How early would you UC? - Mothering Forums

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#1 of 16 Old 04-04-2013, 04:26 PM - Thread Starter
 
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Baby went from LOA to ROP and had stayed there a few days.  I had some pretty intense contractions most the night last night...  about a minute long and 3.5 minutes apart.      Contractions stopped being painful and slowly spaced apart once baby went back to LOA.  I'm 35W1D today, *maybe* a couple days further (was charting, but it can be off by a day or two).  I jumped online between contractions, and read about 35 week preemies.  Sounds like they wouldn't try to stop labor if I had gone to the hospital, so I decided to stay home and see what happened for a while.  I also read that by 34 weeks their lungs are developed enough to breath, but they'll need extra oxygen for a day or so.

 

So, my questions are:

 

1.  How early would/have you UC?

2.  Would you UC and then head directly to the hospital (by ambulance) for extra oxygen?  Any ideas what I'd be dealing with if I did that?  I have been seeing a midwife (she's on a mission trip out of country right now though), so I'm hoping it wouldn't be too bad....

 

 

Thanks!


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#2 of 16 Old 04-04-2013, 08:33 PM
 
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Actually, they WOULD stop labor at 35 weeks. And most 34 seekers' lungs are NOT mature. 35'weeks is iffy. And yes, a 35 weaker may need oxygen for a day or 2, and an I'VE, and maybe antibiotics, and oh yes, 35 weekers still die. I'm a NICU nurse, and have done OB. Please get your contractions stopped next time or you could have a disaster!
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#3 of 16 Old 04-04-2013, 09:13 PM - Thread Starter
 
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I did some more research today.  I did find a few who they'd stopped contractions for, but most they just let continue....   There were a few stories that it sounded like the dates were way off... like babies who didn't have any vernix being completely fine and going home the next day?!??!  My midwife says 36 weeks is ok for a home birth.  She says she'd be more worried about jaundice though because they cant nurse as well as older babies.  She is fine with breeches, twins, and diabetes at home too....  

 

Full term babies still die.

 

I think I'd be ok with going into labor in about 4 more days and staying home though, I was in labor for 20hrs with DD, so that'd just put me a day early for the midwife (would probably call her since she has O2 tanks)...


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#4 of 16 Old 04-04-2013, 09:14 PM
 
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I don't think I'd UC until 37 weeks. I'd risk out of my midwives care and need to birth at the hospital before 37 weeks, so I think it would be best to go to the hospital if I had went into labor before then. 35 weeks would be way too early for me.


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#5 of 16 Old 04-04-2013, 10:14 PM
 
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It is more than oxygen, they need ventilation. I would not do it, but that is just me. Term babies do die, bit I still wouldn't want it to be mine.
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#6 of 16 Old 04-05-2013, 12:11 PM
 
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That depends on many many factors.  In most hospitals now, the standard of care is NOT to stop contractions after 34 weeks, but hospitals have access to all kinds of things you won't in an unplanned unassisted homebirth.  Many midwives will attend births at home from 35 weeks, but some won't.

 

Do you generally have early babies who do fine?  Some women just don't carry for very long but have totally healthy normal babies anyway.  If your older children were all 37 or 36 weekers and transitioned smoothly, you have less to worry about.

 

How far away is your hospital and ambulance dispatch?  If you live a ways out of town, err on the side of caution, and remember that transport after birth will expose you to all kinds of unnecessary interventions and hospital staff will be less likely to listen to you when you say no.  You may be reported to CPS depending on your hospital-- Oregon is one of those "best interests of the child" states where people can get a bit wound-up about unconventional choices "endangering" children because Dr. Expert says so.

 

What does your intuition tell you about giving birth early?  If it scares you, or you feel like early labor would be something "going wrong", go in.  Always listen to your body

 

With near-term preemies, the most important factor that determines their success is being kept near mom.  If you can do an active, supported birth, leave the placenta attached for at least 4 hours, support frequent nursing sessions (remembering that near-term preemies often struggle with latch), and keep baby on your tummy or chest pretty much constantly for several days, then your chances are good.  Part of the reason the medical model of birth is SO sure that full term doesn't start until 37 weeks is that they do a lot of unnecessary harm to babies, especially those they think are struggling.  The human newborn only makes sense as an organism when considered in the context of the mother.

 

But, to me, it sounds like you aren't actually going to go very soon.  I am in your same boat but a couple weeks further along, and since my baby isn't engaged, ze has been swinging in and out of favorable positions all week and it's been altering the pace of my latent labor (I've had a couple episodes of strong regular contractions, too), but I just started getting cervical ripening last night so I think it will still be several days at least.  In a literal sense, all pregnant women are in labor, but that doesn't mean that birth is imminent.

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#7 of 16 Old 04-05-2013, 12:25 PM
 
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It isn't just latch late preterm babies struggle with. At 38 weeks my soon could not coordinate suck, swallow and breathe well enough to suck from a bottle, let alone a breast.
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#8 of 16 Old 04-05-2013, 02:15 PM - Thread Starter
 
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That depends on many many factors.  In most hospitals now, the standard of care is NOT to stop contractions after 34 weeks, but hospitals have access to all kinds of things you won't in an unplanned unassisted homebirth.  Many midwives will attend births at home from 35 weeks, but some won't.

 

Do you generally have early babies who do fine?  Some women just don't carry for very long but have totally healthy normal babies anyway.  If your older children were all 37 or 36 weekers and transitioned smoothly, you have less to worry about.

 

How far away is your hospital and ambulance dispatch?  If you live a ways out of town, err on the side of caution, and remember that transport after birth will expose you to all kinds of unnecessary interventions and hospital staff will be less likely to listen to you when you say no.  You may be reported to CPS depending on your hospital-- Oregon is one of those "best interests of the child" states where people can get a bit wound-up about unconventional choices "endangering" children because Dr. Expert says so.

 

What does your intuition tell you about giving birth early?  If it scares you, or you feel like early labor would be something "going wrong", go in.  Always listen to your body

 

With near-term preemies, the most important factor that determines their success is being kept near mom.  If you can do an active, supported birth, leave the placenta attached for at least 4 hours, support frequent nursing sessions (remembering that near-term preemies often struggle with latch), and keep baby on your tummy or chest pretty much constantly for several days, then your chances are good.  Part of the reason the medical model of birth is SO sure that full term doesn't start until 37 weeks is that they do a lot of unnecessary harm to babies, especially those they think are struggling.  The human newborn only makes sense as an organism when considered in the context of the mother.

 

But, to me, it sounds like you aren't actually going to go very soon.  I am in your same boat but a couple weeks further along, and since my baby isn't engaged, ze has been swinging in and out of favorable positions all week and it's been altering the pace of my latent labor (I've had a couple episodes of strong regular contractions, too), but I just started getting cervical ripening last night so I think it will still be several days at least.  In a literal sense, all pregnant women are in labor, but that doesn't mean that birth is imminent.

We planned an UC with DD.  She was born at 40W5D, but DH decided we were going to the hospital after 10hrs of debilitating back pain during every single contraction.  The hospital was ok for a few hours, but then kept trying to speed things up, which I kept saying no to, then they started threatening, and finally lied to me to get me to do what they wanted.  This is why I'd prefer to have the baby at home, even if it means having the midwife there to have O2 available immediately.  I'd be ok with Transferring afterwards if baby really did need help.... I could always just say I thought it was just braxton hicks, and then everything just happend so fast.........  I dont think CPS would be an issue since I've had prenatal care this time.  I really wasn't worried about having the baby early... I've had a feeling from the beginning that the baby will be "earlier."  I'm more worried about ending up at the hospital....

 

I ended up having to pump and syringe feed DD for a couple days.  It was a good 5 hours after she was born before I was allowed to try to get her to nurse.  (they claimed she needed antibotics and had to go to the nursery, DH went, but I wasn't allowed to because I felt dizzy standing up)  And, after nursing her for almost 2 years, I now know how they were telling me to nurse her was wrong.

 

What's the benefit to leaving the placenta attached that long?  I know some people do lotus births, but that's just not something we're into... we planned to cut the cord after the placenta was birthed....

 

DH works for the fire district in town... he's a paramedic.  They'd be here right away, but it is probably a 10-15 minute ride to the nearest hospital (nursery, but no NICU), 35 minutes to the higher level hospital.

 

I really dont think I'll be having the baby in the next few days, it's not engaged, and although I've been losing mucus, there's been no bloody show, and my cervix doesn't feel like it's changing.  I think it was just my body putting the baby back where it was supposed to be... LOA instead of ROP.  I was just curious what everyone else would do.

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#9 of 16 Old 04-05-2013, 05:15 PM
 
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My last birth was a UC and happened one day shy of 36 weeks.  My first was an induction (pre-e) at 36w4d with contractions (that I couldn't actually feel) having already started and a ripe cervix.  My doc said if they hadn't induced there was a good chance I would have had the baby on my own within a few days anyway.  Neither had problems with breathing or nursing, so, like with everything in life, it depends on you and your body and the baby.  TBH, with the second being early and OOH, it made me nervous, but it was clear pretty quickly from his cries that his lungs were fine.
 

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#10 of 16 Old 04-06-2013, 08:09 AM
 
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Well, you know what I did last time, birth at home, see how he was doing and then I got to stay home because he good to go. I was a few minutes shy of 36 weeks along. He was the best at nursing, the healthiest early baby. Babies can be very different. Healthy babies act a certain way... after having six children it becomes glaringly apparent what health and vigor is, but I don't think you have to have six to figure your own child out.

 

 

My body kept dropping clues that the time was winding up in the last 2 weeks. I'd say if you really want to know if you are about done, notice your inflammation markers. I barely had any joint pain during the pregnancy until the baby was ready, where when not pregnant my joints have been known to complain here and there with my swinging hormones. But a few days before starting labor my knuckles started acting up a little bit. Because I knew about inflammation in pregnancy I pinned my predictions on those symptoms and I was happy to be right.

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#11 of 16 Old 04-06-2013, 12:54 PM
 
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What's the benefit to leaving the placenta attached that long?  I know some people do lotus births, but that's just not something we're into... we planned to cut the cord after the placenta was birthed....

 

Leaving the placenta attached is incrementally beneficial to the newborn.  Cutting about 5 minutes after the placenta is born is the minimum I would ever consider as a MW.  The longer the placenta remains attached, the better baby's chances are of avoiding infection, jaundice, weight loss, anemia, and breastfeeding challenges. 

 

Delaying severance until after the primal-adaptive phase ends (the initial period of wakefulness experienced by most newborns usually defines this pretty well...1-2 hours after birth in most cases) gives baby time to transition more completely to life outside the womb before the support of the placenta is removed, making them less stressed and allowing the first nursing session(s) to occur with a baby who is truly calm and content, which helps support successful nursing overall. 

 

Most people who do "delayed" cord cutting (severing the cord after 3-15 minutes) still cut a cord that bleeds at the severance site-- the blood that seeps from a cut cord is rich in stem cells, vitamins, minerals, antibodies, oxytocin, and endorphins, so IMO, any drop lost is a drop too much.  If you wait several hours to cut the cord, blood transfusion has nearly completed, and it doesn't generally result in a loss of cord blood.  For some mother-baby dyads, this happens as quickly as 2 hours after the birth of the placenta, but for others, it can be 6-8 hours. 

 

Waiting 3-4 hours ensures that the majority of the placental transfusion is complete and allows for a normal primal-adaptive phase, but leaves the placenta fresh enough to be eaten (if you want to) and is less inconvenient for the parents than a full lotus birth.  I consider cutting the cord at all to be an unnecessary intervention, but for people who aren't interested in full lotus, this is a great option.

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#12 of 16 Old 04-06-2013, 01:06 PM - Thread Starter
 
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What's the benefit to leaving the placenta attached that long?  I know some people do lotus births, but that's just not something we're into... we planned to cut the cord after the placenta was birthed....

 

Leaving the placenta attached is incrementally beneficial to the newborn.  Cutting about 5 minutes after the placenta is born is the minimum I would ever consider as a MW.  The longer the placenta remains attached, the better baby's chances are of avoiding infection, jaundice, weight loss, anemia, and breastfeeding challenges. 

 

Delaying severance until after the primal-adaptive phase ends (the initial period of wakefulness experienced by most newborns usually defines this pretty well...1-2 hours after birth in most cases) gives baby time to transition more completely to life outside the womb before the support of the placenta is removed, making them less stressed and allowing the first nursing session(s) to occur with a baby who is truly calm and content, which helps support successful nursing overall. 

 

Most people who do "delayed" cord cutting (severing the cord after 3-15 minutes) still cut a cord that bleeds at the severance site-- the blood that seeps from a cut cord is rich in stem cells, vitamins, minerals, antibodies, oxytocin, and endorphins, so IMO, any drop lost is a drop too much.  If you wait several hours to cut the cord, blood transfusion has nearly completed, and it doesn't generally result in a loss of cord blood.  For some mother-baby dyads, this happens as quickly as 2 hours after the birth of the placenta, but for others, it can be 6-8 hours. 

 

Waiting 3-4 hours ensures that the majority of the placental transfusion is complete and allows for a normal primal-adaptive phase, but leaves the placenta fresh enough to be eaten (if you want to) and is less inconvenient for the parents than a full lotus birth.  I consider cutting the cord at all to be an unnecessary intervention, but for people who aren't interested in full lotus, this is a great option.

 

Where can I find more info on this?  I had no idea there was anything going on after the placenta came out!  I thought once it was out, everything was pretty much done!


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#13 of 16 Old 04-07-2013, 11:46 AM
 
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Obviously lotus birth sites (this is a good one http://www.lotusfertility.com/Lotus_Birth_Q/Lotus_Birth_QA.html) cover the advantages of non-severance in great detail, and you can read about the properties of cord blood via the many (and, IMO, misguided) cord blood banking companies.

 

General information on how much even a very short delay benefits the newborn can be found here: http://www.ncbi.nlm.nih.gov/pubmed/?term=delayed+cord+clamping  Sadly there's no standard terminology to distinguish very early clamping from later clamping-- a delay of as little as 30 seconds can be considered "delayed" in the medical model.  But then, it is interesting to look at the huge change in outcomes between clamping at 30s and clamping at 3 min, and between clamping at 3 min and clamping at 15 min, and you can't really avoid doing that since each study has its own idea of what "delayed" and "early" clamping is.  There are also a handful of studies on clamping in response to a physiological cue (onset of respiration in the newborn, delivery of the placenta, etc.).

 

And some essays and videos on cord clamping, again with various ideas about what the ideal course of action is:

 

http://birthanarchy.com/history-impact-premature-cord-clamping

http://thestir.cafemom.com/pregnancy/125775/delaying_cord_clamping_explained_video

http://www.youtube.com/watch?feature=player_embedded&v=cX-zD8jKne0

http://www.nurturingheartsbirthservices.com/blog/?p=1542

http://thinkbirth.blogspot.com.au/2010/01/obstetricians-attitude-to-delayed-cord.html

 

A baby whose cord is clamped and cut sooner before it is limp and thin (about 15-40 minutes after birth) is clinically hypovolemic, and what blood volume they do have is more likely to include damaged blood cells (which the newborn liver struggles to filter from the blood)-- this is a MAJOR cause of neonatal jaundice and anemia.

 

A baby whose cord is clamped and cut within the first hour has received most of the cord blood VOLUME, but the beneficial components of cord blood may take a while to trickle out-- stem cells are particularly sluggish (this, as a side note, may be the reason newborns have relatively little vitamin K-- their thinner blood may aid stem cell transport throughout the body)-- so the last few drops are relatively more concentrated.

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#14 of 16 Old 04-07-2013, 12:31 PM
 
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Thirty-five weeks seems tremendously early to me. I know several babies born that early (including my twin nieces) who had breathing issues and needed NICU care for several weeks.

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#15 of 16 Old 04-07-2013, 01:16 PM
 
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I would say you shouldn't UC before 39 weeks. UC and HB is best suited for low risk moms and low risk babies. A baby earlier than 39 weeks is no longer considered full term, which is why there is a push for no elective inductions or CS pre 39 weeks.

I had a preemie, and saw many of various ages in the NICU the month we were there. There are multiple reasons a NICU is beneficial- for every preemie birth, there is a NICU team there, which is often needed. Preemies are fragile, and even when they are born breathing, they can stop at any time afterward, which is why they are usually observed for a few days. No amount of lotus birth can fix the breathing issues either. Also, some moms have preemies because there are other problems (infection, IC, etc).

*warning- baby loss*
If a MW thinks 36 weeks is OK for an OOH birth, I would run from them as fast as possible, as thats really bad advice. A dear friend lost her baby after a HB @ 36 weeks, her MW thought it was Ok. After the MW left, everyone napped, the baby stopped breathing, and died before EMS could get there. She was born with these little spots on her face, that looked normal enough to an untrained eye, but were an obvious sign the MW missed. Not all babies w breathing issues will have these spots, but be on the look out for them.

Just because preemie HB/UC sometimes goes well, it is no guarantee that it *will* go well for your baby. I just wanted to share so you could be fully informed. What you do is your choice, of course.
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#16 of 16 Old 04-09-2013, 04:11 PM
 
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36 weeks is the soonest I would UC. I had a baby at 36 weeks exactly, and he was perfectly healthy. I'm hoping to go much further than that with this one though smile.gif
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