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I'm starting to put together my birth plan and came across this question on the tip sheet I got from my midwife........ "do you want to wait to cut the cord until it stops pulsing"<br><br>
Does anyone know what the deal is with this? I had never heard it phrased this way.....
 

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The placenta continues to pump blood into the baby after the baby is delivered. Early cord cutting deprives the baby of some of it's blood volume. There have been some studies that indicated that jaundice would be lessened by early cord clamping/cutting, but from my research, those studies seem to be flawed, and imho, there are many more cardiopulmonary advantages to delaying clamping/cutting of the cord until after it has stopped pulsing.
 

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The baby is also still able to receive oxygen from the placenta as long as the cord is pulsing. If the cord is severed before the baby's breathing pattern is established, the baby will briefly be deprived of oxygen (which certainly doesn't make for a gentle transition) and may need help getting started breathing.
 

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I think it's best to wait until the placenta is delivered, personally. Leaving the cord intact will help facilitate the birth of the placenta and will also give your baby the extra blood he/she needs.<br><br>
Here's more information: <a href="http://www.cordclamping.com" target="_blank">http://www.cordclamping.com</a>
 

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It is my understanding also that babies who have had their cord clamped right away are at increased risk for anemia (thus the reccomendation for iron at 6 months for bf babies and from birth in forlmula fed babies) and also may be a factor increasing the chance of neonatal PDA. This condition is where the vessel that should close signaling the heart to pump blood to the lungs does not close. Sometimes even needing to be surgicly corrected. I don;t have any links to this, just things I picked up from a neonatologist and midwife.
 

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I was just going to say what Pam said - I'd state that they need to wait until the placenta is birthed, and that you'd prefer to do it naturally, with no pit to "help it out" <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"><br><br>
I had midwives that ALL said that they wait until the cord stops pulsing before they cut.....but not a single one of them did. And every one of those babies had post-birth problems, be it with breathing, jaundice, or illness. We waited until the next morning to cut Davey's cord (I just wrapped the placenta in a bedpad and kept it next to him), and he is the only baby I've had yet that did not have breathing problems or jaundice.
 

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Ah, say you're having a lotus birth and cut the cord yourself the next day! That way you won't have to worry about interfering busybodies coming near your child's cord with clamps and scissors too soon! The cord can pulse at the umbilicus for minutes/hours afterwards so if you decide to cut after the cord stops pulsing, make sure you check the cord yourself near the umbilicus!<br><br>
Here are some interesting tidbits i've found:<br><br>
"Some studies have shown an increased risk of polycythemia (more red blood cells in the blood) and jaundice when the cord is clamped later. Polycythemia may be beneficial, in that more red cells means more oxygen being delivered to the tissues. The risk that polycythemia will cause the blood to become too thick (hyperviscosity syndrome), which is often used as an argument against delayed cord clamping, seems to be negligible in healthy babies."<br>
(Morley G. Cord closure: can hasty clamping injure the newborn. OBG Management 1998;July:29-36)<br><br>
"Jaundice is almost certain when a baby gets his or her full quota of blood, and is caused by the breakdown of the normal excess of blood to produce bilirubin, the pigment that causes the yellow appearance of a jaundiced baby. There is, however, no evidence of adverse effects from this."<br>
(Morley G. Cord closure: can hasty clamping injure the newborn. OBG Management 1998;July:29-36)<br><br>
"One author has proposed that jaundice, which is present in almost all human infants to some extent, and which is often prolonged by breastfeeding, may actually be beneficial because of the anti-oxidant properties of bilirubin." (Gartner L. Breastfeeding, breastmilk and the jaundiced baby. Paper presented at The Passage to Motherhood Conference CAPERS 1998, Brisbane.)<br><br>
Botha attended over 26 000 Bantu women over 10 years, and reports that “a retained placenta was seldom seen…blood transfusion for postpartum haemorrhage was never necessary.” Bantu women deliver both baby and placenta while squatting, and the cord is not attended to until the placenta delivers itself by gravity.<br>
(Botha M. Management of the umbilical cord during labour. S.A. J Obstet Gynecol 1968;August:30-33)<br><br>
There is some evidence that the practice of clamping the cord, which is not practiced by indigenous cultures, contributes to both PPH and retained placenta by trapping extra blood (around 100ml, as described above) within the placenta. This increases placental bulk, which the uterus cannot contract efficiently against, and which is more difficult to expel.<br>
(Walsh S. Maternal effects of early and late clamping of the umbilical cord. Lancet 1968, 11 May:997)<br><br>
Clamping the cord, especially at an early stage, may also cause the extra blood trapped within the placenta to be forced back through the placenta into the mothers blood supply with the third stage contractions.<br>
(DoolittleJ, Moritz C. Obstet Gynecol 1966; 27:529)<br><br>
“Lotus Birth” by Shivam Rachana, International College of Spiritual Midwifery, Melbourne, Australia. There is a website with photos of lotus birth maintained by Shivam Rachana and partial chapters from her book. <a href="http://www.womenofspirit.asn.au/lotus_web/lotus.htm" target="_blank">http://www.womenofspirit.asn.au/lotus_web/lotus.htm</a><br><br><br>
Also, something to think about… mammals don’t sever the cord until after the placenta has been birthed and has stopped pulsing – then they bite through the cord (note, no tying or clamping it) and some proceed to eat the placenta and cord.<br><br>
Normal psychological third stage consists of the cord being left alone until both baby and placenta have been birthed, and waiting for the vessels in the cord to completely close off before severing the cord.<br>
This is a lot different from active management of the third stage that seems to be the norm now in hospitals and midwife-assisted homebirths. There is no need for clamping or tying off of the cord before cutting – and if there is a need, then obviously it is too soon to cut the umbilical cord.<br><br>
Also, a cut cord is a wound. An uncut cord with placenta and baby attached is a closed system and once the need (physical or emotional) for the placenta is gone, the cord comes away. Wounds take longer to heal – the cut cord stub seems to take longer to fall off.
 

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Lisa! I love your post! The longest I've waited with clients not doing a lotus birth is three hours, but I still had to clamp the cord. I also have had a client whose cord tie slipped the next morning after the birth and the baby lost quite a bit of blood through the cord - we waited a couple hours before cutting the cord, too.<br><br>
How long do you think it would take before a cord could be cut without clamping it or tying it off? I mean, do you think it's possible in under five hours or so? I haven't tried it yet, but I haven't had any clients wanting to try either. Maybe I should start asking!<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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If you don't want to clamp or tie, you have to wait until the cord is dried.<br>
We waited 12 hours, and his cord still bled a bit - I had to tie it really tight.
 

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I have no idea how long you would have to wait, probably until the cord is starting to dry out. This is one of the biggest reasons I chose lotus birth all the way because even if the cord is not pulsing to touch, I believe there is still some blood transfer going on between the placenta and baby. The placenta is an extended organ of the baby after all and the baby can and will still use it until there is truly no need for it. By then the cord has fallen off or has been pulled off.<br><br>
At my homebirth, my midwife told me the cord had stopped pulsing immediately and she was worried because DD was not breathing yet. We had a waterbirth so I was not too concerned about the slow start to breathing (It took 5 mins until DD's breathing regulated itself) and I knew that she was still attached to the placenta.<br><br>
If I had not known about the benefits of delaying cord cutting or lotus birth, i would of probably allowed the cord to be cut there and then. I think that would of been bad especially with DD not breathing on her own yet!<br><br>
Maybe the best delayed cord clamping is an all out lotus birth hehe
 

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<div>Originally Posted by <strong>pamamidwife</strong></div>
<div style="font-style:italic;">I think it's best to wait until the placenta is delivered, personally. Leaving the cord intact will help facilitate the birth of the placenta and will also give your baby the extra blood he/she needs.</div>
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<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/duh.gif" style="border:0px solid;" title="duh"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/duh.gif" style="border:0px solid;" title="duh"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/duh.gif" style="border:0px solid;" title="duh"><br><br>
Arrrrgggghhhhhhhh!!!!! I wish I had realized this BEFORE!!!! It makes total sense! And here I was thinking that simply waiting for it to stop pulsating before cutting was enough.<br><br>
I know my midwife waited for the cord to stop pulsating before clamping, but she clamped and THEN waited for the placenta to come out. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/banghead.gif" style="border:0px solid;" title="banghead"><br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> Marlena has been congested... I figured it was her big brother passing something (he's had a sore throat and has been coughing) to her. It's such a pain because I know breathing is hard for her... so I've been cleaning out her nose daily with the big bulb thing.<br><br>
She wasn't jaundiced at birth, but a few days later I did notice her eyes were a little yellow. Now that she's 2.5 weeks old, they are fine (and I didn't go out into the sunlight.)
 

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That was the one thing my first OB wouldn't comply with. She said...get ready for this...she had to clamp the cord, because otherwise the blood that was already in my baby would start leaking back into the placenta. Now when I think of it it's funny, but I wasn't laughing when she said it.
 

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I don't recall that being an option on my birth plan with dd's hospital birth. My homebirth I planned to delay, but the whole thing went "wham bam thank you ma'am". In less than 30 minutes I went from 9cm to baby and placenta out and cord cut. We did wait to cut the cord until after I delivered the placenta, but the placenta was out 2 minutes after ds was born so it wasn't all that long. His breathing was a bit raspy, but I assumed it was because we didn't suction him.<br><br>
Next time I'll plan to truly delay cutting the cord- a few hours or more, we'll see. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/yikes.gif" style="border:0px solid;" title="EEK!"><br>
A medical-school trained OB said that? Even *I* know that that is just plain idiotic, and completely against nature & the physiology of a pacenta! Sheesh. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll">
 

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You don't need to suction babies, really. By holding them with their butts higher than their heads and nursing them, all the raspiness will subside. It's just part of the transition. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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OK, now I have a dilemma! I really want to delay or even avoid clamping the cord this time. It was certainly my plan last time too, but despite her assurances to the contrary, my medwife clamped it immediately, long before I birthed the placenta. My daughter did then have some problems breathing, too, and the medwife and her Dragon Lady backup made it worse by suctioning the hell out of her, IMO. They even went so far as to run a freaking tube down her nose, and made her bleed. I can't <i>imagine</i> why it took 7 days before she could breastfeed... her nose was practically closed up.<br><br>
Oh, yes, but I digress! This time, we're going unassisted. (That kind of assistance I can do without.) I've been reading about the benefits of eating the placenta. One of my worries is postpartum hemorrhage, and I hear eating some placenta is great for that. But if I want to leave the cord and placenta alone until, say, the next day, how can I eat some if I need it? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/confused.gif" style="border:0px solid;" title="Confused">:
 

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You can always clip off part of the placenta and then just hold it in your mouth. You don't have to swallow it, just holding it in your mouth is enough. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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<div>Originally Posted by <strong>pamamidwife</strong></div>
<div style="font-style:italic;">You don't need to suction babies, really. By holding them with their butts higher than their heads and nursing them, all the raspiness will subside. It's just part of the transition. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"></div>
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Yeah, it wasn't too bad and the ped. didn't even say anything went we took him for his first well baby check. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> It was mainly just a light snoring sound when he slept. I get all misty-eyed remembering him being that small!
 
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