After what seemed an eternity, the head turned and the next surge came to birth the rest of the baby, and out baby came with two tight loops of cord around her neck. Col pulled the first loop off, and Jodi got he second, then the baby was placed skin to skin up on my side. She was a little limp, so we rubbed her and talked to her a little, but a few quick puffs with the bag were required, as the cord had stopped pulsing pretty much immediatelyafter the birth.
We needed to hop out of the bath in order to give our little one a little more oxygen, and it was when I passed her to Jodi so I could get up that we saw she was girl. After a few more puffs with the bag, her chest was rising and falling strongly. Poor Jodi had been waiting for that telltale first cry to indicate she had taken that vital first breath, but Willow felt it more appropriate to remain calm and quiet for her first moments in this world.
Has anyone had a waterbirth similar to this one? It is strikingly similar to my first waterbirth - cord around neck, baby a bit limp and pale and slow to start breathing after being brought out of the water - a few breaths here and there not regular enough to make m/w happy. She wanted my dd to cry and was rough (not rough rough but definitely rough where I would of been gentle) in trying to get my dd to cry by rubbing her chest hard to the point of shaking her a bit.
She suctioned and used wave by oxygen.
She was concerned because she reckons the cord had stopped pulsing right after dd was born, but I did not feel like I had a cause to be concerned.
So my two questions are -
has anybody had a birth like this?
And do you think waterbirthed babies are less likely to cry/take time to start breathing?
Hmm I have a third question, how long should we be giving babies to switch over to breathing if their cord has stopped pulsing?
I don't know about the cord pulsing, but my waterbirthed baby certainly took her time taking her first breath. One midwife was listening to her heart with a stethescope saying her heartrate was too low and the other midwife was rubbing her up rather hard. She finally let out a good scream and pinked up, but it was a little tense for a few seconds. They never had to give her oxygen, luckily. She was birthed in one push so I don't think she was wrapped in the cord, but I certainly managed to get myself tangled--they had to cut the cord so I could get out :LOL
It should be interesting to hear what other people's experiences are--I had always attributed her reluctance to breathe on her rapid delivery.
I don't think it's necessary to even move the cord over the head. In my eyes, that's alot like cutting it. Any fiddling with the cord will start the contraction of the Wharton's Jelly and begin the vessels clamping down. Exposure to air is also bad, as it does the same thing.
Electra:
Quote:
My mw said my dd's cord clamed down immediately upon air exposure, so basically my dd was cut off as soon as she was born. She was a bit slow to breath as well.
When I read the above, it stuck true. I always had this feeling that if the midwife had not been there, there wouldn't be this issue with the cord nor the panic over the baby not breathing. She was touching my dd's head and cord, looping it over while I was giving birth. It would not surprise me if she was the reason the cord stopped pulsing so quickly.
I think its also normal for babies to take time to start breathing regularly, a few breaths here and there (my dd gave a big yawn at one point!!) shows that the transition from placental breathing to lung breathing is obviously happening right??? So all it would have taken was some calmness and patience and respect.
"I always had this feeling that if the midwife had not been there, there wouldn't be this issue with the cord nor the panic over the baby not breathing. She was touching my dd's head and cord, looping it over while I was giving birth. It would not surprise me if she was the reason the cord stopped pulsing so quickly.
I think its also normal for babies to take time to start breathing regularly, a few breaths here and there (my dd gave a big yawn at one point!!) shows that the transition from placental breathing to lung breathing is obviously happening right??? So all it would have taken was some calmness and patience and respect."
Yes. I think that maybe some (many?) birth attendants have enough fear surrounding the emergence of the baby that they just cannot bear to be patient and stay out of things. For both of my midwife-attended births this was very much the case -- even with the "hands-off" midwife, who ended up doing several unnecessary things not because there was an indication that something was wrong, but because she held some fear and it was therefore more comfortable for her to act in a way that she felt was preventative. At the time I was happy to make that trade-off because it was SO much better than how my first birth had been managed. But with time I've realized more and more how instrusive and interventive her actions actually were. I sympathize -- I think it must be very hard to carry the trust that is necessary for someone to give over to you the responsibility for the life of her child. Because I love birth so much and feel a calling to be involved in helping women become aware of their innate power and rights and the benefits of doing so, I have often imagined myself in the role of midwife, to play that out to see if that was the direction I wanted to go. For various reasons I've decided that it's not, one being that I am positive that I too would find myself acting based on imagined fears and potential dangers -- the unknown -- rather than on what is known in the moment. It's easy enough to do that (the latter) for myself -- I know myself. But I think it would be a stressful thing for me to try to do that for someone else, not having any instinctive or intuitive knowledge like the birthing mother does. I would be going into it somewhat blind, and that is a scary thing to me, and I'm sure it would affect my actions.
Gee, I kind of went off on a tangent, didn't I?
I'm not positive about the answer to your questions. Although, I think that the cord will still be passing blood (and therefore oxygen) to the baby, even when it is not obviously pulsing. Anyway, I think that what was going on with the midwife feeling the need to make the baby cry and move around is that a baby who is responding strongly to a negative stimulus is a known sure thing. A baby that is still and quiet is not. I mean, there were quite a few times when my very serene newborn would be SO still and quiet that I had to put my face very close to hers to make sure she was still breathing. I really didn't know. And I imagine that in the moments after a birth, when people are talking and the light is dim, that it might be especially hard to notice. Not that I'm defending the midwife's actions! Just saying that I think the reason for them was probably other than that the baby truly needed them -- the midwife needed them.
There is a German midwife who came up with an alternative APGAR score for waterbirth babies because they are often much calmer than babies born on dry land. I think it is pretty cool.
I like how the open eyes replaced the score for grimace and simply breathing replaced the score for crying.
I have seen a number of waterbirths just like this. Using a standard APGAR score these calm babies might get a 6 or a 7, making them seem more compromised than they actually are.
Defrenestator, THANK YOU!!! That link is excellent! According to it, the APGAR of my dd would be at least a 7 at one minute after birth (she was given a 4) which I really disagreed on!
And thank you too blueviolet, I think that was incredibly insightful of you - to say that you wouldnt have the instinctive or intuititive knowledge that the birthing mother would have, and that would be like going into it blind.
Thats a keeper, I'm going to save it and show it to my mum maybe that will help her realise her fears if she has any and perphas have some more confidence in trusting in me.
Originally Posted by Quickening
Defrenestator, THANK YOU!!! That link is excellent! According to it, the APGAR of my dd would be at least a 7 at one minute after birth (she was given a 4) which I really disagreed on!
so different than the apgar I am just curious were your baby's eyes open or closed? or closed tightly like squinting shut?
in my experience waterbabies don't usually cry right away, but they do breath immediately & will open their eyes, looking at mom and taking it all in. It's like they just don't have anything to cry about yet. they also stay blue just a little bit longer, because they're not screaming & crying moving the oxygen around quickly.
My 3rd was born in water @ home with a nuchal cord, prolonged crowning, and tight shoulders... he was limp & floppy at birth with the wide-eyed look that goes with decreased O2.. his heart rate was good & I rubbed him up good myself with stimulated his breathing, he still took a few seconds... 30sec?? before he started crying. About 1 minute.
Babies should begin breathing right away, even if not crying, if the baby's not breathing at all there is no need to wait, the longer a baby is without oxygen the longer it'll take the baby to recover.
When I have a mom who has a baby who doesn't cry right away & I'm unsure if baby's doing ok, I'll listen gently with a stethoscope without moving baby... then I can hear the baby breathing & the heart rate & know not to intervene.
While it's true that no one has the same intuitive knowledge that the mother has, I rely heavily on my intuition. In some cases where others would intervene i don't because I feel that all is well. In other cases my intuition warns me and I take action or am more vigilant. I think women are highly intuitive & I rely on mothers intuition for themselves & their babies. I pay particular attention to fears and concerns.
Originally Posted by midwyfmomma
Babies should begin breathing right away, even if not crying, if the baby's not breathing at all there is no need to wait, the longer a baby is without oxygen the longer it'll take the baby to recover.
What is "right away", though? In my experience, sometimes it takes a good 30 seconds to 45 seconds for babies to really start to breathe. IMO, this is ok, especially with a waterbirth, where I feel there is less strain on the cord as it is when it hits air.
Most waterborn babies I see take awhile to breathe regularly. I don't think this is a bad thing, since the cord is still attached to the placenta, and usually in warm water which keeps the cord vessels from clamping down. Baby is getting plenty of O2.
What is your thought about how long is too long? What if tone is good and color is ok (for a waterborn babe)? I usually just let that full minute go before intervening if everything else looks ok, but babies will often breathe before the minute is up.
Mwherbs - my dd's eyes were open, she was looking around a little bit. Every now and then shed close her eyes, then open them again. It was pretty bright in the room, being midday. She looked a bit cranky and I am pretty sure she had one breath in the first minute. Her breathing took a while to get regular enough for the mw's comfort level but as soon as I saw her yawn I definitely knew she was just taking her time adjusting.
After she was breathing a bit here and there, she was trying to close her eyes again to rest and only started crying when the m/w started being a bit more rough in poking around, checking gender, heartbeat etc. After m/w stopped and let us have some time alone with dd, she went back to sleep like she had been asleep during her birth! She got grouchy at me when I tried to bf her so I waited 20 mins after birth before being able to bf her.
She was blue for a while but not limp or floppy, and I could feel her THERE, not as if she was not there you know?
DD still gets grouchy at me when she is trying to sleep :LOL and still has that same grouch expression that she used at her birth.
"In my experience, sometimes it takes a good 30 seconds to 45 seconds for babies to really start to breathe.....Most waterborn babies I see take awhile to breathe regularly....let a full minute go before intervening if everything else looks ok"
Usually if "everything else" is okay, baby is looking around, has good muscle tone, and their color is good, they're usually breathing. It's normal for babies to breathe irregularly, but they should still be breathing. I find that it's often gentle breathing & can be hard to discern, so if I'm concerned I'll ask mom or listen with the baby stethoscope as I mentioned.
The OP asked "do you think waterbirthed babies are less likely to cry/take time to start breathing? " and "how long should we be giving babies to switch over to breathing if their cord has stopped pulsing?"
It seems that we all have the same experience with water babies taking their time to cry and that color can be a little slower.. but they are usually breathing... taking some quiet gentle breaths, along with other signs that they're OK.. looking around, moving around, have good muscle tone.. Now if you have a baby that's not breathing, floppy, not looking around, and blue you wouldn't want to wait a full 45sec to a minute before you did something (not that any of us would)... And if the cord has stopped pulsing for whatever reason (not common) with waterbirth.. but in that case you can't rely on the cord to provide O2 if the baby's NOT breathing.
Jumping in late on the discussion here... My 2nd dd was an unexpected UC (waterbirth) and she took quite awhile to cry. I'm thinking it was probably close to about 2 minutes after birth. She was born seemingly asleep - pink but completely limp. No muscle tone at all. I had dh cut the cord so he could stimulate her outside of the tub (yeah, probably shouldn't have done that but hindsight is 20/20). Anyway, he rubbed her down w/a towel, flicked her feet, etc. Still took awhile til she cried. We didn't think that she was already breathing but she must have been cuz her color remained pink (didn't occur to us to actually check in the moment).
She also has had sleep apnea ever since birth (it's minor). I've always wondered if there might be a corrolation. Anyway, that's just my experience.
Both of my waterbabies seemed to take a minute or so to start breathing... in the first case, my mw got nervous and suctioned her. I wish she hadn't, because dd didn't nurse right away, and I think that's why.
With our UC, ds did start taking very tiny little breaths, and I rubbed him gently, then turned him over, head tilted down and supported with my hand, and rubbed his back. He expelled liquids and then started breathing deeper and more audibly. He wasn't pink, but whitish, he didn't move immediately, but within a minute he was sucking his fingers, and shortly thereafter latched on. He opened his eyes for a split second, and then closed them and kept them tightly squinted closed for hours. He was born outside on a sunny day, and although the sun was behind the house, I'm not surprised, in retrospect, that he kept his eyes tightly shut!
He squalled a little bit, but didn't do any major yelling, and colored gradually.
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