This is a really interesting discussion. This is also
part of my research and my literature review. Again,
if anyone would like more detail/refs let me know. In
summary: The interventions used to 'manage' a nuchal
cord - looping a loose cord or cutting a tight cord -
are at best unnecessary and at worst harmful
(particularly cutting). Therefore, if you aren't going
to do anything - why bother checking?
It is still routine practice in the UK and Australia.
As for numbers re. mw doing this:
In a postal survey in the UK, Jackson, Melvin, and
Downe (2007) found 87.8% of mw loop a loose cord over
baby's head, 57.8% of mw would clamp and cut a tight
cord.
These practices are a traditional/cultural thing - not
based on any evidence.
I also found that this was the biggest stumbling block
when trying to implement waterbirth in a UK unit. It
took a lot of work to convince the mw that women could
birth without mws fiddling on during the emergence of
the baby.
Rachel Reed
--- Amanda Hutcherson <[log in to unmask]>
wrote:
> An interesting snapshot study to do, Amanda
>
>
>
> _____
>
> From: A forum for discussion on midwifery and
> reproductive health research.
> [mailto:[log in to unmask]] On Behalf
> Of Carolyn McIntosh
> Sent: 21 January 2008 20:03
> To: [log in to unmask]
> Subject: Feeling for cord at birth.
>
>
>
> I was taught to feel for cord and always did this. I
> started to question the
> practice when I attended a seminar with Yehudi
> Gordon, Janet Blalaskas and
> Sheila Kitzinger here in New Zealand in 1990. Yehudi
> said that he no longer
> did this and that babies, even if they have cord
> around the neck will be
> born anyway without problems. If the cord is tight
> and causing problems for
> the baby then there will be delay with the second
> stage, fetal distress etc
> that would already have alerted the practitioner to
> a problem. I decided to
> trial this in my own practice and have never gone
> back to routine feeling
> for the cord. I believe that many midwives in New
> Zealand do still do this
> though. Has any data been gathered on this? Is there
> any evidence to support
> feeling or not feeling for the cord?
>
> Carolyn McIntosh
>
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and
> reproductive health research.
> [mailto:[log in to unmask]] On Behalf
> Of Susanne Houd
> Sent: Tuesday, 22 January 2008 6:40 a.m.
> To: [log in to unmask]
> Subject: Svar: Vedr.: Re: water birth
>
>
>
> Dear jette, It has been part of midwifery training -
> at least when i became
> a midwife and I still do it - ok I became a midwife
> 40 years ago.
>
> greetings from Greenland
>
> Susanne
>
> >>> Jette Aaroe Clausen
> <[log in to unmask]> 01/21/08 12:17 >>>
>
> Thought you might like to know, that the idea that a
> midwife should fell for
> the umbillical cord around the babies neek before it
> is born, has newer been
> part of Danish midwifery training/curriculum (at
> least I have never
> encountered traces of such a practice). I still
> remember how surprised I
> was, when I heard about this practice the first
> time.
> Of course it could happen, that a Danish midwife
> will do such a maneuvre in
> a special situation, but it is not part of routine
> practice.
> Robyns mail make me wounder. she writes that she was
> thought this practice
> during the early seventies. Has this practice gone
> into the history books or
> is it still thought somewhere ?
>
> All the best
> Jette
>
>
> Jette Aaroe Clausen
> Jordemoderlærer / Midwifery Lecturer
> MHH (Master in Health Humanities)
> CVU Øresund
> Jordemoderuddannelsen/ Faculty of Midwifery
> Haraldsade &
> 2200 København N/ Copenhagen
> Denmark
>
> Telephone + 45 8942 9209
> Hjemmetelefon + 45 8678 2327
> e-mail: [log in to unmask]
> Venlig hilsen
>
> Jette Aaroe Clausen
> Jordemoderlærer / Midwifery Lecturer
> MHH (Master in Health Humanities)
> CVU Øresund
> Jordemoderuddannelsen/ Faculty of Midwifery
> Sigurdsgade 24
> 2200 København N
> Telefon + 45 3531 0511/ + 45 3531 0500
> Hjemmetelefon + 45 8678 2327
> e-mail: [log in to unmask]
>
>
>
>
> "Robyn Maude [CCDHB]" <[log in to unmask]>
> Sendt af: "A forum for discussion on midwifery and
> reproductive health
> research." <[log in to unmask]>
>
> 20-01-2008 23:39
>
>
> Besvar venligst til
> "A forum for discussion on midwifery and
> reproductive health
> research." <[log in to unmask]>
>
>
> Til
>
> [log in to unmask]
>
>
> cc
>
>
>
>
> Emne
>
> Re: water birth
>
>
>
>
>
>
>
>
>
>
> My story is similar to Carolyn's. At first I had my
> hands down there all
> the time - to feel the emerging head, not the
> perineum. This was more
> because of the way in which I taught how to
> 'deliver' a baby in the
> early 70's than for any other reason and because of
> that old notion that
> one had to feel for the nuchal cord and pull it over
> the
> head.(incidentally, I do not even do this for land
> births now).
> My practice around waterbirth has changed
> enormously, both as a result
> of simply being with women and watching how they
> birth in water and from
> the work I did for my master's thesis. I rarely get
> my hands wet now;
> most of the women I care for let the baby out by
> themselves, by
> instinctively putting their hand over the emerging
> head to let it out
> gently, then bring the baby to the surface (I am
> always amazed at the
> ease with which babies unravel themselves from their
> cords when they
> need to in the water). At a recent home birth (3rd
> baby, 3rd waterbirth)
> the woman did her own VE to check for full dilataion
> ["I don't know
> where I am at" - "why don't you have feel?" "Oh!
> The baby's right
> there"], she proceeded to catch the baby and bring
> it to the surface,
> then 20 minutes later birthed her placenta and
> placed it in a dish she
> had ready.
>
> With regard to the perineum; most of the women I
> have had who birthed in
> water have had no perineal damage or smallish tears.
> Never a 3rd degree.
> I think this is because the water warms and supports
> the perienum and
> allows the head to move down without the women
> necessarily getting the
> strong expulsive pushing urge that can lead to tears
> of
=== message truncated ===
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