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Hi all, I'm not the most medically inclined and I don't understand all the research on cord clamping, but it makes pretty good sense to me to wait.
My first birth was a c/s and the last thing I asked my doctor to do was not to clamp the cord. Well, that's the first thing he did. So I've switched doctors and my new one is going along great w/ everything, but he said he clamps it by the placenta.
Someone explained to me that they need to clamp early or it can cause polycythemia (excess RBC levels) or also jaundice. I'm so confused!!

Has anyone been successful in talking their docs out of cord clamping? How did you do it?
Thanks!
 

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Don't be confused. Instant cord clamping is bad. Very simple. It still has a job to do after the baby is born.
1. It is still working to take away all the toxins created by stress in labour so if it's cut off too soon (before it's stopped pulsing) then bub's immature system has to filter all those catecholamines (stress hormones) on it's own.
2. Because it's working, it can have up to HALF the baby's blood supply still in it when they clamp too early.

It is for these reasons that HB babies have better rates of rescusitation. They are left on the placenta, put on mum's skin and have oxygen wafted over their faces. So they pink up fast and don't have breathing difficulties. In hospitals they are taken away from their mother, taken off their support system and can have breathing difficulties as a result.

Doctors like to cut early because it's convenient. Pure and simple. When you choose hospital birth you get all their protocols and they are not evidence based. So if you want to tell your doctor how best to serve your needs, you may have to get your head around the research. It's not difficult at all. Remember, you're employing your doctor. You're the boss because you're paying. Same as any tradesperson you hire to work on your car or house. Doctors aren't working out of the goodness of their hearts, you're employing them.

Jaundice is more likely in a baby whose cord is cut for the reasons above I've outlined. It's also more likely in a traumatic birth ie c-sec or instruments birth. So avoiding those will most likely avoid jaundice anyway.

This is your birth and it's not for the convenience of your doctor. If you wanted a lotus birth (where the cord isn't cut at all but drops off naturally a few days later) they should have to accommodate you in that too.

So slug it to him, sister! Your body, your baby, your birth, your decision. I'll just check in my files and post a great web site for you with excellent and clear articles to prep yourself with.


www.cordclamping.com

Hugs,
J
 

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I found it very hard to try and "educate" any health care provider who was not open to the experience - which most are not. I think doctors find their niche and stick with it. So, when I was pregnant 5 years ago and finding out all kinds of good information, putting it in our birth plan, and discussing it with our doctor, I was suprised that they did not readily agree nor seem too interested in my wishes. I think the best agreement we reached was something to the effect of "we'll see... if everything goes well...that may be possible" - translation: no way is this going to happen. Then of course, there were other doctors in that practice that may have been on call the day I went into labor and who knows where they stood? The end of this long rant is that late in my pregnancy, we switched providers and went to the hospital with a team of CNM's who were much more open to my wishes.

Five years later, I am expecting again and guess what? I've finally got the nerve to plan the homebirth I always secretly wanted.

My advice to you is to make these discussions a priority with your doctor and maybe even let them know that you are concerned about haveing a good fit with their practice. Now that you know what you want, should you need to interview someone else, it'll be that much easier to weed out the good from the bad.
Good luck! And maybe ask around your area for other moms who had natural births and who can recommend their doctor - at childbirth classes, La Leche League meetings, call some doulas from your phone book... keep at it till you get what you want!
 

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Are you planning another c-birth? At cesarean delivery, it is very difficult to not clamp the cord right away. Since the uterus is opened by incision, there is an amazing amount of blood loss until the uterine incision is sutured due to the greatly increased blood supply to the uterus. The placenta must be delivered quickly so the incision can be closed. I'm not sure you'd be able to find anyone to delay clamping in that situation.
Not all docs cut quickly for convenience. There is at least one study that shows there is decreased rates of postpartum hemorrhage when early cord clamping is employed, and more than one study that suggests jaundice and polycythemia are more common when cord clamping is delayed.
I suggest not trying to "convince" your doc of anything, but sinmply say that this is what you'd like. Then have your doula or other support person remind the doc immediately after birth.
 

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Quote:

Originally Posted by doctorjen
At cesarean delivery, it is very difficult to not clamp the cord right away. Since the uterus is opened by incision, there is an amazing amount of blood loss until the uterine incision is sutured due to the greatly increased blood supply to the uterus. The placenta must be delivered quickly so the incision can be closed. I'm not sure you'd be able to find anyone to delay clamping in that situation.


Anyway, AFTER my baby was born, I learned on this board the very best thing you can do is to clamp the cord AFTER the placenta comes out. Just to wait the longest amount of time to give the baby the maximum amount of blood.


My
homebirth midwife did wait for the cord to stop pulsing before she clamped, but I think she clamped it and then waited for the placenta to be birthed.

I really doubt you are going to be able to convince a doctor to do it.

Maybe if you show him some published studies, that would help your case.
 

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Have someone there with you!!
I just had an emergency c-cection (NEVER thought this would happen to me!!)
and my DH just told the doctor what was going to happen with the cord.. He was right there when my DS came out and he was like look, This is the way it's going to be..
I think that the doctors will listen more to someone other than the "crazy woman" in labor y'know?
 

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Discussion Starter · #7 ·
Thanks all for your replies. Since I'm hoping for a vbac I've searched long and wide for a supportive doctor. This guy has been **great** on the vbac side so I don't want to switch now. I had 3 doctors tell me that I'll never get a baby through my pelvis (dd was malpositioned and big). I live too far away from a hospital for a hbac and I live in an illegal state for mw

As many of you know the vbac climate is not good right now, so I was thrilled when this dr was so supportive of me.

Thanks again and I'll keep the discussion open and have dh chime in at the birth too.
 

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If you check out the cordclamping site, there's a link to an article that reviews the medical literature. From what I remember from that article, there is no good evidence supporting the hypothesis that early cord clamping decreases the incidence of polycythemia.

doctorjen, do you have links to the studies you referred to? I'd love to see them.
 

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Here is a link to a summary of the Cochrane review on active management of the third stage (this actually includes not only early clamping, but often giving meds of some kind to speed placenta delivery)
http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10908457

There are many, many studies on cord clamping and blood count in the newborn and older infant. Some are phrased positively, some negatively (you know, either "Delayed clamping improves blood count" or "Early clamping reduces polycythemia" type of phrasing.) Go to the pubmed and type in "polycythemia and cord clamping" to see a bunch and draw your own conclusion.
http://www.ncbi.nlm.nih.gov/entrez/q...arch&DB=pubmed
 

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You shouldn't have to convince your doctor of anything. You are the client, and he needs to follow your wishes. Period. If you have to sign a waiver before the birth, please do so, so there's no hesitation during the birth about what's going to be done (or not done!) with the cord.

Best of luck!

Darshani
 

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Quote:

Originally Posted by USAmma
You shouldn't have to convince your doctor of anything. You are the client, and he needs to follow your wishes. Period. If you have to sign a waiver before the birth, please do so, so there's no hesitation during the birth about what's going to be done (or not done!) with the cord.

Best of luck!

Darshani


yeah.......there shouldn't be ANY convincing or educating going on......its YOUR baby and YOUR body........just have someone there (a doula maybe?) to step in should they look like they are getting out the scissors. it's like circing.......theres no real solid medical reason to DO it right away, doctors just don't like to wait around.
 

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in my case, the doctor was all for delaying, and it was the nurses who weren't.

i had a vaginal birth in a hospital, and unfortunately, while my ob was wonderful and agreed with me on every aspect of my birth plan, she wasn't there for the actual birth. i had to argue with the nurse about the physiologic process of natural, intervention-free childbirth, and then damn near had to kick her away to keep her from clamping the cord too early. luckily, the cord stopped pulsing shortly after she started arguing with me again, and i gave her the go-ahead.

it's unfortunate that many health-care practitioners still go by all the old 'rules' regarding childbirth. granted, there are some good doctors and nurses out there, but they seem to be few and far between.

just another reason to have a homebirth next time
 

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Quote:

Originally Posted by anothermama
it's like circing.......theres no real solid medical reason to DO it right away, doctors just don't like to wait around.
except with circing there's no reason to do it period.
 
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