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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    May 11
    2009

    ncb info etc...and a few questions?

    Archived User

    sooo....had my dr's appt this AM and brought up birth options/etc.  it was a very nice conversation and very helpful infowise, etc....a few things i'm not sure about but overall i'm pretty happy with everything.

    she is very much in favor of NCB and is pretty much willing to let me do whatever - various positions, saline lock instead of IV as long as I am staying hydrated, walking, birth ball, jacuzzi, etc....delayed cord cutting, delaying baby care for a bit, baby on my stomach right away nursing asap (all barring complications of course), etc.

    inductions - she will not do an induction before 41wks barring complications and will not push for it until 42 - YAY

    episiotomy - she's only ever done one and that was to aid in a vaccuum delivery - not as a matter of routine.

    labor "time limits" - as long as things are progressing and baby is okay they will let me go; and i can wait at home as long as i want lol within reason of course (don't wanna have to deliver in an ambulance, haha).

    pit after delivery - normally done as a matter of routine....not sure about this one yet, i need to do more research....any input?

    also has anyone heard of mom using an oral vitaminK supplement (which passes through breastmilk and crosses the placenta from what i understand) instead of giving baby the oral vaccine??

    ummm.....drat this baby brain i forget what else we covered....oh well when i remember i'll edit, lol.

    oh yeah.  she's in favor but is glad i am keeping my options open - said she had some IV pain meds with her birth that she basically knew she was having cxs but just didn't care....i forgot to ask her which meds she had - that's next appt cuz i have to write stuff down i forgot to ask anywho - but which meds do they use does anyone know and side effects?

    Henci Goer

    Sounds like you have found yourself a doctor whose practice style is in line with what you want.  If she is part of a group, though, you might want to find out how likely she is to be at your birth. One of the problems I've seen is that not infrequently, doctors in the same group have wildly differing approaches. If there is a good chance you might get someone other than her, you'll have to ask your questions of them too. (I know; a pregnant woman's work is never done.  )  

    As for Pitocin after the birth, my take on the research is that the benefits of routine administration are overrated, and it can always be given if a woman is bleeding too heavily. On the other hand, it doesn't seem to have much in the way of ill effects other than, maybe, more cramping than you would otherwise experience. Unless you have strong objections, this isn't where I would draw a line in the sand.

    Much more important is that you do not want the umbilical cord cut before it stops pulsing. Doing so deprives the baby of a substantial proportion of its blood supply. The placenta is also more likely to come away easily and in a shorter time when the blood in it has been allowed to drain back into the baby's circulation. You also do not want umbilical cord traction, that is, the birth attendant pulls on the umbilical cord to deliver the placenta. (Not to be confused with giving the cord a gentle tug to see if the placenta has detached.) The medical literature is clear on the lack of benefits for these and the potential harms.

    About vitamin K, I haven't kept up with that controversy. The issue here is that vitamin K helps with clotting. It is made by helpful bacteria in the gut, but a newborn doesn't yet have its gut colonized. The problem with giving it to the mother is that her milk won't come in for a couple of days. What can be done is to give it orally to the baby, although I don't know how much research there is on this. One concern with oral vitamin K is What if the baby spits it back? Then you don't know how much the baby got. With my last one, now age 23, I did feel strongly about not giving the baby an injection shortly after birth. After talking it over with my doctor, we decided to give her double the dose that would be normally be injected. We put it into a medicine syringe, and once she was nursing, I inserted the tip of the syringe into the corner of her mouth, delivered the dose, and she sucked it down along with the colostrum without even noticing.  

    As for pain meds, they all have side effects and they all--epidural medications too--get to the baby. Childbirth Connection has an excellent section on coping with labor pain.

    -- Henci

    Archived User

    how long does it take for the cord to stop pulsating?  if you choose to wait to clamp/cut, is donating cord blood not an option then?    and how long does the placenta take to deliver on its own? or with pit after delivery?

     

    thanks much for all the help!!!

    Henci Goer

    It takes, maybe, 2-3 minutes for the cord to stop pulsing. I have heard that it is still possible to collect cord blood, but I am not sure. Consider this, though, if it isn't possible: childbirth is magnificently designed to give your baby everything your baby needs to be healthy. Your baby is supposed to get the blood that is in the placenta, which means it has a purpose. Besides the blood volume issue, I would bet there is a good reason why cord blood is so rich in stem cells. Does it make sense to deprive your baby of  what Mother Nature intended your baby to have at birth because of the minute chance that your child will develop an illness for which that blood might possibly prove helpful in the hypothetical future?

    -- Henci

    Archived User

    thanks much for the info.....

    we aren't planning on banking bc its too expensive but i was looking into whether or not our hospital collects to donate for research and anyone who might need it etc.....but if donating means i can't wait till cord stops pulsating to clamp/cut i wasn't going to....now deff not....

    Henci Goer

    Check into it before you make your final decision. As I wrote, I remember hearing that it is possible to get a cord blood sample and wait on clamping the cord, but I could be wrong on that.

    -- Henci


    All Times America/New_York

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