Umbilical cord question

[Emmas Mom]

I was looking at one of those "create your birthplan" worksheets & one of the questions was about whether or not you want to wait until the umbilical cord stops "pulsating" before cutting it. I've never really thought about this but what would the reasons be in waiting to cut it? I'm just wondering if we should consider it & what your reasoning is if you have or have not done it.

[amck]

my memory is fuzzy, b/c it's been a while since labor, but yes, we wanted to wait until it was done pulsating. can't exacly remember why. i think it was because we wanted baby to get every last drop of all the good stuff that is in the blood exchange b/w momma and baby. hopefully someone can elaborate on this more. have you read any of Ina Mae Gaskin's books?

[Tondi G]

If you are planning on banking the cord blood then they will need to cut it asap! If not then waiting is supposedly good cause they will get all those good blood cells that are still traveling through the cord! I never bothered making a decision either way. With my first the cord had to be cut before he could even get out of the birth canal cause it was wrapped around his neck twice! My second it was probably done before it stopped pulsing I don't know for sure!

Good Luck

~Tondi
Mommy to Mason 7/8/01 and Aidan 5/4/05

[DebbieJ]

http://www.gentlebirth.org/Midwife/cordRisks.html

~ deb
DS born at home 12/03
2 year check up: 25 lbs with clothes on and 35 inches!
BFARed for 20 months and 6 days
(Breastfeeding After Reduction is possible! www.bfar.org)

http://www.bfar.org/members/fora/sty...onths-bfar.jpg

[brittone2]

I skimmed the article Debbie posted and didn't see it in there, but I believe it lowers the risk of anemia in the first year of life as well. They get more RBCs into their system.

[babymama]

http://www.cordclamp.com/

We're asking our doc to delay clamping/cutting the cord.

Lydia
Mama to Santiago, born 11/16/03 and
One on the way, due 01/03/06

[Sillygirl]

Here is a link summarizing the pros and cons as published in peer-reviewed scientific literature. The review is done by the WHO:

http://www.who.int/reproductive-heal...apter4.en.html

Basically, there's not enough data to support early vs. late cord clamping. I was surprised to see how much lower the hematocrit (percentage of red blood cells) was in babies whose cords were clamped early! However, the review points out that this has not been shown to translate into better long-term outcomes for late-clamped infants.

Some of the other sites offered up I personally found to be biased and did not offer the same level of citations and even-handedness as the WHO site. And I thought the suggestion one site made to videotape yourself discussing late-clamping with your practitioner to be over-the-top. If you wish to have the cord clamped late, I don't think anyone can criticize you for it. But I also don't think there's enough evidence for benefit to go to such extreme measures as videotaping your talk with your doctor, which I think has a likelihood of damaging your relationship with him or her.

[tarahsolazy]

There are some situations where late cord clamping is not feasible or safe, such as babies born by C/S, babies with cords around their necks, babies who are in distress at birth and require resuscitation, etc. I think the site Katie posted is very nice, love the WHO. Its always nice to make a plan and discuss circumstances in which the provider couldn't follow it.

[american_mama]

Waiting to cut the cord seemed like a good idea to me, but I never really researched it nor asked for it with either of my births. There were things that mattered a lot to me during and after labor, and those are the things I put in my birthplan, discussed with my husband and midwife, and focussed my internal attention on. Those birthplan worksheets can be detailed to the point of rigidity, so I would suggest you ask questions about all the options, as you are doing, but only make certain issues your priority.

Also, my second daughter had ABO incompatibility, a very treatable problem that sometimes happens if mom and baby are different blood types. I believe in that situation, late blood clamping isn't a great idea, but I don't think you know if your child has ABO incompatibility until after they have born. (Many people confuse it with Rh incompatibility, which is more serious and does involve some preemptive measures.) I bring this up because ABO incompatibility is a rather common problem, yet wasn't addressed in most of the late clamping info. I'd seen. It's something to ask your doctor about and factor into your research.

[VClute]

In our birthplan, I requested that the midwife wait until the cord stopped pulsing to clamp, AND that the cord not be "milked." Some docs used to kind of milk the cord to shove all the blood into the baby rather than letting it pump there. That put TOO many red blood cells into baby and increased risk of jaundice. I also get a little scared at the idea of clamping the cord before the baby is even completely delivered. I've seen them clamped and cut when only the head is out!

In retrospect, a lot of the things I had in my birthplan weren't really NECESSARY for my ideal birth, but just letting the midwife know I had thought about these things made her, I think, more thorough in explaining what was being done and why when I actually delivered.

Amy in NC
mom to Dixon, born 2/14/05