This is a good discussion, very interesting!
Defenestrator wrote: "feel around the baby's neck for cord, as gently as possible. If there is cord, try to unwrap it. If it won't unwrap, see if you can slide it down over the baby's shoulders so that the baby is born through the coils, kind of like being born through a coiled spring. If that doesn't work, see if mama can push shoulders out on the next contraction and somersault baby out. Clamp and cut the cord as a last resort."
I'm trying to figure out to phrase this so it doesn't sound like I'm arguing with you.
I guess I want to offer the viewpoint (and if I remember right Pam touched on this) that is not "just the way it is" when you give birth. (This is new territory for me writing on this, so I feel like I'm stumbling a bit, so bear with me...) I feel like, in a way, checking for the cord in a normal spontaneous instinctive birth is like timing contractions, checking dilation, supporting the perineum, etc. In other words, like we cannot trust the process to unfold normally, we have to get in there and proactively protect ourselves from it. This is an intervention and an interference, to some degree. Some people might feel it's a small enough thing that the potential benefits would far outweight the risks, but to me it would feel completely unnatural to stop in the middle of that most intense part of the birth and think, "I have to check for the cord now." A partner could do it, but that would put the partner in the role of midwife (which neither my husband nor I wanted.)
There's also the question of whether or not it's actually necessary and whether it can in itself cause harm. As to the former, I admit I'm not really understanding the logic behind creating slack in the cord -- why would that help the body to born? And to the latter -- what if the cord is especially fragile? Or if, like Pamamidwife says, any handling of it in the air begins the process of ceasing the flow of blood through it.
It just seems to me that the best course of action is first to let nature do its thing, and only
when that fails to try something else. I wouldn't plan on doing anything with the cord unless I had a clear intuitive message that something was wrong. (One thing that is so striking to me about so many UCs stories -- as different from assisted births -- is how often the mother has a deep knowing when something is amiss, and automatically does what needs to be done, often without any medical training at all.)
I also wonder if fears about the cord and the feeling that something
should be done with it has to do with not really comprehending (generally speaking, in our society) what normal birth is.
If birth is always acted on by outside sources, and if those acts become so habitual that they no longer seem "other" or separate from the basic process, then it will not even occur to us that the body would behave differently if not so acted on."The other thing about the somersault maneuver is that I like to manipulate the baby's head and body as little as possible and I wonder about whether or not trying to guide the baby's body in a particular direction might lead to more tearing."
I agree about not manipulating the baby's body -- but in picturing the somersault maneuver what I was thinking was that the body would automatically
somersault out as a reaction to a short cord... seems like simple physics to me."One extremely important thing -- you MUST clamp the cord before it is cut."
I'm curious, do you know the rate at which blood loss would occur if the cord was not clamped? I'm assuming -- if the clamp is a 'must', that it would be significant?