|Concerns about umbilical cord clamping
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an urgent ongoing need
fetal to postnatal circulation
>>Concerns (NCS pp1-13)
Contact: Eileen Nicole Simon
|Placental blood is
|Umbilical cord clamping,
a human invention
|Waiting for the first breath,
a long tradition
|1. Placental blood is respiratory blood
|Circulation in support of aerobic metabolism arises early in embryogenesis. The heart is the
first functional organ circulating erythrocytes from the embryonic yolk sac. The placenta becomes
the respiratory organ of the fetus. Placental blood expands the alveoli of the lungs at birth.
|2. Umbilical cord clamping, a human invention
|Umbilical cord clamping is a human intervention, perhaps intended to prevent hemorrhage, but
it has been the subject of controversy for at least 230 years.
|3. Waiting for the first breath, a long tradition
|Textbooks of midwifery and obstetrics traditionally all taught that the umbilical cord should not be
tied or clamped at least until the newborn infant is breathing on its own, and preferably not until
pulsations in the cord cease.
|4. Recent change of opinion
|Early clamping of the umbilical cord began gaining favor in the 1930s, though most obstetricians
continued to practice "slow birth." The Apgar score became a measure of the effectiveness of
resuscitation for infants who failed to breathe before clamping of the cord.
|5. Hypovolemic shock
|The frequent need for transfusions and blood volume expanders in neonatal intensive care units
indicate that hypovolemia and hypovolemic shock are often encountered.
|6. Ischemic brain damage
|Monkeys subjected to suffocation and umbilical cord clamping at birth were found to have
ischemic damage within the brainstem, most prominently in the auditory pathway at the
|Posted: February 27, 2006
(a work in progress)
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|7. Language development
|Ischemic damage of brainstem auditory nuclei may impair learning to speak "by ear" and
prevent normal development of the later maturing language areas of the cerebral cortex.
|8. Evidence versus opinion
|The long neglected data on monkeys subjected to asphyxia at birth remains as solid evidence of
harm. Umbilical cord clamping on the other hand is a procedure based on opinion.
|9. Increased prevalence of childhood disorders
|Immediate clamping of the umbilical cord is now a published protocol, and included in new
textbooks of obstetrics. This should be considered as a possible cause of increased numbers
of children with developmental disabilities.
|10. Dependency and lifelong need for care
|Developmental disabilities remain as lifelong handicaps, with ongoing dependency and need
for care throughout the lifespan. There is no cure for brain damage; it must be prevented.
|11. Factors in need of closer examination
|a) jaundice, b) maternal-fetal placental barrier, c) cord pulsations are from the fetal heart to the
placenta as an ongoing organ of respiration, d) the essential, ongoing need for oxygen is the
most crucial environmental factor to investigate, e) greater vulnerability of males. f) human
assisted births of thoroughbred foals, g) value of maintaining connection to the mother at birth
until placental circulation stops.