Delayed Cord Clamping after birth. Will you?(32 Posts)
I wasn't aware of the benefits of this, but it seems so sensible when you think about it.
The transition to breathing for themselves after birth must take babies a bit longer than the 20 seconds or so babies are often given after delivery before the cord is clamped. Their little lungs have to inflate and their blood pressure adjust. It seems so much more sensible to just wait a few minutes.
Apparently it used to be common practice to wait.
With my first dc I didn't have a choice and he was quite blue for a good two hours after birth but with DD I made them wait twenty mins to ensure she had all the cord blood and she was very pink and a much healthier baby. I'm not sure it would make a HUGE difference but we all want the best start in life for our babies so surely it's worth it?
I did with ds. The birth went very well, he came out, midwife put him on me and she cut the chord some time later.
We didn't do it with dd as she was whisked away to a paed as soon as she was born.
I did with DS1, DS3 and DS4. DS1 got about 20 mins I think. DS2 needed to be resuscitated so his cord was cut straight away. DS3's cord was still uncut when I pushed the placenta out, 20 mins after birth. DS4 got about 5-10 minutes I think but he was born by C-section so I think they were a bit reluctant to hang around for long with a hole in my tummy.
Yes, as long as the cord is long enough. You can't have the syntocinon injection while its still attached though, so it might take longer for the placenta to detach, but that's not necessarily a bad thing either
I think the link has some info about babies who need resuscitating benefiting more from DCC.
Apparently they are developing a bedside 'trolley' to be able to start treatment without cutting the cord.
Someone in the comments (paed) said that frequently the DCC meant that the resus treatment could be stopped or curtailed sooner than if they did ICC.
Obviously that won't apply in every case, but anything that is likely to help in that situation should surely be considered - particularly if it minimises interventions (which is how some view ICC).
Very interesting, was unaware of this. May ask for this, this time
I've had it with 3 out of my 4 babies.
With my first I nearly has a retained placenta and was almost in theatre, I read up a bit on it after that and decided on a physiological second stage for no 2, no problem placenta was out itself after 20 minutes. Third about the same, I do remember the last one taking about an hour but it's actually quite good because you just have to lie there snuggling your baby and waiting. No rushing them off and dressing them.
IME MWs don't like it, they treated me as odd, I think they want to get things done and dusted and get the paperwork done
You can still have the injection even if you want delayed clamping of a couple of minutes. Delayed clamping is really classed as anything over 1 minute, or up until the cord stops pulsing. Certainly most of the newly qualified midwives where I am do not rush to cut the cord. Interestingly, NICE are reviewing their guidelines on timing of cord clamping next year and the recommendation is expected to move towards delayed clamping even with an active third stage (the injection).
Yes, you can still have it, just not while you're still attached. Mentioned it because my MW used it as an argument not to.do DCC, said I'd haemorrhage without the jab (i didn't)
We didn't cut the cord for 10 mins or so, but she was really pushing me to have the jab.
I didn't know about this at the time when I'd given birth to DS, but his cord was left attached for a while before it was cut. The midwife said something about waiting for the white stuff to change colour or stop pulsing? I'm a bit hazy on what it was that she said now!
I did this with DCs 2 and 3. I also chose not to have the injection for DC3. The delayed clamping was fine - and both babies were much 'pinker' than DC1 who was an extremely pale baby (and is still pale now) - part of me wonders if he just didn't get enough of the good stuff before clamping.
Not having the injection was more of an issue - I think because the staff were very impatient, and weren't prepared to sit and wait for my placenta to come out in its own time. They were stressy and hassling me. After a very unpleasant half hour, I ended up having a midwife manually remove it. I personally think it would have just come away by itself if they'd given me more time - contractions were just beginning at the point they did the manual removal (then they got cross with me for involuntarily 'pushing'!)
Swwtkitty I think you're right about the MWs being under pressure to get on to the next delivery. So short sighted if it has the health benefits claimed for nbs.
Bumble manual removal sounds horrible I hate it when you've got residual doubts about your treatment like that (got a few myself). There's no knowing now is there, so they tend to stay with you as a doubt that can never be resolved.
The manual removal itself wasn't bad - quite quick and painless, in fact, the MW knew what she was doing.
It was the whole stressy atmosphere and the feeling that everyone was thoroughly irritated with me for having insisted on such a time-wasting effort that was clearly (in their eyes) doomed to failure. They kept saying 'if it doesn't come out soon you'll have to go to theatre'. FFS, isn't a natural 3rd stage meant to take an hour or two? They lost patience after 10 mins. IMO I could have just sat up comfortably in the bed, bf my lovely newborn and waited for contractions to get going again and push the placenta out. It wasn't even a busy night in the ward, although I imagine they were still short-staffed, so that may have been the reason.
"Not having the injection was more of an issue - I think because the staff were very impatient, and weren't prepared to sit and wait for my placenta to come out in its own time. They were stressy and hassling me."
This is what I'm scared of. I'm going for a physiological third stage this time, and I am really worry that they're going to be pushy with me, and nag me to have the injection. Last time they were pulling on the cord after 10 mins when the placenta wouldn't come out - it was horrible.
i have this in my birth plan this time for my home birth with dc3
I had this for DD2.
There was a bit of drama when she was born (suddenly progressed and lots of people rushing into a previously dim and calm room) and I had no contractions at all for the placenta. After an hour it still wasn't budging and my midwife was getting a bit concerned.
Her explanation was that they don't really like giving the injection after such a long wait because it increases the chance of retained placenta (and the main benefit of the jab is decreased risk of hemorrage - which after an hour they are pretty sure isn't going to happen). In the end she did though and it eventually came away.
I'd still go for delayed clamping for DC3, ideally until after the placenta was delivered, but I'd live with having it cut before (as I had to with DD2).
It's worth being aware that some units won't routinely plan for the jab with DCC, for the reasons I've mentioned above. So if you want DCC they want you to plan for a natural third stage and just have the jab if there seems to be a problem.
We did with DS.
My placenta got stuck though and I haemorrhaged. I had to have two injections and a catheter to get it out. Not fun.
Robot I think your MW was against a physiological third stage (which sounds like it went fine for you!), not delayed cord clamping. They are two different things. Unfortunately he sounds like her knowledge of the third stage wasn't very good though
She didn't want me to have either, tbh. Third stage may well have gone better if she'd not convinced me to have the jab after 45 mins, and I ended up in theatre
Needless to say I'm going for the hands off approach this time
Robothamster, I'm a midwife and if you're having delayed cord clamping and the injection then the injection can and should be given straight away. It is ok to give it even when the cords not clamped.
Some years ago there was concern that the injection would cause the baby to have too much blood volume and increase the chances of jaundice but this has since been disproven.
Where I work everyone has delayed clamping as routine and injection is given with the delivery of the anterior shoulder.
And if she was pulling on the cord when she hadn't given the injection then her knowledge of third stage is not good.
I didn't know anything about delayed clamping with DD1, and her birth was fairly traumatic so I don't know if I'd have been in a fit state to ask for it even if I had known.
However, I did with DD2, who was a home water birth. The midwives rolled their eyes slightly (it was 5am and they probably wanted to go home! ). I just cuddled her in the pool with the cord still attached, then once it had stopped pulsing, the cord was cut and DD2 was passed to DH for a cuddle while I passed the placenta (didn't need an injection - it just popped out when I pushed) and got out of the pool. All very easy!
How delayed is delayed in that scenario Viva? Interesting that a delay is becoming standard in some units.
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