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Cutting the cord

Back in Melbourne again this week, this time for an Active Birth workshop. This group is full of bright young things - all these midwives are well under the average age for midwives in this country (47 years) and there are several students here as well.

We were talking about complications that can occur during birth and how these could be handled. Although very rare, the problem of a very tight cord around the baby’s neck that impedes further progress was one such issue. I asked the group what they would do if faced with this situation. Most said “clamp and cut the cord”. So I followed with the question “what are the risks of taking this action?” and they replied “danger for the baby is there is further delay, for example from a shoulder dystocia”.

I commented that midwifery students these days are being taught not to ever cut and clamp the cord and showed them how the baby will tumble out itself, often very quickly, if necessary, as though nature detects the baby’s distress and lends a helping hand. One of the more experienced midwives in the group told us that she had witnessed this herself and now was not at all concerned about leaving the cord intact, even when it was very tight.

One of the students said that they had raised this issue with one of their tutors. They asked what they should do when the cord was tight and the baby appeared compromised. The tutor replied that it should always be clamped and cut. When the students questioned this practice, and mentioned the possibility of shoulder dystocia creating further problems, the tutor had replied that “if shoulder dystocia occurs then the baby is gone anyway”! Needless to day, the students were a bit stunned at this reply. I do hope that they have misinterpreted this comment. Cutting the baby’s oxygen supply prematurely can never be a good idea, surely?

Posted by andrea at May 17, 2004 07:10 PM

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