1. Taking Charge of Your Fertility
Labour & Birth Support
Labour & Birth
1. Toni Wescler
Delayed cord clamping is a birth practice that a growing number of parents are choosing for their baby. Delayed cord clamping is where the umbilical cord is not clamped or cut until after pulsations have ceased, or until after the placenta is delivered.
There has been an increasing number of studies done in regards to the timing of cord clamping. A 16 month study published in 2006 was conducted by UC Davis nutrition professor Kathryn Dewey and nutrition graduate student Camila Chaparro at a large obstetrical hospital in Mexico City.
In the UC Davis study, the researchers set out to specifically evaluate whether delayed clamping improves iron status of full-term, normal-birth-weight infants during their first six months. The researchers also examined whether delayed clamping has greater impact among children who are already at increased risk of developing iron deficiency due to low birth weight or an iron-deficient mother.
The 16-month-long study was conducted at Hospital de Gineco Obstetrica in Mexico City, in collaboration with Mexico's National Institute of Public Health. A total of 476 normal-weight, full-term infants and their mothers were involved in the study. Each mother-child pair was randomly assigned to have the umbilical cord clamped at either 10 seconds or two minutes after the baby's shoulders were delivered.
Data on the infants' diet, growth and illnesses were collected when the children were 2, 4 and 6 months old. Iron status of the babies also was measured at birth and at the end of the study.
Of the original group, 358 mother-child pairs completed the study.
The study revealed that a two-minute delay in cord clamping at birth significantly increased the child's iron status at 6 months of age, and it documented for the first time that the beneficial effects of delayed cord clamping last beyond the age of 3 months.
This also was the first study to show that the impact of delayed clamping is enhanced in infants that have low birth weights, are born to iron-deficient mothers, or do not receive baby formula or iron-fortified milk.
"The data show that the two-minute delay in cord clamping increased the child's iron reserve by 27-47 mg of iron, which is equivalent to one to two months of infant iron requirements," Dewey said. "This could help to prevent iron deficiency from developing before 6 months of age, when iron-fortified foods could be introduced."
Dewey and Chaparro are planning their next stage of research: developing practical guidelines for incorporating the delayed clamping of the umbilical cord into standard obstetric practice in various settings.
"By simply delaying cord clamping for this brief time, we can provide the infant with the extra blood, and the iron it contains, from the placenta," said Dewey, an expert in maternal and infant nutrition. "This is an efficient, low-cost way to intervene at birth without harm to the infant or the mother."
The UC Davis study was funded by the Thrasher Research Fund and a grant from the U.S. Fulbright program. You can read more here.
Below is a video on delayed cord clamping, hosted by Penny Simkin, she is a physical therapist who has specialized in childbirth education and labor support since 1968.
Please Note: Cord Blood Donations - Currently there is no organization that collects donated cord blood on Vancouver Island. Canadian Blood Services is running a trial collection in some hospitals located in Ontario, Edmonton and Vancouver. If you are in any of these areas, please contact them for more information: 1-888-236-6283
Placenta Donations - Victoria General Hospital is currently accepting placenta donations for research. If you are interested in donating your placenta, please let your caregiver know and mention it again to your labour nurse after delivery.
I am a huge HypnoBirthing® advocate. It was developed by Marie F. Mongan, which I had the extreme pleasure of speaking to in July of 2015. I can not say enough good things about her program, of pain-free natural childbirth and the benefits many mothers around the world have experienced.
I highly recommend reading her book HypnoBirthing® The Mongan Method. Many include a Relaxation CD in the back. Below is a summary of her teachings.
HypnoBirthing® – The Mongan Method is as much a philosophy as it is a technique. The concept of HypnoBirthing® is not new, but rather a “rebirth” of the philosophy of birthing as it existed thousands of years ago and as it was recaptured in the work of Dr. Grantly Dick-Read, an English obstetrician, who, in the 1920s, was one of the first to forward the concept of natural birthing. The method teaches you that, in the absence of fear and tension, or special medical circumstances, severe pain does not have to be an accompaniment of labor.
With HypnoBirthing® you will gain an understanding of how the birthing muscles work in perfect harmony–as they were designed to–when your body is sufficiently relaxed and you trust birth. You will learn how to achieve this kind of relaxation, free of the resistance that fear creates, and you will learn to use your natural birthing instincts for a calm, serene and comfortable birth.
When you have your baby with HypnoBirthing®, you will not be in a trance or a sleep. What you will experience is similar to the daydreaming, or focusing, that occurs when you are engrossed in a book or a movie or staring into a fire.
You will be conversant and in good spirits–totally relaxed, but fully in control. Awake throughout, you will be aware of your body’s surges and your baby’s progress; but because you will have trained yourself to reach complete relaxation, you will be able to determine the degree and the manner in which you will feel the surges. You will experience birthing in an atmosphere of calm relaxation, free of the fear that prevents the muscles of your body from functioning as nature intended them to. In this calm state, your body’s natural relaxant, endorphins, replaces the stress hormones that constrict and cause pain.
Trained HypnoBirthing® educators are successfully teaching women and their birthing companions to trust birth and release all fear and limiting thoughts. HypnoBirthing® practitioners can be found in 45 countries throughout the world.
If after watching the video below you want to know more, please email me any time to discuss HypnoBirthing® and how it can help you.
Congratulations on the birth of your little one. Understanding your newborn's bowel movements are important, as it can tell you about his/her health. If in doubt, always contact your family doctor, midwife or pediatrician.
A chalky white color can be a sign there is an issue with bile production. The absence of colour in your baby's stool can be a signal that your baby is not producing enough bile. A bile shortage can be caused by liver or gallbladder problems and can be serious. Please call your doctor right away if he/she is having chalky white stools.
Having a Rosey Pink stool can be related to something your baby has recently eaten. Beets, cranberries, tomatoes, or items with red food colouring like Froot Loops, red Jell-O, or cherry popsicles, can cause a rosey pink color.
It can also be a sign of blood, it's always better to eire on the side of caution, please call your doctor if you suspect blood is in your baby's stool.
Constipated stool with a hint of red blood could mean one of the following: baby has a milk protein allergy, has tears in the anus, tiny hemorrhoids or a bacterial infection.
If you see raspberry coloured stool that looks like mucus similar to congealed fat, you need to call your doctor immediately, it could be a sign of serious intestinal problem.
Bright red blood can show up in baby stool for a few different reasons. Please call your doctor or the nurses line (1-866-215-4700) if you notice any of the following:
* Normal stool tinged with red blood, which is often a sign of a milk protein allergy.
* Constipated stool with a hint of red blood (streaked or spotted throughout) could be a result of small tears in the anus or tiny hemorrhoids. Ask your doctor if you can add a tiny bit of prune juice to the next bottle or if you can finger feed the prune juice if breastfeeding (teaspoon for newborns, tablespoon for older babies).
If the stool is watery (diarrhea-like) and streaked with red, may be signs of a bacterial infection. Please consult your doctor.
Mustard yellow is the most common breastfed baby stool colour. It's completely normal. Occasionally you may also see little white 'seeds' sprinkled throughout. These are partially digested milk solids and are also completely normal.
If the consistency is like hummus, baby is probably fine. If it's thicker, like peanut butter, baby may be constipated. Please contact your doctor for advice.
Approximately 90% of all diaper changes will be a brown stool colour, usually after baby food has been introduced. Brown stool is a good sign that baby's digestive system is functioning properly.
Lime green is one of the most startling of baby stool colours. It's usually accompanied by a frothy, bubbly texture. This is a sign of a foremilk/hindmilk imbalance.
Foremilk is the 'first milk' that comes from the breast. It's fairly sweet and thin, like skim milk.
Hindmilk is the milk that 'comes from behind or at the end'. It is richer and fattier and contains most of the power-nutrients your baby needs.
Lime green stool can be a sign that your baby is snacking too much on the sweet foremilk. Try keeping baby on one breast longer, so he/she gets the thicker, richer hindmilk.
Weight checks are another good way to test this. Babies who are getting mom's hindmilk will gain weight easier.
If you are breastfeeding or not breastfeeding and baby is not snacking, and he/she is having lime green stool, please contact your doctor. Lime green stool can also be a sign of a virus. Your doctor may ask to see the green stool colour for testing, so ask before throwing out.
Green stool is a common shade for milk protein allergies and is something you should talk to your doctor about.
An evergreen coloured stool can be a result of extra iron floating through your baby's system. It can also be accompanied by thick constipated stools.
If your doctor has told you to supplement with iron or an iron fortified formula, don't stop. Iron is an important nutrient your baby needs for proper brain growth and develpment.
If your infant is straining and shows signs of constipation, ask your doctor if you can add a little bit of prune juice to the bottle or if you can give baby an over the counter stool softener.
As mentioned above, evergreen or green stool can also be a sign of a milk protein allergy and should be discussed with your doctor.
There are several reasons why a baby's stool could be black. It is normal for your newborn to have black, tar-like stool called meconium, it is a newborn's very first stool and can last for up to 2-3 days.
If you're breastfeeding and your nipples are cracked and bleeding, black flecks sprinkled your throughout baby's stool are the result of baby swallowing and digesting your blood. Please consult with your doctor as it can lead to an infection in your breast called mastitis.
Black stool can also be the result of too much iron. Please refer to the above Evergreen Coloured stool, sometimes a very dark green stool can look black.
A solid black coloured stool can mean a serious problem. You're baby's digestive system could be bleeding somewhere, please call your doctor right away to be safe.
Your baby's stools can easily change day to day. ALWAYS call your doctor if:
* you see bloody mucus in the stool
* your infant has a fever
* your baby is vomiting
* he/she is refusing to eat
* his/her urine is darker in colour or infrequent (dehydration is the #1 reason babies are hospitalized)
* he/she seems limp and unresponsive call 911 immediately
One way to check on how your baby's inner body is functioning is by looking at his/her stool colour. When it comes to your baby's health, it's better to always err on the side of caution, "When in doubt, give your doctor a shout."
A baby will spend nearly 10 months of it's early life submerged in amniotic fluid. During this time they feel comfort, warmth and peace. Waterbirth is felt by Midwives, Doctors, Doulas and Mom's, to be the gentlest of gentle births. Now more than ever, mothers are choosing waterbirth as an alternative way to labour and birth.
During the birth journey, there is nothing like warm, luxurious water to cradle you and give you complete freedom to move during the greatest achievement of your life - the birth of your sweet child, this is the feeling of pure bliss.
There are many benefits to labouring in water, for those wanting statistics, I suggest reading Evidenced Based Water Birth, read it in it's entirety so that you can get a true sense of whether it's right for you and your baby.
14 Known benefits of water labour and waterbirth:
• Facilitates mobility and enables mother to assume any position which is comfortable for labour and birth
• Speeds up labour
• Reduces blood pressure
• Gives mother more feelings of control
• Provides significant pain relief
• Promotes relaxation
• Conserves energy
• Reduces the need for interventions and drugs
• Gives mother a private protected space
• Reduces perineal trauma and eliminates episiotomies
• Reduces cesarean section rates
• Is highly rated by mothers - typically stating they would consider giving birth in water again
• Is highly rated by experienced providers
• Encourages an easier birth for mother and a gentler welcome for baby
By placing a pool of water in a birth room, it changes the atmosphere immediately. Voices are softer, mother remains calmer and everyone becomes less stressed.
The effect of buoyancy that deep water immersion creates allows spontaneous movement of the mother. No one has to help the mother get into a new position. She moves as her body and the position of the baby dictate. Movement helps open the pelvis, allowing the baby to descend.
When a woman in labour relaxes in a warm deep pool, free from gravity’s pull on her body, with sensory stimulation reduced, her body is less likely to secrete stress-related hormones. This allows her body to produce the pain inhibitors-endorphins that complement labour. Noradrenaline and catecholamines, the hormones that are released during stress, actually raise the blood pressure and can inhibit or slow labour. When a labouring woman is able to relax physically, she is able to relax mentally as well. Many women, doulas, midwives, and doctors acknowledge the analgesic effect of water. Thousands of these mothers state they would never be able to consider labouring without water again.
Frequently Asked Questions:
What prevents baby from breathing under water?
There are four main factors that prevent the baby from inhaling water at the time of birth:
1. Prostaglandin E2 levels from the placenta which cause a slowing down or stopping of the fetal breathing movements. When the baby is born and the Prostaglandin level is still high, the baby's muscles for breathing simply don't work, thus engaging the first inhibitory response.
2. All babies are born experiencing mild hypoxia or lack of oxygen. Hypoxia causes apnea and swallowing, not breathing or gasping.
3. Fetal lungs are already filled with fluid. That fluid is there to protect the lungs, and keep the spaces open that will eventually exchange carbon dioxide and oxygen. It is very difficult, if not improbable, for fluids from the birth tub to pass into those spaces that are already filled with fluid. One physiologist states that "the viscosity of the fluid naturally occurring in the lungs is so thick that it would be nearly impossible for any other fluids to enter."
4. The last important inhibitory factor is the Dive Reflex and revolves around the larynx. The larynx is covered all over with chemoreceptors or taste buds. The larynx has five times as many as taste buds as the whole surface of the tongue. So, when a solution hits the back of the throat, passing the larynx, the taste buds interprets what substance it is and the glottis automatically closes and the solution is then swallowed, not inhaled.
For more information, please read Barbara Harper’s Waterbirth Basics .
What is the temperature of the water?
Water should be monitored at a temperature that is comfortable for the mother, usually between 95-100 degrees Fahrenheit (32-38 degrees Celsius). Water temperature should not exceed 101 degrees Fahrenheit as it could lead to an increase in the mother's body temperature which could cause the baby's heart rate to increase. It is a good idea to have plenty of water to drink and cold cloths for the mother's face and neck. A cool facial mist from a spray bottle is a welcome relief for some mothers as well.
How much does a waterbirth cost?
Sometimes Midwives and Doulas will charge a fee for the use of a portable birth pool. You can also purchase your own birth pool through many different sources. I suggest Waterbirth Solutions.com. The cost for a complete birth pool kit is now under $250.
If you have extended medical, some insurance companies do reimburse for the expense of the pool rental. That is something you would need to look into yourself.
Can I have a water birth at my local hospital?
Unfortunately the hospital I attend (Victoria General Hospital) does not host waterbirths of any kind. However, they will let you labour in the shower with support from your Midwife or Doctor.
How long is baby in the water after the birth?
Here in Canada, Midwives, usually bring the baby out of the water within the first few seconds after birth. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth videos that depict leaving the baby under the water for several moments after birth and the babies are just fine.
Physiologically, the placenta is supporting the baby with oxygen during this time though it can never be predicted when the placenta will begin to separate causing the flow of oxygen to baby to stop. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him upright onto the mother's chest.
When should I get into the water?
A woman should be encouraged to use the labour pool whenever she wants. However, if a mother chooses to get into the water in early labour, before her contractions/surges are strong and close together, the water may relax her enough to slow or stop labour altogether. That is why some Midwives limit the use of the pool until labour patterns are established and the cervix is dilated to at least 5 centimeters. There is some physiological data that supports this rule, but each and every situation must be evaluated on its own.
Some mothers find a bath in early labour useful for its calming effect and to determine if labour has actually started. If contractions are strong and regular, no matter how dilated the cervix is, a bath might be in order to help the mother to relax enough to facilitate dilation.
Therefore, it has been suggested that the bath be used in a "trial of water" for at least one hour and allow the mother to judge its effectiveness. Midwives report that some women can go from 1 cm to complete dilation within the first hour or two of immersion. The first hour of relaxation in the pool is usually the best and can often help a woman achieve complete dilation quickly.
If you have any questions about Waterbirth or my Birth or Postpartum Doula services please email me anytime.
Below is a raw video of a beautiful home waterbirth to give you an idea of what it's like. This mom was in control of her body and her birth, this is what a natural waterbirth can look like.
In medieval times the placenta was said to nurture an unborn child in body and soul. An unborn child was only supposed to lie there, so the placenta was also called "the bed of the child." According to an old European custom, many parents believed that the placenta had a spiritual affinity with the life energy of the tree. Many parents of diverse backgrounds want to respect and appreciate the child's organ. As a symbol of gratitude many of them plant a young tree over the placenta. In some traditions, an apple or pear tree is planted over the placenta, an apple for a girl and a pear tree for a boy. In Switzerland the custom is to choose an apple tree for a girl and a nut tree for a boy. The grandmother traditionally determines which kind of tree matches well with the individual newborn because she has may years of knowledge of life in the family. Today using the placenta in some way is gaining in popularity and is common in many places, the tradition of burying the placenta is still alive now.
In addition to the placenta, in France, the umbilical cord is believed to guarantee the child good manual and mental abilities when the child carries it in their pocket or school bag. In Europe and Africa the dried cord was kept underneath the child's pillow or tied to the bed. In the Amazon, one tribe turns the cord into a bracelet decorated with beads to be chewed on when teething.
Historical illustrations can be found as proof that in many cultures, mothers and other people in the community had eaten raw or cooked placenta for healing and to improve hunting abilities.
In southern Germany, in the 16th century, a piece of placenta was added to the mother's first postpartum meal. The custom of offering a woman chicken broth with a piece of the placenta for her first meal after giving birth is still alive in many European regions. According to inventory lists of pharmacies in the end of the 19th century, "a jar of placenta powder" was kept in stock in all town pharmacies. It wasn't until the turn of the 20th century did the use of placenta powder gradually diminish.