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#31 of 46 Old 01-06-2013, 08:29 AM
 
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I'm glad it was just a misunderstanding and she carries oxygen after all.

In my homebirth six days ago, my baby was born purple and not breathing, with a low-ish pulse (80s/90s), and he needed some PPV and a lot of suctioning before he breathed on his own.

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#32 of 46 Old 01-15-2013, 06:05 PM
 
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Ok this has baffled me through this tread and I need to ask: doesn't the placental provide oxygenation for a several minutes after the baby is born? My understanding is most rescesitation needs are able to be determined before the placenta stops pulsating so the mentioned time schedule is skewed?
OP I am glad that your midwife has O2 for the slight chance you might need it in labor. I believe most midwives don't carry intubation supplies for liability reasons. When it comes to neonatal rescesitation I would be more incline to trust a certified midwife's knowledge of up to date information as most certifying organizations require recertification
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#33 of 46 Old 01-15-2013, 06:11 PM
 
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Ok this has baffled me through this tread and I need to ask: doesn't the placental provide oxygenation for a several minutes after the baby is born? My understanding is most rescesitation needs are able to be determined before the placenta stops pulsating so the mentioned time schedule is skewed?
OP I am glad that your midwife has O2 for the slight chance you might need it in labor. I believe most midwives don't carry intubation supplies for liability reasons. When it comes to neonatal rescesitation I would be more incline to trust a certified midwife's knowledge of up to date information as most certifying organizations require regular recertification- most of the midwives I know certify every 2 yrs!!!! And my understanding certifying doesn't mean just sitting for an exam, it also means taking a continuing Ed course with it.
There is a misconception that midwives are not highly trained professionals and that families who chose home births are misinformed "crazy" people willing to risk their child's life. However all the midwives I know have had extensive trainin coupled with active continued education and most parents who choose home birth spend significant amounts of time researching the facts and asking great questions.
I am thankful we have this forum and I am especially thankful the OP asked about this because it has helped me greatly with my own question.

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#34 of 46 Old 01-15-2013, 07:59 PM
 
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There is no way to know how much oxygen is actually being delivered through the umbilical cord.  I know that the following blog is not liked among posters here, but it has a good explanation of placentas and oxygen transfer...http://www.skepticalob.com/2011/05/ncb-stupid-pulsing-umbilical-cord.html

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#35 of 46 Old 01-18-2013, 01:20 PM
 
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Oxygen is actually a very dangerous drug that is overused and causes damage when used by those who don't understand it.  Midwives on the cutting edge of science now understand that it should not be carried to homebirths - if you want more information, contact Jill McDanal on facebook.  She teaches an entire class on this topic if you want to know the science and reasoning behind this position.  It should be noted that hyperoxia (too much oxygen) at birth, due to the use of o2, is being theorized as causing brain damage - http://www.ncbi.nlm.nih.gov/pubmed/21659719 .  The irony is that the o2 is used because they are afraid that the hypoxia (not enough oxygen) will cause brain damage.  Like someone else mentioned already too, the new NRP guidelines call for hte use of room air in a resuscitation situation. 
 

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#36 of 46 Old 01-18-2013, 01:41 PM
 
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NRP--the gold standard for resuscitating newborns who are in compromising situations--does not say to completely avoid supplemental oxygen.  NRP says to have supplemental oxygen immediately available, closely evaluate the infant, and prudently administer oxygen when it is indicated.

 

There are legitimate and emergent needs for oxygen at a delivery.  Risks come from both too little and too much oxygen after birth.  Completely avoiding the use of supplemental oxygen in all situations (which is what happens when you don't have any supplemental oxygen available at a delivery) is not "on the cutting edge of science."

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#37 of 46 Old 01-18-2013, 09:54 PM
 
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Originally Posted by rnra View Post

There is no way to know how much oxygen is actually being delivered through the umbilical cord.  I know that the following blog is not liked among posters here, but it has a good explanation of placentas and oxygen transfer...http://www.skepticalob.com/2011/05/ncb-stupid-pulsing-umbilical-cord.html

 

Here's another post that describes the process and is a bit less offensive:

 

http://midwifethinking.com/2012/05/05/an-actively-managed-placental-birth-might-be-the-best-option-for-most-women/


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#38 of 46 Old 01-18-2013, 10:04 PM
 
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She is going to wait 3 minutes to call 911? Really?

 

The first thing she should do is to direct someone to call 911 while she starts resuscitation

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#39 of 46 Old 01-21-2013, 05:14 PM
 
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Actually, it is more like two and half minutes before calling 911. Not immediately as PPV alone is often enough to start a baby breathing on their own. 


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#40 of 46 Old 01-31-2013, 03:59 PM
 
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This isn't related to homebirth, but I thought it might be interesting to add that my SIL who is a paramedic in KS told me last year that they're finding room air and not oxygen to be better when assisting someone in need - too much oxygen isn't helpful. This is "new research" being used for emergency calls.

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#41 of 46 Old 03-22-2013, 10:15 AM
 
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Why is everyone concerned about a midwife's competence if she doesn't bring oxygen to a birth? Pure oxygen is actually toxic and even a couple minutes of exposure causes cellular damage, causing the baby more distress. They should be resuscitated with a bag of room air.


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#42 of 46 Old 03-22-2013, 10:37 AM
 
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Originally Posted by amlikam View Post

Ok this has baffled me through this tread and I need to ask: doesn't the placental provide oxygenation for a several minutes after the baby is born?

 

The short answer is "no."

 

The longer answer is that as part of the contractions in the second stage of labor the blood vessels leading to the placenta begin to constrict, and after the fetus is expulsed this continues at a rapid pace.  The evidence on delayed cord clamping is mixed, and it might indeed have some health benefits, but nobody should think that it's an adequate substitute for the baby actually breathing.

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#43 of 46 Old 03-22-2013, 10:47 AM
 
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Originally Posted by rnra View Post

There is no way to know how much oxygen is actually being delivered through the umbilical cord.  I know that the following blog is not liked among posters here, but it has a good explanation of placentas and oxygen transfer...http://www.skepticalob.com/2011/05/ncb-stupid-pulsing-umbilical-cord.html

Liked among homebirthers or not, I would rather take info from someone who appreciates and respects birth, instead of someone who thinks that a baby that is born vaginally has a higher chance of becoming a government tyrant.

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#44 of 46 Old 03-22-2013, 11:03 AM
 
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If you have access to a library where you can access this article, you might find it interesting regarding use of oxygen during resuscitation at birth.

 

From JOGNN, Mar/Apr 13

 

http://onlinelibrary.wiley.com/doi/10.1111/1552-6909.12012/abstract

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#45 of 46 Old 03-22-2013, 08:43 PM
 
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I'm an NRP instructor and a midwife.

Oxygen is not to be used during the first 2 minutes of resuscitation, but if baby isn't breathing on its own after that time, the midwife should be using oxygen while she continues with bag and mask.

Two other things to consider. The oxygen may be for you in case of blood loss or if the baby's heart rate begins to drop and you are not in the process of birthing.

Other ways to get air to the baby's lungs is with a laryngeal mask airway. This may be what your midwife is talking about. Makes a very good alternative to intubation, but still gets oxygen to the baby.

 

There are also congenital malformations like diaphragmatic hernias that necessitate the use of oxygen, because the abdominal contents are up in the chest area and it decreases lung capacity, so baby has a really hard time getting enough oxygen. Rare complication.

 

I wouldn't count it against the midwife if she carries oxygen. She may never use it, but if she needs it , you will be glad she has it. It should not be a substitute for good resuscitation skills and excellent clinical judgement.
 


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#46 of 46 Old 04-01-2013, 08:05 PM
 
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Coming from a respiratory therapist who is also doing a homebirth- the oxygen is not only important for emergencies when baby needs further assistance, it's even MORE beneficial for the mother with emergencies in childbirth. Working in the hosp I've seen numerous times where infants needed o2. I can also tell u that the issues that stem from oxygen to babies does not happen immediately. Baby must be on for prolonged periods of time. In any regards its VERY wise to have the basics with homebirth which is oxygen and if poss something to slow bleeding such as pitocin
And no. It's not dangerous to carry oxygen if properly placed and restrained in car
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