torn umbilical cord? during birth? - Mothering Forums

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Old 09-02-2005, 03:23 PM - Thread Starter
 
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A friend of mind had a baby last week--from her friend I heard some stats about the birth: Pit induction at 8:00 a.m., baby born at 1:27 p.m., head was "big" and episiotomy was needed, OB used traction (not vacuum or forceps) to pull out "large" fetal head, and then it was noted that the umbilical cord had torn.

Hunh?

I have not ever heard of such a thing, umbilical cord tearing during baby's birth. I can see how it could tear while yanking on it during 3rd stage...needless to say, I come to bask in the wisdom of this board.

Thanks in advcance for sharing your thoughts, experiences, ideas, etc.. with this phenomenon.
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Old 09-02-2005, 03:46 PM
 
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Do you know what "traction" is? I've never heard of it if it's not forceps or vacuum. And do you know where in the cord the tear was? That is just so wierd, I've never heard anything like it and would think the only way to tear it would be with some kind of instrument.
sorry not much help, but curious to see what others say.
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Old 09-02-2005, 04:04 PM - Thread Starter
 
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I chose to use the word "traction" in my post--in this context I wished to use the word to mean pulling on the fetal head with force/effort.

I do know the cord didn't tear off at the baby's navel, but I don't know where it did tear.
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Old 09-02-2005, 06:22 PM
 
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When a lot of practitioners see a big baby head, they automatically assume that the shoulders are going to be a problem. One way they deal with trying to assist the shoulders is to pull on the head. It is actually called head traction, so your terminology is pretty spot on. I am guessing that the delay with the shoulders had more to do with a short cord or a cord wrapped around the baby. The force of the doctor pulling on the baby probably snapped it. I am guessing that the doctor was panicking and didn't see the cord wrapped around a shoulder or neck.

The only time that I can (from my own perspective as a midwife) think that a woman "needs" an episiotomy to birth a baby with a large head is when that baby is in distress and would benefit from a faster birth. If I am feeling really generous, I would give the doctor the benefit of the doubt and say that it is possible that he/she did the episiotomy for distress, then freaked out over big baby and was a little too aggressive with trying to assist the shoulders (using a technique that is less than ideal) because he/she already had a distressed baby and was scared of an extended amount of time passing before birth. My skeptical side leads me to believe that an unnecessary episiotomy was done (probably part of this doctor's routine) and that he/she missed the cord while trying maneuvers that were doing more harm than good.

Stacia -- intrepid mama, midwife, and doula. Changing the world one 'zine at a time.
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Old 09-02-2005, 06:52 PM
 
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I've heard of a few reports of the cord just snapping off. It really needs to be stopped ASAP, but after that, it's not an emergency. I guess it's more common in smokers or women with poor nutrition, but it can happen women outside of these catagories, too.

I looked up a ton of information for a midwife friend who breeds horses. She just had a foal born last spring that had a snapped umb. cord. There certainly was no artificial birth trauma in that birth. We informally decided that her horse might have nutritional deficeits due to prior intestional surgery and she is treating with additional foods.

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Old 09-02-2005, 11:05 PM
 
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I've seen cords - even those loosely around the neck - break when pulled on around the baby's head. Sometimes it does happen, but yeah, it's usually moms with poor nutrition or babies that have died in utero (so there is virtually no moving blood in the cord) or smokers.

It can happen. I would bet if the woman was in an upright position, neither the episiotomy or the traction on the baby's head would be needed. Traction is not something that is often helpful in "freeing" a baby - and can often result in brachial plexus injuries or nerve damage.
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Old 09-02-2005, 11:24 PM
 
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"pulling on the fetal head with force/effort" sounds traumatic. i do hope this mama seeks some craniosacral therapy and chiropractic for her new baby... it's very gentle therapy and can do wonders in healing any sort of trauma, even the trauma of a non-interventive birth.

peace to your friend...

warmly,
claudia
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Old 09-02-2005, 11:30 PM
 
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Quote:
Originally Posted by pamamidwife
Traction is not something that is often helpful in "freeing" a baby - and can often result in brachial plexus injuries or nerve damage.
I agree, but when working as a doula I have seen it used more than once. Head traction seems to be a first line of attack in the hospital against sticky shoulders, along with super-pubic pressure and mcroberts, at least where I'm at.

To be fair, I have seen one cord break when there was really no fault of the caregiver -- it was just really short and as baby was being brought up to mom it just snapped. It was very short and seemed pretty flimsy.

Stacia -- intrepid mama, midwife, and doula. Changing the world one 'zine at a time.
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Old 09-02-2005, 11:43 PM
 
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I know it's used often, I just don't think it does much to actually work. Suprapubic pressure or McRoberts would work better, but dragging down on a baby's head does nothing for a true SD, ya know?
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Old 09-02-2005, 11:49 PM
 
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Hey Pam, we're on the same side here Describing what I think is likely to have happened is not the same as endorsing it, y'know?

Stacia -- intrepid mama, midwife, and doula. Changing the world one 'zine at a time.
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Old 09-02-2005, 11:55 PM
 
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I know, I figured that's what you meant!
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Old 09-03-2005, 12:26 PM - Thread Starter
 
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Thank you so much, everyone, for your insights!
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Old 09-06-2005, 04:03 AM
 
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Hi all! I was just lurking and thought I'd hrow my 2 cents in! I had a CNM assisted homebirth (water) in May. I had a remarkably perfect PG no sickness, no swelling, no elevated BP, nothing! I had a drug free labor and delivery and wasn't really convinced I was having the baby until I became "pushy" and DD came 2.5 hrs later. My MW is VERY hands off and I'm very laid back. She doesn't perform checks unless requested (I had none) and doesn't do any manipulation of the baby's head/shoulders or traction on the cord. This was my first birth. When my MW arrived I was already "pushy" I had my hand inside myself feeling things the whole time and my MW never checked me. (in fact I caught my own baby!) I felt the bag of waters break in my hand at one point. Later I felt the baby move alll the way down and then suddenly "suck" way back in (not like the gentle rocking backand forth between contractions as previous) and then on my next push i felt a second pop. I assumed it was a second bag of waters. My DD was born 15 minutes later and the cord had broken/torn prior to her crowning (in retrospect it was the second pop) She was pink and alert, but only had 3 inches of cord on her and I had none hanging from me. After delivering the placenta we measured and my cord was just under 12 inches. My Mw did track fetal heart tones throughout the labor and all was well. If it hadn' broken DD wouldn't have gotten out. Everything was otherwise normal and healthy with the placenta and the cord was normal thickness and texture. So, I HAVE heard of it happening I am certain that if I had a medicalized (unfortunately typical) birh at the hospital I would have had a very traumatic birth experience. i know that having a natural and calm birth gave me the edge in this instance. And I am sure there were angels with us! My MW calls my Olivia her "Miracle Baby"

FYI: DD had no hemoraging and is a super strong and healthy baby! I had no hemoraging and a small tear
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Old 09-06-2005, 02:10 PM
 
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cords can break and sometimes we can guess why, and sometimes we don't know why.
head traction is done just about everywhere and I hate it
imagine grabbing your baby by the head at any other time....
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Old 05-28-2008, 03:12 PM
 
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Just thought I'd bump this for my own thoughts. My friend just gave birth to a lovely little boy yesterday w/ a wonderful CNM and he had his cord around his neck. In the process of getting it off, it snapped! I'd never heard of this happening before so I little googling got me to this thread. She's not a smoker and her nutrition is fine, it definitely scared the crap out of her mw though and left quite a mess all over! They think she abrupted in labor as well b/c of the large clots behind her placenta when it was delivered. I told her our boys will be best friends as it sounds a lot like Evan's birth minus the broken cord. Mom and baby are well and at this point that's all that's important.

Jennifer, LPN and nursing student, Doula, CPST, and VBAC mama x3 to
AJ (5/03), Evan (12/04), Ilana (11/06), Olivia (2/09), and Unity (8/2012)

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Old 05-28-2008, 04:10 PM
 
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I had an umbilical cord break with my first baby. She was born 7lbs 12oz 21 inches on 40wks 0 days. She was born at home with a spontaneous labor onset and no interventions. The birth was attended by a CNM and was a compeltely hands off waterbirth. The was no manipulation what so ever. At the time i was a 29y/o non-smoking momma with great nutrtion and a healthy weight. Labor was fabulous. I wasn't even convinced I was having the baby until I got a strong urge to push. Our MW arrived after I had become pushy. My water broke spontaneously about 20 minutes into pushiness. Fetal HT were normal and there was no fever or concerns. i was not diabetic and tested neg. for GBS. About a hour and a half into pushing I felt a second pop and our MW noted it in her chart. heart tone remained normal and then were undetectable as she was about to crown and deep in the pelvis. My DD was born 13 minutes later. i scooped her out of the water and pulled to my chest when we realized there was only a 2 inch cord stump left. She was not crying. My MW took her to a towel and she began crying as I handed her to her. There was no rescusitation needed. My MW instructed me to remain in the tub and feel for cord and pinch it when I find it. I couldn't find any. After the baby was stable she had me get out and there was no cord reachable. I delivered the placenta on a birthing stool. Our cord was 12inches long. There was no cord around the neck or limbs and we were both fine. PPH was not a problem and I did not have any PP pit. We had the case reviewed by a perinatologist and she said my "odds" of having another short corded baby were the same as anyone else and that statistics didn't show any trending.

She was wrong for me

I gave birth to twins at home with a CPM 18 months later and they both had short cords as well 13 and 14 inches. They JUST made it out of my body with ZERO wiggle room. I could not get them onto my belly. I realized the problem instantly and threw my legs over the tub (they were water births as well). That freaked my MW out - b/c she was like "What the heck is she doing?" and I was saying "short cord, short cord" The twins' cords did not break. Again I was a non- smoker and followed the Barbara Luke protein diet reccomendation to ideal.

I guess I just have babies with short cords. My CPM with the twin birth said that when cords break on their own they self colapse and there is less bleeding (like the end of an over stretched raw sausage casing). Where when they are cut - they will continue to bleed. She also likened it to animals in the wild who chew the cord and compress the ends.

Anyways, I thought I'd share since my pregnany was uneventful and my labor and birth completely non-intervention. It seems a lot of the examples are with births with interventions or less than ideal pregnancies.
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Old 05-28-2008, 06:14 PM
 
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My cord *nearly* broke when I was born. My mom was not a smoker, but judging by what she eats today, I can only imagine. I was apparently not born in any particular distress or anything though.
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Old 05-28-2008, 06:53 PM
 
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I've heard of two cords that broke - one from a CNM friend (home waterbirth, mom smoker, long but "crappy cord" per the MW) and another from an OB, don't know any other details. Both said it was amazing that there wasn't much bleeding from cord, that the vasoconstriction of the vessels seemed to be pretty much immediate.
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Old 05-28-2008, 09:24 PM
 
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My dd2's cord broke when she was born. It was thick and juicy, but it was very short. I had a water birth, and I didn't sense how short it was and instead pulled her out of the water. Can I just say I'm happy it snapped instead of my uterus inverting?! I would still definitely have a water birth next time, but I'll be a wee bit more conscious of the length of babe's cord!

And yeah, head traction... not a fan. I totally agree with what pamamidwife said about it not being at all helpful in the case of a true shoulder dystocia. So why bother?

Peaceful mama to three blissfully-birthed and incredible small people: dd10, dd7 and ds5. Always awed and so thankful to be a midwife.
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Old 05-29-2008, 06:40 PM
 
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My CPM with the twin birth said that when cords break on their own they self colapse and there is less bleeding (like the end of an over stretched raw sausage casing).
I guess I can see how that might happen, but in my friend's birth there was a LOT of blood from the cord, on the CNM on the floor etc. I know she's glad she didn't have a hb w/ that mess.

Jennifer, LPN and nursing student, Doula, CPST, and VBAC mama x3 to
AJ (5/03), Evan (12/04), Ilana (11/06), Olivia (2/09), and Unity (8/2012)

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Old 05-30-2008, 02:20 AM
 
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I have a friend who's sisters cord broke with her first. Baby delivered and as doctor started to move baby up the cord desintegrated. Doc clamped baby (right at belly, was barely room to clamp) and threw (literally) him to the nurse and jumped for mom. Both were fine, cord was normal length, just fell apart after birth. In this case it was definitely due to moms diet. This is a woman who, when I met her and her kids, I thought her oldest had lost his first two teeth already at age 4, only to find out that they were still there just had been dissolved by juice and kool aid in his bottle (yes, was still using one) and were down to the gum line. If that's the way his health was at the time, I can only imagine moms during pregnancy.
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