours like you suggested to me; THEN do your thing with the consuming the placenta. (Though, there might be something that you have to process it right away in order to be effective; I don't know much about this part).

Quote:
Originally Posted by Hesperia View Post
...assuming you know to keep the placenta above the babies heart...
No; I didn't know this. How am I supposed to do that when baby spends most of his time in a lying-down position?
post #4 of 66
The placenta is raw meat. I wouldn't advise carrying it around at your side for 24 hours and then eating it.
post #5 of 66
Wow! What a great link and convo. A friend just asked me my thoughts on cord blood harvesting, and I could only get philosophical on him; I hadn't heard or read anything scientific about it.

I'm not exactly in the planning stages yet, but I would love to do a "modified" Lotus birth as mentioned above, perhaps waiting a few hours to a day.
post #6 of 66
Thread Starter 
Quote:
Originally Posted by nashvillemidwife View Post
The placenta is raw meat. I wouldn't advise carrying it around at your side for 24 hours and then eating it.
Ah yes; that makes sense. I eat my words. : In my defense; I just applied a bunch of logic to a 'new' subject to me. There's only so much my pregnant brain can handle before it goes into self-destruct mode.
post #7 of 66
i was under the impression that the baby received all the blood that they would ever receive once the cord was white and limp, within an hour after birth.
post #8 of 66
Thread Starter 
Quote:
Originally Posted by desertpenguin View Post
...baby received all the blood that they would ever receive once the cord was white and limp, within an hour after birth...
I wasn't sure about this; so I went looking for the answer. Most of my search results turned up information on banking cord blood but I did eventually find this site which has a bunch of useful and interesting information on it. You'll have to read the rest yourself because I'm super tired and want to sleep; but here's a bit of information off the site; and the part of it that relates to what 'deserpenguin' said is at the bottom near the bolded section (starting at ''Gravity will also...'')...

Quote:
...There are many reasons why it is beneficial to leave the cord unclamped and uncut until the placenta has birthed. The main reason being that at the moment of birth, the placenta holds a portion of the baby's blood in reserve. Nature designed an amazing system for ensuring a smooth transition from life inside the uterus to the outside world where the new baby needs to breathe on its own. The blood passing between the baby and the placenta carries oxygen to the newborn, possibly even after the placenta has detached and delivered. Thus the natural process protects the brain by providing a continuous oxygen supply from two sources until the second source is functioning well.

While in the uterus, the placenta does the job of lungs, kidney, gut and liver for the baby. Because the baby's organs are not really needed, blood flow to them is minimal until the baby takes its first breath at delivery triggering huge changes in the organisation of the circulatory system. Once the baby is born blood is diverted away from the umbilical cord and placenta and as the lungs fill with air, blood is sucked into the lung circulation. The placenta and cord contain the additional blood necessary for the extra blood needed to supply the lungs, kidneys, gut and liver which had previously not needed a blood supply of it's own. If the baby has to use its own blood supply for these organs it suffers a massive drop in blood volume of anywhere from 1/3rd to ½ of its blood volume.

The transfer of the blood from the placenta to the baby happens during the contractions of third stage, with blood is being pushed into the baby with each contraction, and some blood is returning to the placenta between contractions. It is thought that the baby may be able to regulate the transfusion of the blood depending on its individual need by crying which causes constriction of the blood vessels in the cord which slows the intake of blood.

Gravity will also affect the transfer of blood from the placenta to the baby's circulation, so it is ideal to have the baby remain at or below the level of the uterus until the cord stops pulsing. This process of "physiological clamping" can take between 1 and 3 minutes.

You will know that natural cord clamping has occurred when:

There are no pulsations in the cord. This tells you that the arteries are closed.

The baby is breathing and is pink. This tells up that the heart and lungs are working.

There is no blood in the cord . This tells us that the transfer of blood from the placenta to the baby is complete....
post #9 of 66
I read on the WHO site that the cord has it's own on/off valve and after a certain amount of time after birth (usually about 30 minutes) the valves shuts off in the cord. That is when you will see it not pulsing anymore.

I can never find the information twice on the WHO site, I should probably book mark them. You definitely do not have to do a lotus birth for the entire blood supply to reach the newborn though. I left the cord attached to both of my babies for about 20 minutes, the cord had stopped pulsing at that point.
post #10 of 66
Quote:
Originally Posted by Blu Razzberri View Post
So; the faster they clamp the cord; the more blood they get for harvesting. Which means that (logically speaking); the longer they wait, the more blood leaves the cord and ends up.... in the baby...? It appears so...
I'm not sure that actually logically follows. The blood in the cord/placenta doesn't necessarily continue to circulate after birth. The mother is no longer there to fuel the mechanism. The baby eats differently now.
post #11 of 66
Seems like I also remember hearing that the cord blood VERY rarely is used for the child is was collected from. It's more beneficial to a sibling or someone in need of a donor. I'll look for the links.....

The whole cord blood banking thing sounds more like a scam to me. The cost is astronomical. See http://www.viacord.com/pricing-storage-plans.htm and it's not even guaranteed to "fix" the conditions it's being stored for. http://www.viacord.com/stem-cell-expansion.htm

I got kind of off topic on that, sorry.

I wonder what the likelihood of keeping the cord attached longer is if the baby is delivered via c-section. I might ask my dr about that tomorrow.

Thanks for the info Blu!!
post #12 of 66
I'm not into Lotus Birth, but choose to wait until the chord stops pulsating before cutting it. That's pretty standard for hb.

In a hospital, I would put it in a birth plan and then make sure you have someone specifically reminding your caregiver not to cut the chord right away.
post #13 of 66
No; I didn't know this. How am I supposed to do that when baby spends most of his time in a lying-down position? [/QUOTE]


By keeping the placenta on babies tummy while laying down (wrapped up in a nice soft cloth diaper). Most important obviously within the first hours, and after that point I wouldn't trouble yourself over it. I've seen photos with the placenta swong over moms shoulder for a diaper change (long cord).

As for complete and total blood to the baby, that is cord clamping DELAYING. Lotus birth isn't just about the blood aspect. To me, lotus birth is giving the baby a gentle entry into the world and allowing him/her to let go of the cord/placenta when they are ready, seeing as they are from the first cells devided it seems only fair. Some go as far to say that cutting the cord hurts the infant, and that isn't something I would like to try out, when leaving it alone is a simple solution.
I guess lotus birth can be looked at as similar to child lead weaning, it is theres to choose when to stop and it should be peaceful and safe to let that comfort go.

Great topic, I love chatting about lotus birth.
post #14 of 66
So; the faster they clamp the cord; the more blood they get for harvesting. Which means that (logically speaking); the longer they wait, the more blood leaves the cord and ends up.... in the baby...? It appears so...

But the cord is not a one way street. As blood enters the baby doesn't "used" blood also leave the baby? Of course this is "used" blood so it still seems better to keep the cord attached for longer to get the oxegen rich blood to the baby. Just something I was thinking.



Sarah
post #15 of 66
Hesperia is right - delayed cord claming and lotus birth are really two separate conversations. I think most people who are supportive of natural birth and especially homebirth do not advocate immediate clamping and cutting of the cord unless there is an emergent medical reason to do so.

i strongly considered doing a lotus birth. in the end, though, the logistics hung me up. with two other small children and with DH and my mom only able to be here to help for a couple of days before needing to return to work, i just didn't want to add another level of complexity to my need for being mobile and caring for my other kids.

so what we chose to do instead was to allow a few hours to pass after the birth before we dealt with the cord, and then rather than abruptly cutting it, we used candles to slowly and gently burn through the cord while the baby nursed. my m/w observed this practice when she was overseas volunteering after the tsunami, and burning the cord was being used as a way to prevent infection since it cauterizes the cord rather than leaving a raw opening that can invite bacteria. a m/w she met there gave her a special box you use to lay the cord over and which catches the wax. it was quite a gentle and lovely ritual, and the first time one of my children has been separated from his/her placenta without crying (we have always delayed the clamping/cutting for at least 30 minutes, until the cord was no longer pulsing and it was clear the blood transfer for complete).
post #16 of 66
Lotus birth is a beautiful thing. There is little reason for everyone not to try it, because you CAN change your mind. You'll most likely discover that it is easy. A placenta treated with salt and herbs shrinks and dries quickly, it is not unpleasant to smell, it is not actually difficult to handle with your baby, because it is in a little cloth sack that lies on the baby. You'll find it beautiful, calming, and suprisingly easy. BUT if you DO find it still out of your realm, then you simply break off/cut the cord. It is a simple thing to change your mind on, there is "going back" when it comes to this. However, if you cut the cord first, you have cut your options. Leaving it intact allows you to still make a choice in 24 hours, 48 hours, 4 days, etc. Go for it.
post #17 of 66
The thing about this discussion that leaves me wondering is this...both of my children had jaundice. Jaundice develops from the body breaking down the extra red blood cells needed for oxygen transport in the uterus. Once the baby is breathing room air (instead of depending on mom's arterial blood supply for oxygen) their livers start breaking down the extra unneeded cells, which results in bilirubin circulating in the blood. The baby needs to eat and poop to get rid of this.

Susan Weed in "The Childbearing Year" says to cut the cord "as soon as convenient" to prevent jaundice.

Also, physiologically, a little bit of crying is good for the baby, it clears the lungs and helps close the foramen ovale and ductus arteriosis in the heart (switching from fetal circulation to "adult" circulation).

We worried about the little bit of jaundice our older children had, it makes them sleepy and not want to nurse, and then get dehydrated.

Also, in c-section birth I do not believe it is possible to leave the placenta attached. The baby must be moved out of the way for the surgeon to get in to extract the placenta, and the baby must be warmed right away to prevent hypothermia. Surgical suites are kept quite cold, and holding the baby near mom while the surgeon does his/her work would not be good for the baby.
post #18 of 66
I never was shown the placenta and I always wanted to, this time around I'm going to be firm that the cord will not be cut until it has quit pulsating. It seems once your in the hospital you really have to be clear on what you want, otherwise they just take it upon themselves to cut and clamp right away.
post #19 of 66
Quote:
Originally Posted by Blu Razzberri View Post
No; I didn't know this. How am I supposed to do that when baby spends most of his time in a lying-down position?
?? Wouldn't you just put the placenta on a higher surface? Like a pile of pillows?
post #20 of 66
Quote:
Originally Posted by mossimo12 View Post
But the cord is not a one way street. As blood enters the baby doesn't "used" blood also leave the baby?
I thought the return path closed off first?
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