Hi from NZ. I was certainly taught to feel for the nuchal cord and clamp and
cut prior to the birth of the baby, as required, if very tight. However,
over the years my practice and the practice environment have changed
dramatically and I TRY to support women to birth physiologically.This
requires significant 'unlearning' of the so called routines we were taught
to do, many of which do not have evidence to back them up. While the
majority of the births I attend are in the hospital (25% are homebirth) I
have long ago abandoned this practice. A significant number of the women I
care for birth in water and I love to watch the baby unravel from its cord,
sometimes gently assisted by us. I have grown in confidence to practice
'hands off' birth especialy in water as any stimulation of the baby ie by
feeling for the cord, is not recommended. I certainly can not remeber the
last time I cut and clamped a cord prior to birth of the body. However I was
the supporting midwife at a birth where the baby took a very long time to
crown and eventually birth its head, despite good maternal effort.The cord
was very tight around the neck x 3 times. The attending midwife clamped and
cut and unravelled the cord and the baby was pulled out. It was virtually
lifeless and needed extensive resus. I always felt uncomfortable about the
clamping of the cord in this situation. What if the baby had gone on the
have shoulder dystocia? As a midwifery lecturer I talk this issue through
with the students and we discuss the pros and cons. They are not being
taught to clamp and cut the cord. However in the clinical environment where
they obtain their practical experience, many of the practitoners still do. I
would look froward to finding more out about the 'evidence'
Cheers, Robyn
----- Original Message -----
From: "Denis Walsh" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, January 24, 2003 12:02 AM
Subject: Re: Help and advice


> Where I work this practice was almost routine until a few years ago when
> 'hands off' births and waterbirths began. Anecdotally, not feeling for a
> cord has never caused a problem - the cord comes out draped all round the
> body and you just unwind it after birth. I think it is very widespread as
a
> practice because when mentioned in the Courses I do, most midwives do it
and
> it usually generates a little debate about pros and cons .e.g.
implications
> for third stage etc. Also have noticed it on American birth videos.
> Denis Walsh
> ----- Original Message -----
> From: "Elaine Jefford" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Thursday, January 23, 2003 10:19 AM
> Subject: Help and advice
>
>
> > Hi EVERYBODY
> > I have just registered for my PhD and the topic I am researching is the
> > practice of feeling for the cord after delivery of the head but before
> > delivery of the shoulders. This practice is mentioned in some of our
> > English text books (Myles) and I have and am still witnessing it in
> > practice, but to date I can find no literature or research to make this
> > evidenced based practice.
> > Does anyone know when this procedure was introduced or why? Also why
have
> > we as midwives adapted it, is it linked to ritualistic practice?
> > Do you know of anyone who practices this procedure or do you do it
> > yourself? Do the women consent to this practice?
> > Any help or advice to any aspect of these questions would be greatly
> > appreciated
> > Elaine Jefford
> > Senior Lecturer
> > Anglia Polytechnic University
> > Chelmsford England
>