Has anyone had experiences of their baby being resuscitated with the cord intact?(32 Posts)
I am keen to know if anybody has given birth to a baby either vaginally or by C/S where the baby required resuscitation at birth and the cord remained intact during the process. Has anyone had any experiences of fighting for resuscitation with the cord intact and if so where did you have your baby? Cheers x.
For premature infants if you leave the cord before clamping they can get an extra 50% red blood cells, helping them oxygenate effectively and the oxygen they are still receiving from the placenta helps tide them over until they are breathing.
Our independent midwives keep the cord intact in this type of situation whenever possible because it gives the baby additional few minutes of precious oxygen - makes sense if the baby is not breathing independently! However in a homebirth situation the resuscitation station is portable so is simply moved to where mum and baby are whereas most hospitals don't seem to have this facility so unfortunately can't seem to benefit from this amazing additional oxygen supply.
DS2 was resuscitated at birth and the cord was clamped and cut (had delayed clamping with my other 2). The midwife was very nice about it all, she asked me if it was ok to cut the cord (I wasn't going to say no but it was nice to be asked) and she stood at the side of the resuscitaire so we could still see him. He was back with me 2 mins after he was born according to the notes but it felt like 20 mins at the time.
It is not good enough! I wish that there were more HCP's like David Hutchon.
There is resuscitation equipment that is being used that makes it possible.
Traditional resuscitation units are not suitable for use at the delivery bedside, thus requiring the umbilical cord to be cut to allow the baby to be treated.
LifeStart overcomes this issue due to its compact design and ability to deliver all the required functions close enough to the mother to permit the umbilical cord to be left intact for the critical first few minutes, much of the research shows that at least 3 minutes gives the most benefit.
It is an additional emotional and bonding advantage, when that the baby does not need to be separated from its mother in the first minutes after delivery.
The unit has been designed with guidance from a multi-centre team of obstetricians and paediatricians who have been conducting extensive research on DCC."
amandine its done in some hospitals with the equipment shown, click able link now!
I guess its a funding issues well but it benefits the baby so would be great if this equipment was available in all delivery wards!
This equipment has been designed so babies can be resuscitated without clamping the cord.
So it is possible.
It's just not feasible, sorry. I'm a NICU nurse so attend resuscitations. The baby needs to be kept warm, hence the overhead heater on a resuscitaire - there has been massive amounts of research done that demonstrates the improved outcomes in babies kept warm, the only exception to this is the rare cases where the baby is actively cooled to prevent brain damage. They also need to be dried and either wrapped or placed in a plastic bag. The baby needs to be on a hard surface with good lighting, and good access to observe/intervene. Oxygen and suction need to be available. There may be several members of staff attending to the baby and they all need access, at a height that enables them to pass ET tubes, insert lines (some of which may actually need to be inserted directly into the cord) or perform whatever other interventions are needed. I just can't see how we could do that at the mother's bedside
sandy I have a midwife friend and she said about delivering c-sectionbabiesin the sac with placenta attached. Its beneficial for prem babies, amazing they can do it.
Yes, I see that sometimes logistics are a factor
Basically early cord clamping has been standard for years, you have to ask for delayed clamping.
And the resuscitation equipment in hospitals isn't set up to be used without cutting the cord.
But it can become and us at home births.
There is a a small board a bit like a vegetable chopping board! That can be brought to the bed to lay baby on so they haveafirm flat surface an do obviously the oxygen equipment needs to be portable etc.
And if the evidence shows its safer to leave it intact, maybe the reviews should be about how to adapt the equipment to work on the baby.
It to ignore the evidence and say we have built our room and equipment so that we have to disregard it.
Ambu bags are very easy to move around, suction can be portable...
Just thinking, not criticising
It very much depends on the situation surronding the delivery.If you deliver a very premature baby then cord clamping can be delayed to allow for transfer of blood from the placenta but only if you deliver vaginally if you have c section then the surgeon will deliver the baby in the sack and still attached to the placenta that is then transferred to the resusitaire.Also it depends on your definition of resuscitation.If your baby was born vaginally and just did nt cry with no indicators of distress in labour then what we describe as rescue breaths could be given insitu.However if your baby had been in distress during labour it is possible that baby had pooed this being the case we like to check air way before begining resuscitation.then it could nt remain attached as you need a really good view.Please do remember that healthy babies are born in a variety of shades of blue this is not usually a problem.Babys who are white in colour are the ones we worry about.Very prem babies need to be placed in plastic bags to maintain their temperature as quickly as possible after delivery so again any resus or treatment could not be done in situ.If you have concerns speak to the midwife she can reassure you.Ive just thought are you considering a lotus birth? Is this why you are concerned.If so you can tell staff at delivery and they can be prepared to be accommodating if this is safe for both you and the baby.There are loads of considerations I've just gone through the basics feel free to pm me if you think I can help.
It makes total sense to keep the cord intact ask as poss.
What's the argument FOR clamping it and cutting as soon as poss?
It delivers oxygen to the baby... So it makes total sense to leave it in place until the baby is breathing and providing its own oxygen
Resuscitation is an emergency situation where everyone involved works to strict protocols. This is essential to ensure that all parties know what they are doing and nothing gets missed.
The protocols themselves are based on evidence and subject to regular review. It's safe to say that any reliable evidence such as a Cochrane review would be taken into consideration, but must be balanced with other important considerations (eg the need to resuscitate on a firm surface with good lighting, enough space, and easy access to equipment such as suction etc).
If (God forbid) my baby needs resuscitation when he is born, I would not dream of interfering with the action trained professionals who are trying to save him. It's downright dangerous. And I have a medical degree.
One of the things said us about the blood being oxygen rich and also not clamping can give a baby 50% more red blood cells which helps with oxygenation.
Do you know its not something I have er thought about much but its interesting reading and there is call for resuscitation equipment in delivery rooms to be made more portable as it is for a home birth.
both babies were fine btw and handed to me about 5 mins after they were born.
In both cases my babies had to be resuscitated. For each of them, we didn't even know whether it was a boy or girl, and it didn't occur to us to ask - we didn't want to disturb the professionals who were basically saving our baby. It would simply not have occured to me to start 'fighting' for anything with them.
Apart from anything, after ds1 I was still in stirrups after a long delivery ending in ventouse, and with ds2 i had a spinal for a CSection. I'd have had to be wheeled over to where the equipment was, on my bed. In both cases the resusctiation equipment was several yards away, and on 'worktop' attached to the wall.
Even in the event of me and the (still not delivered) placenta and cord being taken over to where baby was; for me to have been near enough, the bed would have been alongside the bench. Where would the staff have stood while they were working on the baby?
Not to mention possible damage to my uterus should the cord have been pulled on while they were handling the baby and the placenta come away before it was 'ready'.
No, I did not try to say that the cord should not be cut while they were being resuscited, at that point I was just so exhausted and so worried about the baby, it would not have occured to me to interfere with how a bunch of professionals were doing their job.
I am however intrigued as to why you ask?
There wasa Cochrane report in 2010 that concluded delaying camping actually HELPS babies that need resuscitation.
dc1 didn't breathe at first but he was placed on my chest and the midwife or paed rubbed his back and had a oxigen pipe next to his phase. don't remember when the cord was cut.
Having just done a quick Google the WHO recommend delayed clamping and cutting even in cases where the baby needs resuscitation. The blood they get from the cord in the first minutes after the birth is oxygen rich and studies showed babies who needed resuscitation, particularly prem babies did better if cord clamping was delayed.
They are saying to delay it for a minute or two to make sure the baby gets the oxygen rich blood and the extra blood volume they need.
I can see how it would be very difficult in hospital unless they have portable resuscitation equipment.
I guess you can ask before the birth?
Happened so quickly for me when the turquoise blue baby was born that I didn't even know what was happening.
Why would someone want to challenge this?
DD was quickly fine. But that colour will always stick in my mind.
I would guess at a home birth the equipment is portable? Hence being able to do it whilst attached to the cord?
But in a hospital the have the little resucitare station that they use so would have to cut the cord to move the baby?
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