One of birth’s biggest questions is ‘What about the cord?’
Many people have a sense of urgency that the cord must be clamped and cut in a dramatic and special way. This is not the case. Far from it, in fact. Did you know that it is unnecessary to clamp the cord or cut it?
Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child.
1801 Erasmus Darwin, Charles Darwin’s grandfather
Some people choose to leave the cord intact. This does involve more considerations (as described by Lotus birth). After a few days, the cord and placenta come away from the baby.
This means that the cord is never cut, and you keep the placenta with the baby until the cord (and placenta) come away after a few days.
If this sounds like too much, it may help to know that:
some hours after the birth the cord is thin, dry, hard, and exsanguine. It can then be cut without any special precautionOdent (p.71 Childbirth in the Age of Plastics (exsanguine means bloodless))
Once the cord is thin, dry, hard and bloodless, you don’t need to worry about the tie. You can keep the placenta in a bowl next to the baby. The first few hours are about skin-to-skin contact, rest and breastfeeding. So if you are comfortably in bed, holding your baby, the placenta can be in a bowl next to you. No drama, no worries. Uninterrupted. An excellent resource and campaign is #waitforwhite.
And yes, this means that the baby remains attached to the placenta. It is useful to have a bowl ready for it. Once the cord is white (after a few hours), it can be cut without the need for tying (about 10cm away from the baby.). The cord will continue to dry out and come away from the baby after a few days. The placenta can be encapsulated, printed, eaten, planted or frozen. With this in mind, you can relax. Leave your shoelaces in your shoes, and put the scissors away while you #waitforwhite.
If you find yourself birthing without assistance
(as you may in the event of a fast birth)
simply leave the cord alone
Don’t pull on it, don’t clamp it, don’t cut it
BUT WHAT IF THE CORD IS AROUND THE BABY’S NECK?
There is a lot of misunderstanding about nuchal cords (cord around the neck). The cord around the neck is rarely a problem, and the ‘somersault manoeuver’ is useful. Understanding nuchal cords and this manoeuver can be very reassuring in the event of unassisted birth. It is also helpful to understand even when being assisted, as you will be more aware of the language and less likely to feel anxious or confused about this situation. Knowledge is Power!
Midwife Thinking has written an excellent article discussing nuchal cords. This includes a description of the somersault manoeuvre (also shown in the video below).
You may have heard that in very rare situations, a baby has a ‘true knot’ in the umbilical cord. For this, I encourage you to read this article by midwife, Jane Palmer.
AND WHAT IS THE DEAL WITH DELAYED CORD CLAMPING?
At some point, you are likely to hear about ‘delayed cord clamping’ or Optimal Cord Clamping. The evidence supports it, and it is increasingly becoming standard practice (to varying degrees). However, you still need to request it and discuss it with your care provider to find out what they consider standard.
It comes down to the definition of ‘delayed’. Researchers will consider anywhere between 30 seconds and 3 minutes as delayed. Most parents expect MUCH longer than this, usually ‘until the cord stops pulsing’ (though what does that mean?), and definitely, after the placenta is birthed. This is why it is imperative to specify exactly what you expect with cord management in your Birth Map. Simply stating ‘delayed cord clamping’ could mean just 30 seconds. If this differs from what you want, you must discuss this with care providers to ensure your needs are met. You must be implicit about how long you want to wait if you intend to sever the cord.
WHAT ABOUT CORD BLOOD BANKING?
Ask any cord blood banker, and they will say you can have delayed cord clamping AND cord banking.
So what do cord bankers define as delayed?
NOT MORE THAN 1 MINUTE.
If your definition of ‘delayed’ is more than one minute, the answer to the question is NO, you can not have delayed cord clamping and cord blood collection.
For a detailed article on cord blood collection, see this article on Midwife Thinking
Preparing to Wait for White
If you are birthing in the system, and your goal is a birth ending in skin-to-skin for several hours, as you wait for white, you will need to map your preparations carefully. A birth ending thus, will have progressed spontaneously. It means being supported by physiologically focused and patient people. It means midwifery care. Choose continuity of midwifery care, tune into yourself and take full responsibility for Your Birth. Your birth partner will be briefed and prepared, having worked through their own concerns and replaced fears with understanding. If your birth needs to shift onto a more medical pathway, you can confidently do so, knowing that it is possible to keep a baby attached to the placenta in a caesarean. And if it unfolds in a way that means letting go of this, you will understand why: we make the best decisions we can, based on our circumstances and our understanding of them. Knowledge is power.
For more go to Mapping Your Birth