The Evidence Says: Delayed Cord Clamping

One of the emotional touch points circulating in social media regarding birthing practices is the subject of delayed cord clamping (DCC).  Medical and nursing schools may not be teaching about DCC, perhaps in part due to the December 2012 ACOG Opinion² that stated “Currently, insufficient evidence exists to support or refute the benefits from delayed umbilical cord clamping for term infants that are born in settings with rich resources.”

ACOG does support DCC in preterm infants.  “As with term infants, delaying umbilical cord clamping

to 30–60 seconds after birth with the infant at a level below the placenta is associated with neonatal benefits, including improved transitional circulation, better establishment of red blood cell volume, and decreased need for blood transfusion. The single most important clinical benefit for preterm infants is the possibility for a nearly 50% reduction in intraventricular hemorrhage.”

However, Dr. Mark Sloan, author of Birth Day: A Pediatrician Explores the Science, the History and the Wonder of Childbirth, states that “medical habits can be glacially slow in changing.” http://www.scienceandsensibility.org/?p=5730

A 2011 study³ of 400 full term infants found that delayed cord clamping resulted in improved ferritin levels and reduced the prevalence of iron deficiency at 4 months of age.  Added to that, dcc also reduced the prevalence of neonatal anemia at 2 days of age without increasing the rate of respiratory symptoms or need for phototherapy.  Conversely, early cord clamping has been linked to hypovolemia, anemia and low iron stores in the neonate.⁴

In 2009, the Academic OB/GYN Blog¹ stated that “after some research I found that there was some pretty compelling evidence that indeed, early clamping is harmful for the baby.  So much evidence in fact, that I am a bit surprised that as a community, OBs in the US have not developed a culture of delayed routine cord clamping for neonatal benefit.”

Mary Ceallaigh, Lotus Birth advocate and midwife educator was interviewed by the New York Post⁶ saying that the best reasons for a Lotus Birth is that there is complete transfer of placental/cord blood into the baby and allows for the mother and baby to focus on bonding rather than “who’s cutting the cord”.

We are just beginning to see a surge in evidence supporting DCC.  Initial research remains positive.  And as Levy⁵ stated, “the balance of available data suggests that delayed cordclamping should be the method of choice.”

References

      1. http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/

2. http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/Timing%20of%20Umbilical%20Cord%20Clamping%20After%20Birth.aspx

3.       Andersson, O. et al.   Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomized controlled trial.  BMJ 2011; 343: d7157.
4.       Hutchon, DJ. Immediate or early cord clamping vs delayed clamping.  Journal of Obstetrics and Gynecology 2012 Nov, 32(8): 724-9.
5.       Levy, T. and Blickstein I.  Timing of cord clamping revisited. Journal of Perinatal Medicine 2006; 34(4): 293-7.
6.       Lotus Birth trend keeps umbilical cord and placenta attached to baby for Days.  New York Post April 11, 2013.

Quite Possibly The Shortest Blog Post I'll Ever Write...............

We cannot and should not expect physicians and nurses to know how to care for physiologic birth if they have never been taught.  

Childbirth Education: It's not just for expectant parents.

International Week for Respecting Childbirth May 20-27

The International Week for Respecting Childbirth (SMAR = Semaine Mondiale Pour L’Accouchement Respecte) is an opportunity to express a common commitment through an international campaign for the respect of the birth. It takes place every year in May. Each Global Week focuses on a specific theme. The theme for 2013 is "Please do not disturb, Birth in progress". (To get more information on this global even, go to www.smar.info.)

Imagine what we could accomplish if we all worked together!

So let’s try it!

International Week for
Respecting Childbirth
May 20-27, 2013

First, friend me on Facebook and encourage all of your peers and colleagues to do the same – then, look for the Facebook Event “International Week for Respecting Childbirth” – join it!

Second, begin now to write blogs, update your Facebook page and Tweet about the importance of attending childbirth education classes.  While this is not quite the Global Theme, you would learn about undisturbed birth and laboring the way the mother wants to labor if you attended childbirth classes!

As birth professionals, regardless of the smaller segment we represent (childbirth educators, doulas, nurses, physicians, midwives, massage therapists, lactation consultants and others), if we band together toward one common goal, we CAN and WILL make a difference.

Are you with me?

What Kim Kardashian's Pregnancy Can Teach Childbirth Educators

Do you feel like voyeur into Kim Kardashian's life?  

Sometimes, I feel like I do.  All over my newsfeed are stories about Kim's pregnancy, body hair

nightmares, weight gain, fears, anxiety, relationships, parenting.....WHEW!

And I began getting annoyed with it all until I had an AH HA! moment.  

Kim Kardashian's publicist(s) really do a great job with social media!

Think about it. She can't even take a breath (Lamaze or otherwise) without everyone knowing about it.  We'll probably know the contents of her Lamaze bag, layette, how she is feeding the baby and so much more than we should know.

Now, if childbirth professionals took a topic each "trimester" and infiltrated social media like that, we could very well change the face of maternity care in any country....in every country.

Just sayin'.........

Why Childbirth Education Teaching Strategies Need to Change

Who is the person in childbirth education classes now?  

Gen X and Gen Y - the two most tech savvy generations, who also use social media and online learning to expand their knowledge base.

Unless guided to evidence based websites and blogs, even the most knowledgeable expectant Gen X or Y will still have a solid element of fear.  Hard to believe, studies are showing that women are not exposed to normal, uncomplicated vaginal births in the media (Morris & McInerney, 2010).  These same women may be unaware of childbirth education philosophies and practices that support low/no intervention births or physiologic births. This along with the rising cesarean rate, elective induction rate and high epidural rate, this makes for an evidence-based information dissemination nightmare.

According to Dr. Julia Kish-Doto, women of childbearing age rely heavily on social networks for health

information including childbirth knowledge.  By using social media to expose Gen X/Y to physiologic birth concepts, we may increase awareness of physiologic birth and decrease the fear factor.

It is also important to point out that women and especially mothers are the major influencers on their family units in regards to medical care.  If they do, in fact, rely on social media for information about pregnancy, birth, infant feeding and other medical issues, as childbirth professionals, this has become a mandate for us to assimilate social media into our education/teaching strategies.

Childbirth education using social media has a major advantage to the typical childbirth education classes: information can be accessed at ANY time day or night.  Information regarding newborns, breastfeeding and postpartum issues are available at 2 a.m. as well as 2 p.m.

We have a unique opportunity to wage a dynamic and comprehensive information campaign that can change the way our society looks at childbirth.  May is coming up and contains Mother's Day (May 12) and International Week for Respecting Childbirth (May 20-27).

What if, for one week, we all joined together in one gigantic media campaign to set right the information about childbirth, physiologic birth, evidence based information?

Imagine...........

References:

Kish-Doto, J. RUprego? The Role of Social Media to Educate Young Women about Low Intervention Childbirth.  Cases In Public Health, Communication & Marketing. Vol IV, Summer 2010.

Morris, T. and Mclnerney, K. Media representations of pregnancy and childbirth: an analysis of reality television programs in the US.  Birth 2010; 37(2): 134-40.

Interview with Katrina Kaslavsky Part 3

Interview with Katrina Zaslavsky Part 2

Facebook and Breastfeeding ~ What's all the hoopla?

What is the old saying?  If you don't like what's on television, change the channel.  

The same holds true for Facebook.  And also, Facebook should get a grip on reality.

Last week, Facebook pulled Christie Kemp's Breastfeeding Mama Talk  Facebook page because it violated their policy on nudity. Seriously?

Kristy Kemp created the breastfeeding support page on Facebook called "Breastfeeding/Mama Talk” and the page began to help other mothers. Kemp had her son three years ago and felt the need to stop breastfeeding him after 3 months because she felt embarrassed.

"When I started the page, women kept coming to me saying how embarrassed they were, how ashamed they were to breastfeed in public," Kemp said. "And I realized it was a bigger issue than what I even imagined."

She's posted many breastfeeding photos but one in particular got the attention of Facebook. The photo was taken down because the social media site said it "violated" policy. Kemp was locked out for 24 hours. After the lock out  was over, she posted another photo. It showed a mom breastfeeding her baby and five year old at the same time. It was also removed. This time, she was subjected to a three day lock out by Facebook.  Kemp used the media against Facebook and outed them.  Since then, Facebook allowed her back on her site and has issued an apology.

At 5000+ "likes", I don't think that Kemp is on the wrong track.  Quite the opposite.  I do believe that Facebook's reaction is a narrative on our society's view of breastfeeding: it is porn rather than a method of feeding a baby. Are we so small minded that we cannot see that food is being given to a hungry child when breastfeeding is shown?  

Perhaps instead of attacking mothers who already feel embarrassed and ostracized for breastfeeding in private and public, they should keep their focus on their software updates, which in my humble opinion, illustrates an epic fail.  Their latest redo doesn't load properly on a computer and often when one tries to "view more stories", one is taken back to the top of the page to stories already seen on the newsfeed.

Stick to something you know, Facebook.  Leave mothers who are feeding their children alone.