Embracing_mothers

Posted • New research has added to our knowledge that it is better to wait for a while after a baby is born before clamping and cutting the umbilical cord.

We now know that it is safe to wait six minutes after birth, even when an oxytocic drug is given.

Waiting, which is sometimes called optimal or delayed cord clamping, means that the baby has the chance to get all the blood that they need from the placenta before the supply is cut.

We have known for many years that it is better to wait than to interfere, but it is taking a while for things to change in some areas.

This is because, in recent decades, there has been a tendency to interfere with birth.

But a new research study further confirms that there are advantages to waiting.

Winkler et al (2022) carried out a study in Sweden in which they compared the outcomes of 904 mother/baby pairs whose cords were clamped and cut at different times after birth.

These were the key findings:

Research shows that it is safe to wait six minutes before clamping the cord.

(It may be safe to wait longer, and many women choose to do so. But a study can only report what it researched, and six minutes was the average time in this study.)

Waiting longer doesn't increase the chance of phototherapy being needed (for jaundice).

It doesn't matter whether oxytocin is given before or after cord clamping.

I have blogged about this study at https://www.sarawickham.com/research-updates/delaying-cord-clamping/

Winkler et al (2022). Cord clamping beyond 3 minutes: Neonatal short-term outcomes and maternal postpartum hemorrhage. Birth https://doi.org/10.1111/birt.12645

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Posted • .birth.club 📷

Everything you need to know about....

THE CERVIX

Did you recognise it from this photo? Good old, trusty cervix.

Birth stories are always littered with "I was 5cm when I was admitted", or "I was only 3cm so was sent home" (let's not start on the use of "only" at this point....that's a whole other post)

We are OBSESSED with how dilated the cervix is during labour (no one ever wants to know how effaced you were, or its position when you tell yous birth story), but do you have an idea of HOW It opens up?

Many of us often picture it as this hole that just gets wider and wider of it's own accord, but that's not entirely true....
..imagine you are putting on a jumper. The head hole looks pretty small when you get it out of your wardrobe, but as you pull the jumper over your head, the opening slowly gets wider and wider until *pop* your whole head comes through - THAT'S more like how the cervix works.

With each contraction the muscles of the uterus that run from the cervix to the fundus (the top) contract, and become slightly shorter each time. This shortening has 2 main effects:
1. A gathering of uterine muscle at the top of the uterus (fundus), and
2. The gradual opening of the cervix, pulling it over the head of the baby.

So what does knowing the dilation of the cervix tell us?
..............well.......not a huge amount in an uncomplicated physiological birth. Being 2cm dilated doesn't mean your baby can't be born in 15 minutes, same as being 9cm doesn't mean you've not got 10 hours left!

"Your cervix is not a crystal ball"

This is one of the reasons I encourage everyone to consider whether they would like to consent to routine vaginal examinations or not.

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👇 Tell me below, did you consent to vaginal exams?