Interesting Facts I Bet You Never Knew About Delayed Cord Clamping

Interesting Facts I Bet You Never Knew About Delayed Cord Clamping
Delayed cord clamping is all the rave right now. I can tell you that about 99% of the deliveries I attend, they are requesting this.  Do you know why delayed cord clamping is being requested?  I personally think most people are asking for it because “Dr. Google” tells them they should, lol.  But in all honesty, I think most people have no idea why it is good and what the cons are to doing it.  So, here are the reasons that I know of to support and discourage delayed cord clamping. 

  1. Did you know the placenta holds around 1/3 of your baby's blood? Delayed cord clamping allows time for that blood to be given back to your baby. This also allows for a smoother transition of life from womb to earth side for your baby. 
  2. It can increase baby’s blood volume by 30%.
  3. Delaying can transfer an additional 40 to 50mg/kg of iron, which reduces the risk of your baby suffering from severe side effects of iron deficiency
  4. It can increase red blood cells by 60%.
  5. Delayed clamping can increase hemoglobin levels.
  6. It can create an infusion of stem cells, which play an essential role in the development of the immune, respiratory, cardiovascular, and central nervous systems, among many other functions.
  7. When the cord is delayed being clamped, it can help decrease the likelihood of needing resuscitation, and if the need occurs can be lifesaving due to the cord still supplying blood and oxygen.
  8. Preemies who have delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain and have a lower risk of life-threatening bowel injury
Delayed cord clamping IS an option during a cesarean. The best option is to ask your provider to delay cord clamping for as long as possible and to “milk the cord”.  Do not be afraid to ask, remember this is your birth, they are just guests to the party.  
There are two drawbacks that I am aware of to delayed cord clamping at delivery.  The first is that with an increase of red blood cells, we see jaundice levels go up.   Jaundice is the yellowing of the skin and eyes that many babies get.  If this level gets high enough it can cause brain damage.  The way to combat high levels is with phototherapy treatment.  This means we are seeing more babies going home on bili-blankets or having to stay longer in the hospital for the phototherapy.  
The second drawback is that there is a reduction in the volume of umbilical cord blood available for harvesting stem cells.  This only would apply if you are choosing to save the cord for stem cell donation or personal use.  
I personally think a happy medium is the way to go.  Delaying clamping for 30-60 seconds still gives the benefits without getting the entire 60% of red blood cells, leading to higher jaundice levels.  Reasons to forgo delayed cord clamping would be if baby needs to be resuscitated away from mother or maternal distress.  
These are the current recommendations for how long to delay the cord.
*ACOG and AAP recommends 30-60 seconds*
*WHO recommends at least 1 minute*
*The Royal College of Obstetricians and Gynecologists recommends at least 2 minutes* 
*The American College of Nurse–Midwives recommends 2–5 minutes*

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5 Reasons You Should NEVER Have a Doula During Birth

5 Reasons You Should NEVER Have a Doula During Birth
What does a doula do anyway?   They know about birth but so does my labor nurse.  They only are used for natural births, and since I want an epidural, I do not need one.   Doula’s help with positioning and charge me for it, I do not need that extra expense with a baby on the way, especially since the hospital has nurses for free.   I have heard and believed these things for years so I wanted to make sure others knew when they should not use a doula.  

  1. If you do not mind having a cesarean section.  Doula’s help women to increase their chances of having a vaginal birth.  They know positions to help baby to engage in the pelvis quicker, relax mother so they can dilate quicker and encourage the mother when they are ready to give up.  Some people are fine with a cesarean section and may opt for it from the start.  If this is you, then maybe a doula is not for you.
  2. If you feel 100% comfortable with labor and confident in the process.  Doula’s help to decrease the negative feelings that surround childbirth.   Birth is meant to be positive and they help you answer any questions you might have before birth, during and after.   Basically, it is like having your best friend with you during labor, doing everything to make you at ease.  If you already know everything or enjoy flying by the seat of your pants, then maybe you do not need a doula.
  3. If you enjoy having metal or suction instruments applied to your baby’s head to get baby out, chancing you tearing more and injuring your baby.  Many times, at delivery your baby will need to be assisted out with forceps or a vacuum.  Having a doula decreases the chances of needing to have these used.  If this does not bother you at all, then maybe you do not need a doula.
  4. If you like to labor for days before meeting your baby.  Having a doula can shorten the time you are in labor.  The nurse many times has other patients and can not devote all their time to you.  Having a doula allows that one on one time.  If you like having strong contractions for longer then you need to, then maybe you do not need a doula.  
  5. If you like suffering from postpartum depression.  Doula’s can help you have the labor that you desire, help with breastfeeding and be a sounding board after delivery.  These things decrease your chances of having postpartum depression.   Doula’s love helping women birth and seeing that bond that comes from delivery.  They will be there after delivery as well.  If you enjoy being sad and not connecting with your baby, then maybe you do not need a doula.    
There is NO evidence that having continuous support in labor has any negative outcomes 🤯NONE!

Please hear my heart... this must be said, heard and repeated....
Doulas want you to be informed, know the ins and out of birth, your options and to be completely supported throughout your pregnancy, birth, and postpartum period. You, your baby, and your pregnancy are unique. It is not supposed to look like anything but what you need it to.
Doulas support ALL Births....Will they support your birth?
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What Everyone Ought to Know About Epidurals

What Everyone Ought to Know About Epidurals
So many women decide even before getting pregnant that they want an epidural.  Most reasons are because they do not want to feel pain.  I totally understand this as I am that woman who asked for an epidural before labor even started, lol.  I am a total wimp when it comes to pain.  

Many women will try to go as long as possible without an epidural, but remember that once you are tightening up, or out of control, your body can not dilate any longer.  This is when you need to get the epidural, so you can relax.  

Almost every labor patient that I have had or heard about has the same perception about epidurals.   “I will get an epidural, then feel nothing during labor and delivery.”  Wrong!  An epidural helps to take the pain away from contractions, but many still feel pressure and discomfort as you near the finish line.  This is a good thing!  You want to know when it is time to push and feel to push correctly.  

Do not worry though, they will make sure you are comfortable, and the epidural is working once you get it.   Most people can sleep for a while during labor and some wake up ready to push.  At the same time, do not try to be superwoman.  If you are in pain, tell your nurse because maybe your bladder needs emptied, your epidural pump turned up or you are ready to deliver.  

Ways to keep yourself comfortable with an epidural are to continue to rotate positions in bed as it helps to keep the epidural even and you will have a button to push if you need a little bit more medication.  Epidurals also work by gravity, so if you are sitting up in bed, lay back so that the medication can spread as it is supposed to.  You always want to be able to move your legs if you cannot the epidural will need to be turned down.  

Do not fear labor and delivery because of the pain.  There are many pain management things that can be done to help your pain, including positioning, medications, essential oils, and relaxation techniques.  Once it is over you will forget all the discomfort as you hold your baby in your arms.  

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The TRUTH about having a baby during Covid

The TRUTH about having a baby during Covid
2020 has come with many changes to the norm and this includes childbirth.  Support people not being able to be present at appointments, ultrasounds and at times the actual birth has sent everyone scrambling for a new normal.  

Childbirth does not have to be scary, but this virus is making it just that for many people.  

Every hospital is handling this virus differently, this is what is normal for my hospital and what you can do to help ease your mind.  One support person is allowed with the laboring mother if they are symptom free.   There is no changing of your support person the entire stay.  Every day they must be asked questions again and go through another temperature check.   

Masks are given upon entering the hospital and they are always to be worn in the hospital except when your nurse leaves your room.  Yes, this includes wearing it in your room if any staff are present.  We understand that this is difficult especially when it comes to pushing time.  We do not want to wear the mask anymore than you do but for everyone’s safety we need to comply.  At any time that you need a break, please tell your nurse and we will step out of the room so that you can catch your breath and regroup.

I personally have always been a “hands on” nurse and enjoy being at the bedside getting to know my patient and doing my best to grant them the labor and delivery that they desire.   During this time, I have had to try to stay out of the room more than normal so that my laboring mother can take her mask off and enjoy this special time.  I hate this but I want a healthy mom and a healthy baby in the end.  

People are still allowed to walk the halls if their mask is covering the nose and mouth.  Depending on the time of day you deliver, either your doctor/midwife or a partner will deliver your baby.  

Many people are scared going into hospitals and this is not what we want.  We are doing the best we can to keep everyone safe.  We are still the same amazing, caring, educated nurses we always have been!

Many parents are finding they are enjoying the peace of not having constant visitors and enjoying those special moments with just them.  I have seen more Facetiming and video calling than ever before to allow other people to be “present” during this special time.  Another option is using aromatherapy to calm your nerves and help you with this added stress.  

Remain confident in your body and what you want from your labor & delivery.  There might be a virus going on, but nothing changes the joy you will have when you meet your baby!

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