Are you pregnant? Do you have a husband or partner who will be attending your birth? Have you talked to him about the birth? REALLY talked? Have you discussed WHY you don’t want an episiotomy, or why it is MUCH safer for the baby and for you to allow the placenta to be birthed before you cut the cord?
Oh? You hadn’t heard that? Well there are a few very good reasons to make VERY SURE that you have a discussion like that with your birth partner. It is very hard to look at somebody you love, who is in pain, and have coherent thought about medical procedures. So, knowing all the good reasons, knowing exactly why you feel the way you feel about things that will take place at your birth, knowing them so that they can recite them front, back, and sideways? It’s a really great idea.
So, back to the placenta thing (and you’ll see how this ties in to the whole of the post in a minute). Did you know that your lungs have little finger like thingies (like the scientific talk there?) in them that increase the surface area and allow you to absorb a greater amount of oxygen on the intake of a breath? Well they do. AND, did you know that, if you don’t have your full blood volume, they don’t stand up, and so they don’t work to increase your blood oxygen levels? That’s true too. So…when the baby is born, they do not have their entire blood supply in their body. Some of that blood is still pumping to it from the placenta. IF, as most hospital practitioners do, your birth attendant cuts the cord at what THEY consider to be “delayed” timing, around 2-3 minutes, it is entirely possible that your baby could go into respiratory distress, or like a former client of mine, actually have collapsed lungs, because the lungs cannot inflate properly without the full blood volume.
So, it used to be routine that doulas and others suggested that women put “please delay cord clamping/cutting until the cord has finished pulsing” in their birth plan. How well do you think THAT worked? Let me tell you. Okay, instead I’ll ask another question. If you are not a birth professional, have you ever seen a cord pulsing? Probably not. I’ll tell you what it looks like. It is thick. It’s a blue/grey color, and you can see the cords of the vessels in many cases, wrapped like rope around the outside of the cord. If you have seen a cord pulsing, have you ever seen a cord that was DONE pulsing? The chances of that outside of a homebirth are so slim that I can count on one hand how many hospital clients of MINE saw a cord that was done pulsing until we changed the wording in their birth plans around a bit (but I’ll get to that in a minute, I’m getting ahead of myself). Again, I’ll tell you what to look for. Imagine one of those long balloons that clowns make balloon animals out of. Imagine a white one, that somebody put air into, and then let the air out of. You know how it sort of gets floppy, and collapses into itself? That’s what a cord looks like when it’s done pulsing. WHITE, no longer blue/grey, and floppy, like a balloon with the air let out of it.
Okay, so when your baby is born, who is watching that cord?! Are YOU? Nope. You’re falling in love with the beautiful baby on your chest. Your husband/partner. NOPE. He is watching YOU watch the BABY. Soooooo…that leaves…the doctor, right? Riiiiiight. And how many hospital birth attendants can you imagine waiting up to 20 minutes for a cord to stop pulsing. Let me tell you, there are very, very few.
Next, did you know that it is VERY common, in fact, it is unlikely that protocols are different in many hospitals in the United States (okay, except in Baby Friendly hospitals, but they are few and far between, and there are NONE here in Michigan), for the baby nurse to take the baby from mom as soon as the cord is cut, to weigh, measure, do the Newborn Exam, wash, wrap, poke, prod, eye goop, and warm baby…to the tune of a minimum of sometimes 45 minutes? And you remember, right, that the first two hours are crucial for mom and baby insofar as bonding?
Hmmmmmmmm… how can we keep the staff from taking the baby away? Bingo. Don’t cut the cord till the placenta comes. INSTANT leash, really, that ties mom and baby together. And lets them bond, all the while, causing the staff to NOT have to give the baby oxygen or formula or do any of the other “necessary” procedures that they might “have” to do because mom and baby are separated at a time when mom and baby should ONLY be together. So now we're getting to the new wording on the birth plan. It should go something like, "We are choosing to wait to cut the cord until the placenta has been birthed."
And then, you should STILL have that conversation with your partner. Because in the end, even if you DO wait till the placenta is birthed, but the baby has yet to nurse, dad will have to look whomever has laid hands on his child FIRMLY In the eye, and tell them, “NO. They will stay together until the baby has nursed and has come of on their own.” No, “If that’s okay with you.” No, “I hope you don’t mind, but…” Simply, “We are choosing to breastfeed, and we are choosing to have mom and baby bond before procedures are done." If the staff comes back with "But that's not protocol, sir." He could say something like, " I am sorry if that is not protocol, but protocol is NOT the law, and this is what we have chosen for our care.” It all goes back to remembering that you are the consumer, that you are paying the bill (and trust me there WILL be a bill at the end of all this!), and that you DO have choices, even if the choices are not presented to you.
Did you know that you can do everything, to the benefit of the baby, but use PADDLES to restart the baby’s heart, while baby is on or very near (I’m talking touching, like between Mom’s legs) mom? And the benefits are great, too. Better oxygen saturation, better respirations, better blood sugar. Better outcomes. No, it’s not what they are accustomed to. But baby and mom are always better off, in normal healthy births, near each other.
Did you know that those little blue bulbs that they use to suck gunk out of your baby’s nose and mouth are AGAINST THE GUIDELINES set by the American Academy of Pediatrics for their NNR guidelines? You are NOT to suction, EVEN IN THE PRESENCE of MECONIUM, unless baby is not making attempts to breathe on their own. Using suction on a vigorous baby can actually cause baby to INHALE meconium because they gasp when the tube or bulb is shoved down their throat.
All you have to do is say “No thank you. We are choosing not to suction if the baby is making attempts to breathe well on their own.” Of COURSE you can tell if the baby is not vigorous. You have eyes. Talk to the baby, welcome them to the world. Oftentimes, it’s all it takes to bring a baby around when they are transitioning from inside the womb to outside the womb. Ask for a piece of gauze or use the corner of a sheet, and wipe the snot away that the baby brings up. Sometimes you can put the baby’s head “downhill” which will help the snot to run out. This is easily done on mom’s chest…put the little toes by Mom’s belly button, and the head by her ribs. Turn baby on it’s side so you can still look in it’s eyes and talk some more and fall in love.
In all, protecting baby and mom can be a scary job. It can seem like you are encroaching into a place where you don’t belong. That is often taken advantage of. I have heard medical staff say to fathers, “Do YOU have a medical degree?! What’s YOUR specialty!? NONE? Oh, okay, then let me do my job.” While doing completely non-evidence based procedures on a child. Luckily for that particular baby, the Dad looked at the doctor and said, “I don’t need a medical degree to use the words, I DO NOT CONSENT to the care you are giving my child. Stop now.” Many fathers, though, have been taught as they grow up to believe that the medical establishment is the be-all and end-all…that you must never question them, even if you feel strongly that what they are doing is not appropriate. And so they feel helpless as they watch their baby be unnecessarily poked and prodded, separated from it’s mother (who is often crying for the baby, and asking for them over and over again), for sometimes an hour or more.
It is such a good idea to talk a lot about what you want out of your birth, what the medical evidence is to support those preferences, and that you are the consumers, and in normal healthy births, there is no reason other than protocol NOT to have your baby with you until you are comfortable handing them over for the weigh and measure. Find your voice. If you are afraid that you might not remember to use your voice, consider hiring a doula, who can remind you of your birth plan, and what your preferences are before they take that baby out of your arms needlessly, causing a whole lot more trouble (oral aversions, trouble latching, trouble breathing, low blood sugar, the list goes on) than you bargained for.
Keep an eye out for a video for dads called, “The Other Side of the Glass” (you can watch the first ten minutes here on their blog: http://theothersideoftheglassthefilm.blogspot.com/2009/01/prenatal-human-rights.html
) It’s made for dads, but really is for anybody who plans to have a baby, or loves somebody who is having a baby.