Heads up, Babywearing Fanatics! ;)

Check out the Spring Baby Carrier Giveaway at Lil Daisies, a fellow blogger! $50 towards a friend's baby carrier store, and good publicity for two hard working AP mamas! :O)

Article about Delayed Cord Clamping

Good article about why the cord should not be clamped/cut until it stops pulsating after birth.

Excerpt:

"Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial(7)

Randomized 72 VLBW infants (< p =" 0.03)" p ="">

The Influence of the Timing of Cord Clamping on Postnatal Cerebral Oxygenation in Preterm Neonates: A Randomized, Controlled Trial (8)

Randomized 39 preterm infants to immediate clamping vs. 60-90 second delay, and examined fetal brain blood flow and tissue oxygenation. Results showed similar blood flow between groups, but increased tissue oxygenation in the delayed group and 4 and 24 hours after birth.

Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomized controlled trial(9)

Randomized 476 infants to immediate or 2 minute delayed clamping and followed them for 6 months. Delayed clamped babies had higher MCVs (81 vs. 79.5), higher ferritins (50.7 vs. 34.4), and higher total body iron. Effects were greater in infants born to iron deficient mothers. Delayed clamping increased total iron stores by 27-47mg. A follow up study showed that lead exposed infants with delayed clamping also had lower serum lead levels than immediate clamped infants, likely due to iron mediates changes in lead absorption.

A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints(10)

Infants delivering at 30 to 36 weeks gestation randomized to immediate vs. 1 minute delay. Delayed group had higher RBC volumes (p = 0.04) and hematocrits (p < p =" 0.03)">

Immediate versus delayed umbilical cord clamping in premature neonates born <>

Randomized 60 infants to clamping at 5-10 seconds vs. 30-45 seconds. Delayed clamping infants had higher BPs and hematocrits. Infants <>

And that’s just some of it. I’ll be happy to send you an Endnote file with a pile more of you’d like it. If the burden of proof is on us to prove that immediate clamping is good, that burden is clearly not met. And furthermore, there is strong evidence that delaying clamping as little as 30 seconds has measurable benefits for the infant, especially in premature babies and babies born to iron deficient mothers.

So basically, we should be doing this. I’m going to try to effect some change in my department, but there are a lot of things that need to happen for us to change as a general culture. It can’t just be the OBs. L and D nurses and pediatricians need to buy in as well.

Some people will argue that premature babies need to be brought to the warmer right away for resucitation. I don’t know the answer to this, but it’s worth study. One might think that it is important to intubate a very premature baby right away, but I have to wonder if that intact cord will be better at delivering oxygen to the baby for 30-60 seconds than the premature lungs. Particularly in cases of fetal respiratory acidosis, there is strong logical argument that a baby might be better resuscitated by unwrapping the cord and letting it flow a bit than trying to oxygenate it through its lungs. Until that placenta is detached, you have a natural ECMO system. Why not use it? Certainly there are exceptions to this logical argument, abruption being the biggest one, and perhaps even severe pre-eclampsia and other poor feto-maternal circulation states.

I wonder at times why delayed cord clamping has not become the standard already; why by and large we have not heeded the literature. It is sad to say that I believe it is because the champions of this practice have not been doctors, but midwives, and sometimes we are influenced by prejudice. Clearly, midwives and doctors tend to have some different ideas about how labor should be managed, but in the end data is data. We championed evidence based medicine, but tend to ignore evidence when it comes from the wrong source, which is unfair. It is fair to critique the research and the methods used to write it, but it shouldn’t matter who the author is. In this case, Mercer and other midwives have done the world a favor by scientifically addressing this issue, and their data deserves serious consideration.

To quote Levy et al (12) “Although a tailored approach is required in the case of cord clamping, the balance of available data suggests that delayed cord clamping should be the method of choice.” We ought to heed this advice better. Like episiotomy, this change in practice may take awhile, but we should get it started. I’m going to work on it myself. How about you?"

Placenta....Not for the Sqeamish of Stomach

I'll warn you...unless you're committed to alternative birthy crunchiness, you might get a little ill over this one. :P I'm trying to spare you, so you can reconsider and not scroll down if you don't wanna. If placentaphagy gacks you out, turn away, dear reader. Laaaa dee da, dootie do: filling up the page so you can click away if you must...
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No? OK. Here we go.




This weekend, I had several doula friends at my house, and, at my request, we all had some fun with the placenta from Eva's birth (which, until Sunday, had resided in my freezer). Wheeee!
;OP It was actually really cathartic for me to examine it and marvel at the miracle of life, after the whole retained placenta drama. A friend helped me examine it and try to find the spot where the retained piece had been, and then we dehydrated it for encapsulation.

my friend L helps unfold it, while Essie is very interested. She's striking a pose here...silly willy.

Essie's words were, "This is SO. COOL. I'm going to be a midwife or a SURGEON when I grow up, because I'm a *lover* for how the body works!" She asked us over and over to explain the order of how nutrition gets to the baby. Her original theory was that the placenta carried milk directly to baby's tummy, and when she found out that the nutrients and oxygen went from one bloodstream to another, she was over the moon. She asked us to draw us a diagram: mommy to placenta, placenta to cord, cord to baby's belly button.


We first thawed it with lukewarm water...you can see the cord (white) still attached

The water bag membrane was tough and wicked cool, if I do say so myself. :P All that vitamin C payed off, apparently, because it was beautifully flexible but super, super tough. It was so very smooth and supple, the perfect home for a tiny baby in utero. God's seriously smart. That bugger was STRONG. No wonder my water stayed intact until the pushing phase! That's the way mama likes it. ;oP


When it finally thawed and we could unfurl it completely, my friend Jen pointed out small patches of white calcification, on par for a 41 week baby. :O) Baby's side was smooth, while the side that had been attached to the uterine wall was wrinkled, and the wrinkles fit together like a puzzle piece. It was really amazing to see how functional, comfortable and miraculous this temporary organ was for my baby girl...her very first "home".
Jen shows me how the wrinkles line up. It look oddly pale after rinsing, as I'm used to seeing them very red right after birth.

There was literally an odd, small rip on the very edge of mine on the side where the piece had been retained, and it was exactly the length of the piece my midwife retrieved and showed me. Bingo! Little booger. That was the trouble maker. :P There was a bit of strangeness going on at the cord attachment site, AFA how the membranes were attached to it. I need a midwife opinion on that one.

The actual separating of the membrane and the placenta was the trickiest part of the whole deal, really. My friend J did that bit, and I'm forever grateful...it took quite a bit of doing. Then I (forgive the gory detail) chopped it into little chunks and we blended it to a pate consistency witha ridiculously funny shot taken by my Lindsay...placenta bead provided by another sweet, funny friend. Oddball humor abounds.

some ginger (ginger optional ), spread it thinly into dehydrating trays and dehydrated it. I left the dehydrator on 150 or so for probably 12 hours, and probably it would have been safe with less...but we went to bed.

(At this point in the process, I suggest cooking something that smells rather strong, or sticking the dehydrator on the porch. My dh made curry for us that evening, and the scent of the dehydrator was pretty much completely masked. No earthy icky weirdness, unless you just stuck your nose into it. MUCH better than I'd imagined.)

Me and baby Eva...cuter than her "wombmate", eh?

It's broken into dried wafers and stored in my fridge (sorry, dh).

I have some pics of the dehydrated bits for anyone who's interested...in fact I'll go ahead and commit to posted them later. This afternoon, I'll do the actual encapsulation and post that, too. :O) Thanks for looking, and HTH if you're intested in your own dehydration! It's much, much simpler than I'd originally supposed.

Finally, Eva's birth montage

Make an on-line slide show at www.OneTrueMedia.com

The Other Side of the Glass

A new documtary, The Other Side of the Glass. A birth film for fathers, discussing (from daddy's perspective) the effect of modern birth on the family. I'm so excited someone finally picked up that ball and ran with it! :D There appear to be some great interviews, including Micheal Odent. I can't wait to see the whole thing.

Bed commercial...love it!

Miss Eva at a month old!