July 2, 2014
Volume 16, Issue 14
Midwifery Today E-News
“Umbilical Cord Care”
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Read about the Umbilical Cord in Midwifery Today, Issue 108
The Winter 2013 issue of Midwifery Today is packed with useful information. Umbilical cord articles include “Optimal Cord Clamping” by Mary Esther Malloy, “Cord Cutting in the Framework of Neonatal Beliefs and Rituals” by Michel Odent and “Premature Ligation of the Umbilical Cord” by Patricia Edmonds. Other topics covered include “Gestational Diabetes: Real Risks beyond the Controversy” by Crystal Ogle and “When a Midwife Becomes a Doula” by Ireena Keeslar. To orderMT online store

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In This Week’s Issue

AU conferenceJoin us in Australia

Plan now to attend “Promoting Midwifery: Skills from Around the World” in Byron Bay, Australia, this November. You’ll be able to learn from a great line-up of teachers including Robbie Davis-Floyd, Gail Tully, Sister MorningStar, Sarah Buckley, Carol Gautschi and Gail Tully. Planned sessions include Promoting Optimal Fetal Positioning, Breech, Shoulder Dystocia and “Malpresentations” as well as a two-day Midwifery Issues and Skills class.

Learn more about the Byron Bay, Australia, conference.

Quote of the Week

In the current scientific context, it is not justified to routinely interfere with the physiological processes by cutting the cord during the third stage of labor.

Michel Odent

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The Art of Midwifery

At the time of birth, approximately two-thirds of the baby’s blood is in the baby’s body and about one-third of the baby’s blood is circulating in the cord and placenta. If the cord is clamped and cut immediately following the birth, the blood still circulating in the cord and placenta is lost to the baby. The result is a newborn starting life on the outside lacking a significant percentage of her blood volume.

Mary Esther Malloy
Excerpted from “Optimal Cord Clamping,” Midwifery Today, Issue 108
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Editor’s Corner

The Amazing Umbilical Cord

Along with being an editor for Midwifery Today magazine, I also teach childbirth classes, so I love hearing people retell details of the births they’ve experienced. Apparently being married to a childbirth educator means that people feel very comfortable talking birth with you, too, which is the case with my husband. He has had numerous chances to retell details of our daughters’ births. Whenever I hear my husband talk birth, he will almost always mention the umbilical cord.

Apparently our oldest daughter had a remarkably beautiful umbilical cord. “It twisted and turned and was so thick…it even looked iridescent! There were so many colors…” These are some of the phrases I have heard my husband say over and over to people. He will tell expectant couples, “Be sure to check out the umbilical cord…it truly is amazing!” And you know what? He’s right! It is amazing and it is beautiful. After all, it is what helped to nourish our babies for those 9+ months when they took up residence in our bellies.

— Nancy Halseide is the managing editor for Midwifery Today. She is also a childbirth educator and co-owner of Eugene Birth Education. Read Nancy’s blog, The Birth Educator’s Blog.

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Featured Article

The Navel String

Have you ever really looked at an umbilical cord, felt its texture and marveled at the twists and turns and the glistening of the vessels as they travel its length? Have you ever experienced its tragic betrayal—a random knot, that too-tight nuchal cord, a life that left behind only brokenness when errant vessels ruptured and poured out the life of an unborn baby?

The umbilical cord has worn many names over the millennia, but never before have we had the depth of knowledge that we do today to puzzle out its mysteries. A condition that can affect the umbilical cord, that most are familiar with, is that of a single artery. The normal configuration is that of two arteries and one vein. Missing that one vessel within the cord is associated with the possibility of a baby being born with one of over 100 different anomalies. Though non-predominate, urinary tract defects are most common.

We may marvel at those fascinating twists in the cord, the first thing that catches our eye after birth, but understanding why and how they develop may be lifesaving. The best approach to understanding this vital part of the placental organ is a systematic routine examination. Observe the cord as a whole:

Chirality. The twisting or coiling of the cord is well established by week nine of gestation. The average cord at term has about 40 coils, but as many as 380 have been noted! Active, healthy babies have moderately coiled cords whereas babies who may be neurologically at risk have less coiling. Chirality is directly related to the activity level of the baby. Single artery cords also have less coiling.

Length. The average length for a full-term baby’s cord ranges between 12 and 24 inches (30–60 cm). The length of the cord, similar to chirality, is linked to the activity level and, therefore, the overall expected health of the baby. Cords may be physiologically short or foreshortened due to nuchal or other body part wraps. Short cords are at risk for torsion (twisting that interrupts blood supply) and can contribute to mal-presentation because of limited mobility of the baby. Though I have never read any discussion regarding this, I have often seen long labors and pushing phases of labor with a short cord. If left alone to stretch, I feel there is less risk for the baby as he moves down the birth canal.

Long cords carry some risk as well, but from the possibility of entanglement, knots, torsion, thrombosis or prolapse. Hyperactivity in the baby before birth may be evidenced by the presence of an unusually long cord.

Patricia Edmonds
Excerpted from “The Navel String,” Midwifery Today, Issue 108
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What’s black and white…
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Website Update

Read this editorial by Jan Tritten from the Summer 2014 issue of Midwifery Today:

  • Homebirth and the Microbiome

    Excerpt: I have valued homebirth ever since my doctor talked me into having one! I had two homebirths and they were the most empowering events I have ever experienced. After a horrendous hospital birth with my first child, these births were especially amazing.

Read this article excerpt from Midwifery Today magazine, now on our website:

  • Collusion and Negligence in Hospitals—by Judy Slome Cohain

    Excerpt: One predominant problem with planned hospital birth stems from the requirement of collusion among hospital workers. … Each individual worker and patient enters with needs and hungers of their own. In order for the hospital to survive, the patient’s needs are sublimated to the needs of the staff and hospital. Ensuring the survival of the hospital takes precedence over the individual needs of a patient.

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Birth Q&A

Q: How long did you breastfeed your baby/babies? Was it longer or shorter than you had expected? What changed? [Responses on breastfeeding theme continued from E-News Issue 16:12.]

— Midwifery Today

A: I nursed for 2.5 years with my son and 3 years with my daughter. It was longer than I had expected. What changed was my children needed it and I loved taking care of them.

— Cyndi Gross

A: I had no expectations and no role models. One small comment by my sweet husband, “Oh, I thought you’d breastfeed,” got me to the bookstore. With a copy of the Womanly Art of Breastfeeding and nothing else to teach me this art, I birthed our first child out of hospital and with no medications. That was the first blessing. The second was that my little beauty of a daughter knew just what to do. She latched and suckled and grew. At two weeks we discovered La Leche League (LLL) and went to our first meeting. Time passed and in the blink of an eye she was 3.75 years old and let me know that she was done with nursing. I went to a LLL meeting 10 days later and cried. I was soon pregnant again and I never even questioned how this baby would be fed. He was born under the same roof as his sister and seemed to follow her lead regarding breastfeeding. This time, I got the bonus of no engorgement! Two days before his fifth birthday was our last nursing. I was ready and so was he. Now as my children are beyond nursing, I miss those days, weeks, and years. I’m getting emotional as I type this out. My passion never waned but only grew and I now help other mamas and babies as an LLL Leader and IBCLC, and I thank my husband for the encouragement he gave many years ago.

— Yvonne Maalouf

A: Each child had their own agenda. My first baby breastfed for 18 months, my second for 3 years and my third for 26 months. I never expected anything. It was their decision. My dad nursed for five years. His sister, who is six years younger than he, “stole his ninnies.” Grandma was from Sicily.

— Deb Phillips

A: I ended up breastfeeding for 14 years straight. That is much longer than I expected! Of course, I had six kids in those 14 years. I nursed them for three years each and had them two years apart. These 14 years do not include my first baby, who I breastfed for 18 months, but there was a space between him and the next one where I was not breastfeeding for three years.

— Marlene Waechter

A: I nursed both until they were three. I had originally planned only breastfeeding for about six months to a year with my first child, but I just couldn’t wean that early. Thanks to La Leche League, I was able, and had the courage, to keep breastfeeding; without them I might not have lasted past six weeks. Thank you, LLL! You are my hero!

— Beth Ann Ruark Weagle

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