When Should You hurry and cut the cord ?

In the delivery of multiple births.

I found this information from this website very helpful. Ebwhealthcare.com

It also states that You Should Not hurry to cut the cord if the mother is Rh Neg. I Am Rh Negative so this was helpful to know.  Here is what the link says.

1. "The umbilical cord must not be allowed to bleed after the delivery of the first infant in a multiple pregnancy. In identical twins with a single placenta (monochorionic placenta), the undelivered second twin may bleed to death if the umbilical cord of the firstborn infant is allowed to bleed.
2. The umbilical cord should be allowed to bleed if the patient’s blood group is Rhesus negative (Rh negative) with a single fetus. This will reduce the risk of fetal blood crossing the placenta to the mother’s circulation and, thereby, sensitising the patient. Nevertheless, anti-D immunoglobulin must always be given to these patients.
3. Allowing the umbilical cord to bleed during the third stage of labour reduces the placental volume and, thereby, speeds up the separation of the placenta. As a general rule, the umbilical cord should be allowed to bleed once a multiple pregnancy has been excluded."

How to cut the umbilical cord ?

Cutting The Cord Video

In this video, it appears it is cut after the cord has stopped pulsing but before the delivery of the placenta. 


Information from this website: About.com

Here's How:

1. Be sure the cord has stopped pulsing for most births.
2. Ensure that there are two clamps on the cord.
3. Hold the section of cord to be cut with a piece of gauze under it.
4. Using sterile scissors cut between the two clamps.
5. Dab excess blood.
6. Place scissors away.

Tips:

1. The gauze keeps excess blood from splattering.
2. Remind everyone that mom and baby can't feel the cord being cut.
3. The cord is thicker and harder to cut, more like meat gristle. Don't be surprised.

Resuscitation and Premature Cord Cutting

Here was a great blog entry that I found on a midwifes website. She reinforces the need to delay cord clamping and gives some helpful suggestions as what to do if the baby first has trouble breathing.

One good thing that I learned is that some babies make a slower transition to breath. She states,
"Their colour change may be the only obvious indication that they are making the transition. The cord pulses at the same rate as the baby’s heart, so feeling (or watching) it will reassure you that all is well."

I think I am going to be more prone to freaking out, so this was helpful for me to read.

If there is a problem she suggest milking the cord firmly toward the baby... to initiate breathing. I definitely would not have thought to do that on my own.

Her other suggestions include :

Suggestions

• Try and ensure that the baby does not arrive compromised by minimising unnecessary interventions.
• Do not clamp or cut the cord.
• Give the baby time to transition – if the cord is pulsing the placenta is providing oxygen… relax and reassure the mother if she needs reassurance.
• Do not clamp or cut the cord.
• If the baby requires assistance, start small – gentle stimulation, talking, blowing in his face (all can be done by a parent).
• Do not clamp or cut the cord.
• Milk the cord firmly towards the baby. This shunt of blood into baby is often enough to initiate breathing.
• Do not clamp or cut the cord.
• If further measures are needed, take the resuscitation equipment to the baby and resuscitate him in his mother’s arms.
• Did I mention – Do not clamp or cut the cord.

Note: Routine suctioning of the baby is totally unnecessary, invasive and could potentially create problems by stimulating a vagal response (a drop in the heart rate). "

The Website: Midwife Thinking Blog

Waiting to Cut the Umbilical Cord

One thing that I had never considered before was waiting to cut the umbilical cord after birth. I have done a little research and it seems that it is a great benefit to the baby, for many reasons. If you wait until the cord stops pulsing before you cut it then more nutrients and oxygen gets delivered to the baby, along with other benefits. If waiting a short time to cut the cord is a benefit to your newborn, then I have to ask, Why Wouldn't You Wait?

Here are some links that give more information on the subject.
You can also just Google the topic to see for yourself.

Television News - Msnbc.com

In the Newspapers - The Telegraph

Science Daily