NHS cutting cord too early?

[wifflepuss]

Just wondering what peoples thoughts were on this.

www.guardian.co.uk/society/2013/apr/25/cutting-cord-babies-risk-nhs

Thanks, Martha. I'm midlands too...
Baby was delivered to the neonatal team in her amniotic sac. I think this is where the confusion happened-but I need to check at the debrief. I don't think that was standard practise at the hospital (I wasn't at my own hospital but transferred) but the obstetrian was also from elsewhere?
Baby is very well. Finally home.
I will have a look for that film. Thank you.

duchese she was anatural delivery. I remember her not kicking much during pg. Could feel her hiccuping lots, and some glitters. Just thought cos I'm chunky, the movements weren't great. When pg with dd, she used to beat my tummy like mad, and could see her hands, feet, legs when she moved.

As a result of the cord breaking, the placenta was retained. But, eventually came out with synocotyn (sp)

It'd a miracle she's here, as she could have been smotheredin the birth canal :(
The mw was flapping loads, as she'd never seen anything like it, and could donate the cord fir stem cell research.

I wanted to delay the cord clamping and possible natural 3rd stage (depending on how I was feeling after delivery) but in the end my DD birth was so traumatic that I didn't have a choice. Cord cut asap as she has shoulder dysocia (sp?) and they had to check she was paralysed, then I had the injection, they tols me as they were giving to me. However, I think I'd have opted for it anyway after that birth.

I think its a great idea but I guess its not always possible. My friend had it while her DS was being assisted to breath for 8 mins I guess it possibly saved his life?

I had requested delayed chord clamping too but when he emerged after a very traumatic time, the chord was wrapped around my ds 's neck twice so had to be cut free there and then by the doctor.

He is now a week old and doing well

I'm a bit confused by all this and unsure what to do in this pregnancy.

DD was born in a birth centre, very natural (but quick active stage) labour, midwife didn't really touch me. DD was born, I bfed with cord intact until after placenta was delivered then cord cut. Roughly an hour.

DS was a BBA at home with paramedics. Quick labour, bit hectic and crazy but not traumatic. I beeged for the syntocin, no idea why now....I'm assuming I just wanted it over quick and they didn't have gas and air. Paramedics were calm and soothing and delivered baby and immediately cut cord. Placenta delvered naturally fairly quickly, when midwife arrived they explained they don't give syntocin unless a midwife is present or there appear to be complications.

This baby I was assuming I would go for delayed clamping and no syntocin, hoping for a calm birth like dd's. However at booking they said they strongly recommend me having the injection as the risks are higher due to it being my third.

littlethey said the same to me for no 3, 4 and 5 but it was fine. Did you bleed heavily with your others.

There is a study to show that in healthy mums in places with good healthcare is the UK,Europe etc that being a 'multipareous' mother does NOT raise your risk of having a pph. It was linked on another thread recently.

I had delayed clamping but after had the injection, that was what I requested, I had no idea that was not guidelines, why is syntocin not recommended after delayed clamping?

I was told that it had to be given within a certain time frame after delivery or the drug would pass into me (I think - I may be mis-remembering). I also wanted delayed clamping but was advised against after delivery (although I did manage to hold them off for about a minute which is when I was told about the time frame).

I wanted to delay cord clamping, and said so in my birth plan but somehow at the final stages of labour I agreed to having the injection to speed up delivery if the placenta (and therefore cord had to be clamped). There were no complications, and no clear reason why my midwife felt this had to happen. I regret agreeing to it and wish I'd have stuck to my original plans. I'm sure the common practice of cord clamping is just about convenience and speeding up third stage labour!

Viva do you have two midwives at a birth? Because otherwise it's impossible to give syntometrine with the anterior shoulder! Most of what I have read says there's no evidence that giving it with the shoulder or immediately afterwards has an effect on PPH rates, but I will look again. Also I too have never found any research regarding this supposed 'shunt' of blood from synt. With my current mentor we tend to wait a minute, clamp and cut, then give the jab but some other midwives give it, then wait to clamp and cut. I can't decide yet what my usual practice should be.

no idea what happened with DS (DH can't remember either) but he was born on an MLU and I had a physio 3rd stage - does that mean his cord would have been left pulsating?

He was lightly jaundiced but I'd already read up on it so wasn't worried. We were told to leave him by the (closed) window as much as possible (so as to "sunbathe" him but not in direct sunlight) and that sorted things pretty quickly.

Probably having a homebirth this time round and will ask for delayed clamping.

As far as I'm aware, it's quite common for newborns to be lightly jaundiced, and if properly managed that's not a problem at all, and not a good enough reason to clamp the cord immediately.

A friend's first-born was a bit jaundiced, and some idiot of a midwife told her not to breastfeed! As a first time mum, she went along with that and was sorry later.

If you had a natural thitd stage i would think they would have done delayed clamping.

Whrn i gave birth they called a second midwifd for delivery but she literally stuck her head round the door as i delivered, not involved at all and barely in the room for a minute!

My ds had delayed cord clamping he was later found to have severe jaundice made worse by the delayed cord clamping but we were not told that could happen.

There's research by Prof. Cecily Begley, Trinity College Dublin, which says that there is no risk to waiting to administer syntometrine and to wait to see if it's needed as it is effective within seconds. There is also a suggestion that syntometrine given prophylactically may make it less effective in the future - so if you give it to a woman 'just in case' at birth the first time, then a dose given when she has a second or subsequent baby may not work so well.

Info from AIMS also seems to back up that there's no reason why syntometrine cannot be given later, if it is needed, rather than prophylactically. It's ok to try a physiological third stage and then have syntometrine later on if the placenta doesn't appear or if PPH does occur.

fliss that was my understanding as well and is what my midwives said to me.

Had mine at home and natural third stage both times. I know I asked for delay with dc3 nine years ago and midwife was fine about it but don't remember a huge rush to clamp and cut with dc1 and 2.

DD2 was born in the car and everyone seemed OBSESSED about whether we'd cut the cord or not - it was the first thing the rapid responder, ambulance staff, hospital staff etc asked us. TBH it never occurred to us to cut it (what with??), rather the opposite, that there were very real benefits to NOT cutting it until we were somewhere warmer and more stable.

Bramshott they may been more worried about the risk of neonatal tetanus from cutting the cord with an unsterilised instrument.

How long does it take for it to stop pulsating? I thought I had delayed clamping with DS's birth. He was put on my chest as soon as he was born (still attached) and no one touched the umbilical cord for quite a while. But reading duchesse's comment now I'm not sure, as I did have the injection to speed up delivery of the placenta.

Fliss- There is also a suggestion that syntometrine given prophylactically may make it less effective in the future - so if you give it to a woman 'just in case' at birth the first time, then a dose given when she has a second or subsequent baby may not work so well. - That is so interesting. I must try to find the research.

My dd was born blue and not breathing, the midwife bless her didn't clamp the cord properly in her haste to resuscitate my baby and as she cue at the cord a load of blood came pumping out, my feet were sitting in blood up to my ankles :(
It was horrible but she successfully got her breathing and she was (and still is) absolutely fine. However she did get very jaundiced afterwards and we had to stay in hospital on a phototherapy bed and had to have a cannula put into her tiny little hand.

I requested that my baby's cord clamping was delayed, and regretted it.
She went on to develop AOB incompatibility jaundiced, and spent a week in the neonatal unit. She was nursed with double UV lights, and had cannula fitted and was fed via a nasogastric tube. The paediatrician said that the delayed cord clamping contributed to the severity of the jaundice.

I asked for DS's cord clamping to be delayed when he was born 17 years ago. The midwives weren't terribly keen because they wanted to give me the injection to deliver the placenta, but they 'humoured' me until the cord stoped pulsating, which took IIRC, about five minutes

I had physiological 3rd stages with dds 2 and 3. But they are very quick to try to give you the injection to expel the placenta without asking you.

A couple of weeks ago I was being treated for threatened pre-term labour at 27 weeks and was approached to be part of a trial looking at the immediate and long-term effects of deferred cord clamping in very premature babies. We asked a lot of questions and in the end decided that we couldn't be part of the trial and risk being in the control group who would have immediate cord clamping. What they would do for such a premmie is make the mother's bed higher to be a touch higher than the resuscitaire and with the cord still in tact, start to treat the baby (primarily intubate and ventilate) then after at least two minutes clamp and cut the cord. They could clamp and cut at any point if it was deemed medically necessary for me or the baby. I asked to have the third stage drugs after the cord was cut (as I've had a previous PPH and retained placenta) and they were happy with that. I felt bad not taking part in the trial but at only 27 weeks we felt it would be reckless to choose anything else when there is already building evidence that very premmie babies need less blood transfusions and are less likely to have an intra-ventricular haemorrhage if they have had deferred cord clamping.