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June 2011 Moms
kimbo1216
member
Is delayed clamping worth fighting for?
kimbo1216
member
So, a couple of weeks ago, I brought up to my OB that I am very interested in delayed cord clamping. She said she didn't know much about it and would research it and get back to me. Well, the next week she said she looked into it, and she doesn't recommend it. Her words, "if you want to risk giving your baby jaundice, then we can delay it for 30-40 seconds max." When I said that I had read in a number of places that the "risk" of jaundice has been unfounded, her response was that "you can find an article to back up just about anything."
Although I do kind of agree that you can find an article to back up anything, I think this boils down to the fact that she is very set in her ways and maybe I'm a little too Bohemian for her. I don't even think I'm that Bohemian. I think I'm just more open-minded than she is.
I don't believe in private CB banking and donation is not an option for us. So what would you do? Would you fight for it? Or just let it go?
This discussion has been closed.
Re: Is delayed clamping worth fighting for?
It decreases risk of anemia, increases iron stores, decreases risk of bleeding on brain. There are others I can't think of off the top of my head.
Here's the link to the article I got this from: I think it does a good job of explaining it. However, since it's from a MW web site, I'm hesitant to share it with my OB. Something tells me she wouldn't like that.
Risks associated with early cord clamping are 1, 2
? Hypotension (low blood pressure)
? Hypovolemia (low blood volume)
? Anemia (low hemoglobin/iron)
? Hypoglycemia (low blood sugar)
? Metabolic acidosis
? Respiratory Distress Syndrome
? Hypothermia (low body temperature when deprived of warm blood flow through the cord)
? Higher incidence of cardiac murmurs in the first 14 days of life
? Suboptimal flow of blood to the gastrointestinal tract increases risk of necrotizing enteritis in preterm babies
? In the asphyxiated new born: Brain damage, including possibly cerebral palsy and autism
Benefits of delayed cord clamping include2
? 50 % larger red cell volume, enlarged blood volume, and higher hematocrit. The iron in these cells is stored by the body, which protect your baby from anemia. The notion that babies who are breastfed are anemic becomes irrelevant.
? Increased amounts of white blood cells and antibodies which help the baby to fight off infections
? Increased platelets, important in normal blood clotting
? Increased plasma proteins and other nutrient benefits that come with adequate perfusion
? Better circulation in the first few hours after birth due to increased systemic vascular resistance
? Less trouble with maintaining a normal temperature
? The baby receives his or her own stem cells. These may contribute to health and well-being in ways we do not fully understand yet.
You nailed it on the head!
I have another appointment in the morning. This may sound horrible (even flamable), but I'm trying to decide if I should bring it up then or (the flamable part) just wait until I go into labor and hope she's not the on-call doctor and just tell them it's what I want. I've done my research.
Definitely bring it up! You have done your research (hell bring all the studies that you have on it!), and she is your baby!! Unless your OB can give you solid medical reasons as to why you shouldn't delay (other than if a medical emergency arises during the birth obviously) then there isn't sufficent enough reason not to delay cord cutting. Your OB probably doesn't want to have to hang around a few extra minutes.
I agree with this. I'm fighting for delayed clamping. The unfounded risk of jaundice outweighs the long-term benefits to me.
FYI- Although most internet sites suggest to delay clamping until the cord stops pulsing (and I've read that can take 15-30 minutes), almost all of the delayed cord clamping studies (in the primary journal literature) suggest that the benefits are achieved in the first 60-90 seconds after a vaginal birth. Most of these studies were done with premature infants and infants born in third world countries with high anemia rates, but a few looked at full term infants too. Most were just looking at immediate post-delivery iron status and anemia outcomes in the first few months after birth (some recorded data for 6 months). Keep in mind that there have been no long term studies done to really analyze the developmental benefits of delayed cord clamping.
Additionally, there was no effect of delayed versus immediate cord clamping in infants delivered by cesarean in the few studies I read that addressed that situation.
The present viewpoint in the literature is that the timing of clamping is still controversial, however, recent reviews do mention that the jaundice issue is benign.
So if you can get her to the 1 min mark at least, I think you can feel pretty good. If not, some papers say that clearing 30 seconds will do the trick too
PS- You can search for "delayed cord clamping" in PubMed and look at the original primary literature- maybe there will be an article you can print out for your midwife? Generally, you can access the abstracts for free at least with the conclusions clearly stated... I'm affiliated with a University so I can see the whole article just not sure what you can access.
Good luck :-)
As long as their is no risk to the baby (meconium, other risk factors), delaying cord clamping by even 30 seconds can be extremely beneficial. I would fight for it. It's not like you're asking to have a lotus birth or something else much more extreme.
I asked about delayed clamping at our hospital birth class (because we were told to decide if we wanted to donate/bank or not, and how to go about it), and the nurse who was teaching the class just replied "that's something only midwives do. Doctors don't do that; it's never done here." This is one of the most prestigious womens' hospitals in the country - Prentice hospital, which is the hospital affiliated with Northwestern, in Chicago.
This same nurse spent much of the class telling us ways to try to avoid many common interventions, epidurals, pitocin, etc., if we wanted to - which is much more "liberal" than pretty much any of the doctors I've met with. So her response surprised me!
Is anyone delivering at a major medical/teaching/research center and having delayed clamping?