"Baby will bleed out into the placenta..." - Mothering Forums

 
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#1 of 17 Old 08-19-2003, 04:41 AM - Thread Starter
 
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Okay, so I just got home from my 34wk apt at the midwife clinic I have been attending. Most of the midwives I see at this clinic also work on the hospital maternity ward/family birthing centre where I will deliver my bub.
The midwife I saw today does for sure work there, as I asked.

I was bringing up some birth choices that I was putting down in my birth plan, and when I asked if waiting until the placenta be delivered before cutting the cord, she looked at me like I'd as good as said that I want my baby to die.
She said that she really thought that would not be possible because "baby will bleed out into the placenta", but that I could have them wait at least until the cord stopped pulsing. But there's a half hour limit on delivering the placenta all up (??).

Then she acknowledged that she'd heard of Lotus Birth (which I have thought about but my partner would rather not do this, and that's okay...this would be sort of a compromise) where the cord is not cut at all, and she said she didn't know how that worked, with the "not cutting".

I plan on declining the routine shot of oxytocin(??) immediately after delivery, and I told her that. Which she also seemed vaguely shocked about. The thing is I can't remember why I decided that when I did. Another midwife had said it would interfere with 'something', and I made the decision upon hearing that thing. Maybe something to do with the cord clamping...or breastfeeding immediately.

Anyway, back to the point. What exactly is the harm in waiting until the placenta is delivered (and waiting beyond 30 mins) before cutting the cord? Was she right that the "baby will bleed out into the placenta" or was she just trying to discourage me? It doesn't seem to ring true from what I've read all over MDC.
Doesn't Lotus birth completely dispell this theory of hers??

FWIW, I plan on having the most natural, drug free, private birth I can possibly get in hospital, with mid-wife only care, and I have told them this. They have also heard me express my desire to have this baby at home, which my partner would support, but we can't afford atm. So they do know I want to go as intervention free as possible.

I am a huge fan of these boards....but it's so hard to keep everything straight.

Any advice is hugely appreciated...thanks!!
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#2 of 17 Old 08-19-2003, 10:21 AM
 
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OK...

Quote:
I was bringing up some birth choices that I was putting down in my birth plan, and when I asked if waiting until the placenta be delivered before cutting the cord, she looked at me like I'd as good as said that I want my baby to die.

She said that she really thought that would not be possible because "baby will bleed out into the placenta", but that I could have them wait at least until the cord stopped pulsing. But there's a half hour limit on delivering the placenta all up (??).
Uh, *scratches head* That doesn't really make sense to me what she said lol that it was ok to wait til the cord stopped pulsing but not to wait til the placenta is delivered! It sounds like she has no idea what the hell she is talking about or that she's got her wires crossed somewhere.

Quote:
Doctors are taught (and believe) that delayed cord clamping / placental transfusion gives the baby too much blood, (hypervolemia) while neonatal intensive care units (NICU) are filled with weak, fast - clamped newborns exhibiting signs of severe blood loss [5], pallor, hypovolemia (low blood volume) anemia, (low blood count) hypotension (low blood pressure), hypothermia (cold), oliguria (poor urine output), metabolic acidosis, hypoxia (low oxygen supply), and respiratory distress (shock lung) to the point that some need blood transfusions and many more receive blood volume expanders. [2] [5]
This above quote comes on this article on Early Cord Clamping if you want to read more into it. http://www.atlaschiro.com/cord_clamping2.htm

The reason you probably declined the oxytocin injection is because it can pass thru the placenta to the baby. You can breastfeed to release natural oxytocin and help the placenta to deliver itself. You will probably have to get on your knees or stand up and bear down to try and help get the placenta out if there are no contractions to help you expel it. If you are given the shot, then I'd imagine they'd want to cord clamp immediately (which can be a shock to the baby's system).

Bah. I just did some quick research and I really can't find any danger to not cutting the cord until after the placenta delivers. Nature knows what she's doing - she's been doing it for thousands of years and along come all those doctors and people who assume that they know all the workings of nature and know best.... uh sure : ) Don't get me started on a hospital/doctor etc rant hehe

something to think about:
Animals DO NOT bite their cord til after the placenta is delivered. It would be insanity for them to do that - cutting off their offsprings lifelines.... they wait for the placenta to deliver, bite off the cord, and eat the placenta!



Also, www.cordclamping.com (heaps more on cord clamping issues)
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#3 of 17 Old 08-19-2003, 10:37 AM
 
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Quote:
Originally posted by seven_lux
.
She said that she really thought that would not be possible because "baby will bleed out into the placenta", but that I could have them wait at least until the cord stopped pulsing. But there's a half hour limit on delivering the placenta all up (??).
Quickening has given you wonderful advice. All I'm doing is posting my very opinionated opinion that, judging by this quotation, this midwife couldn't find her butt with both hands and a three-way mirror.
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#4 of 17 Old 08-19-2003, 12:12 PM
 
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Uh oh sohj, you've set me off : )

Thats prolly cos the midwife's head was already up her butt

Stupid midwife - obviously doesn't know that the vessels in the cord naturally restrict and close up once the cord stops pulsing properly and no further blood transfusion occurs (and by then the baby has got ALL the blood stores he/she needs!).

I actually think some of those vessels constrict after the placenta has detached, a valve near the baby end of the cord closes off so that the baby gets blood from the placenta but doesnt give blood back to the placenta iykwim!
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#5 of 17 Old 08-19-2003, 02:07 PM
 
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See also http://www.cordclamping.com/

http://www.gentlebirth.org/archives/cordIssues.html

On the oxytocin, why is that routine practice? As far as I've heard, it's not routine practice even in hospitals here in the US (and our hospitals are hardly a model of enlightened obstetrical care!). My midwife-run birthing center does not give routine shots of oxytocin. Maybe if you're having a bleeding problem they can't get under control by uterine massage, etc., sure, but I believe oxytocin is only given on an as-needed basis.

If there's no good reason for a drug or procedure other than that "this is our routine", why do it?

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#6 of 17 Old 08-19-2003, 09:13 PM
 
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if it's so necessary and potentially dangerous, why on earth wouldn't the cord be born with it's own clamp?

Honestly, I hope you're able to pass on the information from the cord clamping websites given.

Babies automatically start clamping down the arteries and the vein soon after birth. Babies don't bleed out because of this amazing built-in mechanism.

If I ever question whether or not what I'm doing is a good idea, I always go back to the wisdom of Mother Nature.
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#7 of 17 Old 08-21-2003, 05:28 AM - Thread Starter
 
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Thank you very much everyone

I will certinaly be talking with her again about this issue, and passing on printed information to her if she still seems so freaking clueless.
That's the scariest part...she seems so clueless, and vaguely annoyed by "out of the norm"...like why on earth would you want to do that...how many other midwives at the hospital will be like her? I can't control who I get taking care of me when I go in if you know what I mean.

God, she's scary.

And it was the "better" midwife (my more preffered anyway) who told me that I would recieve a shot after giving birth to help the uterus contract & deliver the placenta, but that I COULD decline it, since I was busy questioning & declining just about everything else...heh.

It goes from one week with me going...well, okay this sounds manageable, hospital won't be such a nightmare...it'll be okay, to F*CK why am I going there...we're going to die.
The in-hospital L&D classes did seem for the most part, reassuring, they put a lot of emphasis on "my choices...bithing in my own way...etc", so I thought, yes ok! But the scope does seem to be gradually shrinking as I look into it further. More like, "my labour & delivery...sure, as long as it's not very different to what we would normally do, because thats a pain for us". Argh.

Another question....can I push the baby out and refuse to let them cut the cord, and refuse to let them interfere with my placenta delivery even past their "time limit" of half an hour? I mean...how far do my rights to my own body extend? Is the baby still considered a part of me if the placenta hasn't delievered and the cord is intact? I am of the understanding that it can take a fair bit longer than half an hour to deliver a placenta with no interventions, and still be safe, is that right? How long is too long?

I plan on breastfeeding as soon as the cord is long enough to let the baby reach my boobs...
Shouldn't this be all I need to get the placenta out?
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#8 of 17 Old 08-21-2003, 09:38 AM
 
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As far as I know, the cord, placenta and baby are all your "property" and they cannot do anything to either of them without your consent.

I understand your feelings on hospitals - it just came down to my deciding that while I knew I could birth in hospital the way I wanted, I just was not willing to fight for it.

Why the hell should I have to fight for my choices (and while giving birth too?) I want to enjoy my births without having to fight for it!

I don't know how far is too long or even if there is actually a limit where it becomes dangerous to retain the placenta. I am pretty sure that two hours would not be dangerous if you weren't haemorrhaging or anything. From what I know, most placentas come out within one hour of the baby being born. Realise that you may have to get on your knees and push yourself to expell the placenta.

After birthing my dd at home, I had about 20 minutes with her in the pool then I got out and dd was dried on the floor right next to me while I was on my knees in a squatting sort of position, pushing to get the placenta out. It was harder than giving birth lol birth was a breeze, I had to work to get the placenta out (this was without bf'ing too) and it just went plop out!

Then I laid down on the mattress with dd for a rest and a feed!

If homebirth is out for you, then have you considered a doula, a friend or maybe assigning your partner to be your "lion" ? Someone to be your guardian and protector of your birthing space - someone to roar at those interfering busybodies and keep them away from you, to make sure you don't ahve to fight for what you want - they'll do the fighting!
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#9 of 17 Old 08-21-2003, 10:09 AM - Thread Starter
 
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I'd love to have the baby at home...but I don't feel comfortable this first time without a midwife, so I'm just having to go where the midwives are. I don't plan on presenting until as late as I can manage. The hospital is only 2 minutes down the road.

I will have my partner there, and while I so want to trust that he won't allow anyone to do anything against my will/wishes, I'm still so scared that things will happen anyway & they will ignore him or something. I mean, what can he do ultimately? If they really wanted to they could make him leave, he's a big guy and can look very scary, maybe they'd find him just too aggressive or something and make him leave!

My mum will also be there (wasn't planning on having her in the room as I deliver though) and while she is a generally mousey little woman, I believe she will be able to step up to the plate too... she does look at me weirdly sometimes when I discuss birthing, and I get the impression she believes that what I want now just won't matter to me as much at the time. Like, my baby is going to be born reguardless of whether I get my "delayed cord clamping" or not and I should just be happy with that. I wish I could say that I trust them so ultimately for protection, but in the back of my mind, I'm too scared.

As I type, I do realize how paranoid I am. The closer it's getting to the birth, the more scared I am.

I would stand on my head and twirl if that was the best way to get the placenta out naturally. I don't really know how to articulate why as natural and gentle as possible is important to me for my baby and myself. It just is. I wish I could just let it go and go in and hand myself over to "them" and trust that my baby will be okay, thousands of women probably do that every day and come home with beautiful little babies...but I can't. It would eat me up forever.

I think I will look into a professional doula, I know that will upset my partner a bit, but hopefully that will pass when he realises how much I freaking need something like this. I have to do something though...as it stands right now I'm sitting here bawling my eyes out, and thinking how the hell I'm ever going to do this.

This has been so off topic, but I'll be able to come back and read this in the morning with a clearer head, so maye it's a good thing.

Thanks Quickening.
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#10 of 17 Old 08-21-2003, 05:23 PM
 
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I think the doula is a good idea - I mean, it's her *job* to advocate your wishes. I sooooo much wish I had hired one for DS's birth - it probably would not have changed the outcome (c/s), but I would have been much more comfortable and relaxed about the "care" I was receiving.

Another aspect to the doula is that she will be someone who has experience in different types/durations of labor. I know (if you don't mind me sharing my experience) that even though my mom and dh were with me, neither one had been through as hard a labor as I had (well, duh, of course dh hasn't been through labor - I was referring more to my mom) and neither one really knew how to help me. Mom just ended up rambling off lists of what she could do - "Do you want to walk? Do you want me to get the birthing ball? Do you want some water? Do you want some ice? Do you want me to rub your back? Do you want to get in the tub?", etc. and if something sounded good I would agree, b/c I really couldn't put a name to what would help me. DH just stood back and watched, which I am still upset about - I feel that he was not the support I needed, while he feels hurt that I depended on my mom so much over him.

So I say, yes get a doula to help you through this first labor at least, and be sure to be clear about what your wishes are. I went over and over my wishes w/dh and my mom, and I still ended up literally RUNNING from my hospital room to the nursery two days after my c/s in order to stop the PKU test - while DH stood outside the nursery and watched! Thank goodness Mom had listened to me and said "Ummm, you didn't want the PKU, right? Cause Jeff just gave Will to the nurse". It wasn't that DH wanted DS to have the test, he just wasn't aware enough to realize that's what they were doing, and was still in the trusting mode, even though I had (I thought) drilled into him the importance of Will never leaving our arms.

Whoa, sorry didn't mean to write a novel, here, I just really, really want to make sure your experience is better than mine was. I'm crying right now as I write this. I *know* the important thing is that DS and I are both alive and well, but that doesn't mean that I'm any less regretful of the interventions that occurred, necessary or not.

Good luck in birth. You WILL do it.
Kinsey
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#11 of 17 Old 08-23-2003, 02:33 AM
 
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It has been my experience that each hospital/center is different but that the well being of the baby is their responsibility/liability and they will do whatever they believe they need to to insure that baby's well being,
You have no choice if they deem your bebe's medical well being is in question...they have the legal right and responsibility to do what they feel is medically neccessary, that usually has a broad spectrum of definition.
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#12 of 17 Old 08-23-2003, 12:22 PM
 
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You sound so scared! *hugs* Do get your DH to read this thread if you are worried about him being offended at you wanting a professional doula. Honestly, if you have that many fears about your place of birth, you NEED someone who is able to give you the support you need and do all your arguing for you so that you and your DH can enjoy your birth without having negative experiences.

This is one of the reasons I had a homebirth, I was terrified of what would happen in a hospital because as soon as I set afoot in hospital then I essentially would be giving up control to THEM!

Yeah, I'm a control freak lol (kidding) I wanted to allow my birth to go as it would go - I did not want it controlled or managed by anyone!

On the other hand, having one midwife allowed me to build a trust with her, and I knew that if there were any issues, she would be in MY home and I had every right to kick her out if I wanted to! I can't very well order or kick out people out of hospital can I? hehe

Btw I just realised you said you werent comfortable having a baby for the first time without a midwife (ours was a midwife attended homebirth) - can't you have one attend your home?

I wanted an UC but was not confident enough in myself to do it for our first baby either! *waiting for the second one to come along so we can UC!*
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#13 of 17 Old 08-25-2003, 08:51 AM - Thread Starter
 
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I had to give up on the midwife homebirth because of money, I regret not planning for it (homebirth) financially first now, but I'll for sure know better next time!

Thanks for everything everyone said, I think it all just got the better of me that night. And the next day I cam down with the most vicious cold I've ever had...which is weird because I've barely had so much as a sniffle since giving up the cigs 2 years ago. You're right Quickening, I was (still am at times) very scared.
I think all my anxieties just came out at once.

Since though, I've talked to my partner, I think we needed to connect again somewhat...because he's working very hard right up until I go into labour (then it's holidays for him!) which left me feeling a bit lonely I suspect, and we had kept putting off on actually writing down our birthplan, which he really wanted to do together. I figured it just wasn't getting the job done and with only about a month to go, I have put one down that we can just go through together and discuss. I feel much better knowing that my wishes are now on paper.
I also spoke with my mum, and I feel confident about her now too. I really do think it was just my paranoia getting to me, because I can't think of one instance where she's ever really let me down before ever! Oh "me" of little, little faith...
She is also excited about going over my birthplan with it, and when I was explaining my concerns to her she rolled up her sleeves and said "well! it looks like we've got our work cut out for us then!"...which I must add, was said in a very good way that I needed to hear.

Also, having my birthplan down now to look at...I do realize that i'm not all as radical as hell, and I can't see why I can't have what I'm wanting (providing that is...that the midwives on duty at the time CAN actually "find their butts with both hands & a 2 way mirror"...lol).
But the reasons behind why I want what I want will be explained to my partner & mum (as in the research pertaining as to why, i feel having them confronted with research, rather than just my word will allay any doubts their hiding, as well as my own in them), and I will also keep copies in my hospital bag to back it up to the maternity ward staff!

What I am asking for should not be that big of a deal...although I still find myself very worried about that one particular midwife I first wrote about (with vaild reason I think!). I will try to have a bit more faith in the others until they bust out a beauty like hers also.

That "routine after shot" too that I spoke of, was pitocin, not oxytocin...I was confused :

Yea, so anyway, thanks all
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#14 of 17 Old 08-25-2003, 09:52 AM
 
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No problems! We're all here next time you get a bout of paranoia! At least those bouts help you to prepare for eventualities!

I'm glad to hear that you've talked to your mother and your DH, communication is really important - communication and support!

Yay!


Your body knows how to give birth and I'm sure you'll give birth beautifully and even if you did not have support of others close to you, you're a mama! (Mamas are known to roar and rear up like grizzly bears when need be!)
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#15 of 17 Old 08-26-2003, 09:56 PM
 
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I think that my cord was clamped but not cut, then I birthed it, then it was cut. And I gave birth at home. If you have to compromise, have them clamp after the cord is done pulsing, then wait until it wants to come. Make sure your DH knows for them not to pull on it (a doula would remind him of this). And pitocin is routine here in Minnesota, although I warn all of my moms and they refuse it. It is given so that no matter what, your uterus clamps. (lawsuits avoided!) You have the right to say no, I would rather breastfeed and we will see how I do on my own. Then ocasionally, a mom needs it, but very rarely. There are a lot of other things you can do. If you need to find a doula in your area, you can go to
www.dona.org

Good luck !

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#16 of 17 Old 08-29-2003, 10:13 AM - Thread Starter
 
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My next appointment is this this Tuesday, so I am still preparing for my next barrage of misinformation & scare tactics :

My birth plan is fairly done. But is a work in progress at all times if you know what I mean. I'm taking it in for them to pick to bits on Tuesday, but I would be ok to use it if I went into labour, say tonight (*crosses her legs*).

DoulaSarah - please tell me why it is that I should not allow them to pull on the cord? Do you mean ever, not at all? Is that to avoid hemmorage? (...so they can freak out and pitocin me up, thus hurrying me on their merry schedule...?)
DH seems great about all what I want, but he does want to be able to back it up in the moment also.

In my birth plan it basically says when it comes to the cord, "No cord interference until placenta has been delivered. No artificial means of stimulation. Will try natural methods, positioning, nipple stimulation/breastfeeding, etc."

At this point I don't want to compromise on that at all, no matter what they try and say. I can't see why it would be a problem all things going naturally & uncomplicatedly, so I shouldn't have to right?

When it comes down to the wire though...I would be able to live fairly happily with just delaying the clamping/cutting until it stops pulsing, but I'm not going to let them know that yet. I'm just saying that so you know that i'm not a complete fruitcake on this particular issue, and I could see my way to compromise...if I have to...boooo. Really, isn't the only difference between delaying cord cutting until cord stops pulsing & delaying cord cutting until placenta delivered, TIME? Like, time that a mid-wife has to wait around?

Please please tell me if I'm wrong, it is much easier to look like a dufus here than in the midwife clinic, I don't have to look at the irritated look on your faces like in real life

All I ask is that they give me information that is right & true & unbiased on their personal preference! Is that too much to ask!!?

Thanks for the doula link DoulaSarah, I checked it out but I'm in Australia & I don't think anyone on there would like to come all this way
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#17 of 17 Old 08-29-2003, 11:53 AM
 
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leaving the cord intact will help facilitate delivery of the placenta.

if you don't deliver upright (and I highly recommend vertical delivery!), then be up right for your placenta. Get on your knees or sit up. This will help with the birth of the placenta and keep anyone from pulling on the cord.

Sometimes, I have used cord traction to get a placenta out that has separated from the uterus, but is sitting right inside the cervix. I do it gently and slowly, with the mother's attention and feedback. I had a client recently that I asked to do this and she did it herself. Worked great.
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