Thursday, April 22, 2010

Hold your horses (er... scissors)

Cord cutting on the brain because of this and this...

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Tianna said...

Actual curiosity here, not bashing at all. Promise.

I had heard many of the benefits of delayed cord clamping, so when I birthed naturally at the hospital with a midwife, that's what I requested. The midwife agreed to let me wait until the cord stopped pulsing. Except after a few minutes she started very firmly telling me she had to clamp it because the placenta was about to come out. I didn't know any better, so I agreed. (Now I've done more research and understand that it's ok for the placenta to come out and not cut the cord. But it's all good, cuz she did still get a lot more time than the typical 30 seconds or less.)

My baby was jaundiced for 10 days. May I just say that I hate the bilibed? Ugh.

I didn't even consider that the two were related until someone pointed out an article on Wikipedia* that says, "The 2008 Cochrane review found that infants whose cord clamping occurred later than 60 seconds after birth had a statistically higher risk of neonatal jaundice requiring phototherapy."

Really? Huh. So, although I see the benefits of delayed cord clamping, I'm almost terrified to do it again because of the 10 days that I couldn't hold my newborn unless I was nursing her. I don't know that I could handle going through that again, knowing that I quite possibly caused it.



Buscando la Luz said...

Thanks for sharing your experience, Tianna. I'm sorry about your baby's jaundice.

I found an article by Dr. Sarah J. Buckley, an Australian MD, which I think gives a good answer to your question. She says:

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. (Morley 1998)

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. (Morley 1998). 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 1998)

Here's a link to the full article:

My thoughts are... Clearly excessive jaundice can be harmful, but if delayed clamping was always to blame for jaundice, the human species would certainly not have survived for so long.

It's possible the delayed clamping contributed to your baby's jaundice. I don't know. I'd say to go with your gut next time. If you feel that your baby's cord should be cut before the cord stops pulsing next time, then I think you should go with your instincts. I don't blame you for feeling the way you do. I'd hate the bilibed too, if I were you!

Hilary said...

My midwife told me it's up to me, but she prefers to cut the cord not immediately, but also not waiting for several minutes, as she too is convinced that jaundice is worse in babies who are left 'attached' for too long . . .
So, I've been researching this recently too . . . thanks for more links to read!

Carol said...

I recently attended a birth as a Doula and the doctor told my client "If you leave the cord attached the blood will go back into the placenta and leave your baby." I was shocked because I had never heard anyone say that before. Is there any truth to it?

Tianna said...

You should have told the doctor that the umbilical cord is a muscle not a drain. From what I understand, having the baby high above the placenta could cause some blood to go back down and having the baby way below it could cause the blood to flow in too fast. But if you just put the baby on the momma's chest (the most obvious thing to do), it keeps the baby at the right level to keep that wonderful muscle pumping the blood at the correct rate.

Amber said...

Before my son was born, my midwives agreed to wait to clamp and cut the cord until it stopped pulsing. However, because I ended up with a c-section, the cord was clamped and cut immediately. Here is my question, though: Since they have to remove the placenta anyway, could they not leave the cord intact as they remove the placenta, and then cut the cord once the placenta is out of the body? Have you ever heard of delayed cord cutting in the instance of a c-section?

Buscando la Luz said...

Amber- Dr. Fischbein in the video clip talks about how he does delayed clamping and cutting with cesareans, but I've never heard any other doctors talk about it.

I haven't really done much research on delayed cord cutting with cesareans though. Definitely something to think about!