Optimal cord clamping

What do you know about your babies cord?

Do you know that your baby receives Oxygen from her cord after she is born and that it keeps pulsating for anywhere from 5 to 45 minutes. She has two arteries taking away carbon dioxide and one vein giving her oxygen from you.

How long your cord pulsates for partly depends on whether you choose to have an active or physiological third stage of labour, and you may be recommended and offered to have an active third stage of labour if your labour has been long, you’ve received oxytocin to bring about contractions or if you are at higher risk of bleeding after you’ve had your baby.

Active birth of your placenta

With an active management of the third stage of labour (birth of your placenta) the oxytocin and possibly ergometrine drugs that you receive by injection can stimulate quicker separation of your placenta from your uterus and so your cord stops pulsating sooner. That said your baby receives the oxygen she needs from you, provided the cord is not clamped before at least one minute of age.

Natural birth of your placenta

Ideally your cord if all is well your cord can be left to stopped pulsating naturally, and your placenta separate naturally. Bleeding rates are reported to be the same in low risk births with physiological and active management. Your birth partner can cut babies cord when you feel ready. Ideally for physiological third stage your baby stays attached until your placenta is born! Or you can choose a lotus birth where you keep your placenta attached to baby until the cord drops off (with the help of lots of dried lavender!). For cord clamping you can choose to have hand ties rather than plastic clamps, which are lovely and soft…check out the very talented Umbical cord ties by heartstrings at ://m.facebook.com/profile.php?id=1431294533778523&ref=content_filter

With meconium

With meconium stained liquor your baby may need some additional support to start breathing at birth, and so this may indicate cutting the cord sooner. However some specially designed side tables are being created at top hospitals to aid starting neonatal resuscitation (giving baby her first breaths to expel fluid from her lungs) while she is still attached to the cord (thus still receiving oxygen).

What your midwife will do is assess immediately at birth how responsive your baby is. She will look at your babies colour, tone, reflexes and if your baby is starting to breathe. The first step, if your baby is not already breathing and active, with the cord still providing oxygen to baby as attached, is to vigorously rub baby down, rubbing toes, hands and body to stimulate the first cry. This cry helps your baby expel any fluid from her lungs, and if meconium stained liquor was present, get rid of this from her lungs. Your baby will then be breathing by herself.

If your baby doesn’t show signs of wanting to cry or react to the rubbing then your midwife will cut the cord, and will call for some additional help. This is by a buzzer that brings help quickly and can sound quite scary but more people = strong team.

If your baby doesn’t immediately cry

Your midwife will then take your baby to a warm flat surface, and with an additional rub down with assess babies colour, tone, breathing and heart rate as well as reactions. If there was a lot of meconium present at birth your midwife might suction some of this from babies mouth, before giving inflation breaths. These breaths are long slow breaths designed to inflate babies lungs and expel more fluid. After 5 of these, we would hope to see your baby starting to breathe by herself. Sometimes some babies need a little more time to come round, and we continue with shorter breaths for 30 seconds until we see baby pinking up and breathing herself. More rarely and if a baby has had a tougher birth, babies need more support with breathing and these breaths given by us to maintain babies oxygen levels need to continue.

and finally…

It’s important to remember that not all babies are born crying immediately and its normal for baby to take a little time to transition from being in the womb. Also your baby might be born a little blue and floppy but we expect by 5 minutes your baby to be nice and pink and alert.

Meconium stained liquor can mean your baby needs a little additional support too when she is born, often just an extra rub down or a few more breaths-that pesky poo!

Any questions or if anything happens in birth and you want to know more about your babies transition to this world ask your midwife or get in touch xxx

To learn more read the fantastic blog post at https://www.bloodtobaby.com/post/optimal-cord-clamping-and-meconium-stained-liquor

Gorgeous image of dad cutting the cord from @southwalesbirthphotographer
You can book Lilian Craze for birth photography to capture those magical moments when your first meet your baby ❤️

Midwife checking the cord pulsation by @liliancrazebirthphotography

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