Birth attendants often claim that their high cesarean rate is due to their clientele - that
they provide care for a lot of high-risk clients. This analysis shows that:
Among lower risk women, likelihood of cesarean delivery varied between 8
and 32 percent across hospitals.
Among higher risk women, likelihood of cesarean delivery varied between 56
and 92 percent across hospitals.
Hospital variability did not decrease after adjusting for patient diagnoses,
socio-demographics, and hospital characteristics.
This shows that practice variation in cesarean rates is real, substantive, and not just a
reflection of the mother’s risk level.
Here's some of the thoughts and ideas I have gleaned over the
year s about leaving the umbilical cord to pulse until it stops.
Leaving the cord to pulse does "no harm" and therefore should
be encouraged. If you can think about what Nature intended, our
ancestors way back before scissors and clamps were invented must
have had to wait to deal with the cord/placenta until the
placenta was birthed. They probably chewed it, ground it with
rocks, or burned it through with hot sticks from the fire. The
little teeth on the clamps indicate the traumatizing of the
vessels is necessary to quell bleeding.
Leaving the cord to pulse slows down the "fire drill" energy
that many birth attendants get into after the baby is born.
Leaving off the busyness of midwifery for a half hour allows the
mother and baby undisturbed bonding time without a "project "
going on i.e. the cord cutting instructions, explanations,
jokes, etc. The father, too , is undisturbed and able to enjoy
this "high" time without focusing on a job at hand.
Educator Joseph Chilton Pierce in his book "Magical Child"
makes ref to studies that were done on primates who gave birth
in captivity and had early cord clamping. Autopsies of the
primates showed that early cord clamping produced unusual
lesions in the brains of the animals. These same lesions were
also found in the brains of human infants when autopsied.
In Rh neg women, many people believe that it is the clamping
of a pulsing cord that causes the blood of the baby to transfuse
into the blood stream of the mother causing sensitization
problems. Robert S Mendelsohn, M.D., in his book "How to Have a
Healthy Child. . . In Spite of Your Doctor" blames the whole Rh
neg problem on too quick clamping of the cord. Especially in Rh
neg mothers I urge midwives to wait until the placenta is out
before thinking about cord clamping.
I think it is interesting that scientists are now discovering
that umbilical cord blood is full of valuable T-cells which have
cancer fighting properties. A whole industry has sprung up to
have this precious blood extracted from the placenta, put in a
cooler with dry ice, and taken to a special storage facility to
be ready in case the child gets cancer at some time in the
future. This is human insanity of the first order. That blood is
designed by Nature to go into that child's body at birth, not 30
yrs later! We need to acknowledge that there are things about
the newborn circulation and blood composition that we just don't
know and we need to bet that Mother Nature had things figured
out pretty well for us to survive this long. Maybe the supposed
need for Vitamin K in the newborn comes out of early cord
In my work (800 births), I have only given Vit K to one baby (on Day
8 after having blood on the umbilicus every day < l tsp.--it was
probably unnecessary). I have only had one Rh neg woman who showed
fetal cells in her blood (she had had a bad fall 2 days prior to
birth). We have waited hours before cutting the cord and one couple
never did cut it (just carried baby, cord and placenta around
together for days). The nice thing about that was that it really
limited the postpartum visitors list! This is called Lotus Birthing
Parvati Baker, a midwife from Ca.,is the goddess of that
method (author of Prenatal
Yoga and Hygiea).
The only time I cut a cord before the placenta comes out is if I
have a mother in a water tub and I'm worried about blood loss.
Then you have to get both out onto a dry surface quickly and it's
easier to hand baby over to an adult while Mom is lifted
If the baby needs resuscitation, it is important to leave the
cord and do all work on Mom's body. Cutting the back up oxygen
supply doesn't make any sense at all.