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

Tips On Breathing During Labor

Another topic of my research is the best breathing techniques of labor. I have no idea why I didn't pay more attention to this with my other births. Here is a good link that gives some suggestions like...

1. With each contraction start with a slow cleansing breath
2. Begin slow breathing when contractions are intense enough that you can no longer walk or talk through them without pausing. Use slow breathing for as long as you find it helps you. Switch to another pattern if you become tense and can no longer relax during contractions.
3. Focus your attention
4. Slowly inhale through your nose and exhale through your mouth, allowing all the air to flow out with a sigh. Pause until the air seems to “want” to come in again.
5. With each exhale, focus on relaxing a different part of your body

During the Active Phase of Labor

The website give a suggestion on light accelerated breathing. I tried it and felt like I was hyperventilating. It gives another option which is the  “pant-pant-blow” or “hee-hee-who” breathing. It says that this type of breathing combines light shallow breathing with a periodic longer or more pronounced exhalation. I think that I like this better.

Breathing Patterns for Second Stage of Labor - The Pushing, it suggest...


1) Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over—head to toe) as you breathe out.
2) Focus on the baby moving down and out, or on another positive image.
3) Breathe slowly, letting the contraction guide you in accelerating or lightening your breathing as necessary for comfort. When you cannot resist the urge to push (when it “demands” that you join in), take a big breath, tuck chin to chest, curl your body and lean forward. Then bear down, while holding your breath or slowly releasing air by grunting, moaning or other verbalizing. Most important of all, relax the pelvic floor. Help the baby come down by releasing any tension in the perineum.
4) After 5-6 seconds, release your breath and breathe in and out. When the urge to push takes over join in by bearing down. How hard you push is dictated by your sensation. You will continue in this way until the contraction subsides. The urge to push comes and goes in waves during the contraction. Use these breaks to breathe deeply providing oxygen to your blood & sufficient oxygen for the baby.
5) When the contraction ends, relax your body and take one or two calming breaths.

Here is the website: American Pregnancy Association

I will have to research more on the breathing during the pushing stage.

Thinking Outside of the Box

The older I get (even through I am just 30) the more I see how people just think "inside the box," especially when it comes to birth and babies. I see how the pressures of society really mold your thinking. If you don't do certain things then you are frowned upon. Weather it is your kids having to be in the best school, or you haveing to give birth in a hospital, etc. Whatever is the "norm" at that time. When we go back an visit America I watch commercials and see how they really use their selling techniques. They play on moms and give the sense that if you don't use certain products that you are exposing your family to danger. For ex. If you don't use certain cleaning products then everyone is going to get sick, because germs are Everywhere, oh no! Ex. Lysol spray. I guess my point is that I see where people should really stop and actually think for themselves. Ask yourself, why am I doing this and is it Really the best thing to do. People should truly study things for yourself. This can go along with religion, but since this blog is about birth and babies, I will stick to that. Now with the Lysol spray, okay why sure not, go ahead and kill some germs, but what about immunizations, birth in a hospital, which labor positions are really the best... And Why ! So why am I rambling about thinking outside the box ? I guess I am just frustrated because I was trained as a registered nurse and have given birth to 3 children in the hospital... and I am just now learning about birthing and the way your body really works. For ex. Sitting up/walking to progress labor !Birthing classes teach you the these things, but when you get to the hospital it is all thrown out the window. It is... lay down, strap in, hook up, and wait for the epidural. Completely against everything natural. Now when I think of "going natural" I think of a person that is all organic, hippy type.. no offense to anyone. But really I the more I study for myself, and learn from experience, the more I see a benefit in natural birthing techniques. I will try to post my previous birth stories with you in another post. In short, the first with an epidural, the second- very fast barely made it to the hospital. The third, Demeral/Phenergan a few hours before birth. The first time I even questioned an epidural was when I was working in the hospital, taking care of a postpartum mom. Long story short... she had a reaction to the epidural, she quit breathing, emergency c-section, and a previously healthy baby was not expected to live... because of the epidural. This fourth little one will be born here in Tanzania, and unless there is a severe emergency, will completely natural. Sooo keep coming back to read more post on how things turn out.

Bonnie in TZ