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an urgent ongoing need

fetal to postnatal circulation





>>Question Authority




Contact: Eileen Nicole Simon
Question Authority: Be informed before giving consent
Any real authority on any subject should be open to questioning.  Too often we are
told, "The current thinking is..." without further explanation.  I am glad to see women
now draw up birthing plans; and, that also include waiting for pulsations in the
umbilical cord to cease.  How to proceed in an emergency, like dystocia or nuchal
cord must also be addressed in these plans.
Asked at my last visit for a gyn exam if I had any questions, I broached my concerns
about umbilical cord clamping.  The doctor didn't understand why that should matter to
me anymore, and I told him that my children are hesitant to start families because so
many of their friends are dealing with handicapped children.  His response was that he
didn't think it matters how soon the umbilical cord is clamped.  This is scary, and I won't
be going back to his office!
Outcome studies never go past discharge from the newborn nursery.  The National
Children's Study (NCS) will address development through the school years, but
shouldn't common sense prevail against current obstetric protocols?  Most obstetricians
and midwives, I hope, wait for an infant's first breath before clamping the umbilical cord,
but younger practitioners may be overzealous in adhering to the protocols they have
learned from newer textbooks.
It is difficult to go against the advice of professional experts.  A niece of mine discussed
the timing of umbilical cord clamping with me shortly before the birth of her first child.  
She requested waiting for pulsations in the cord to cease before clamping, against the
better judgement of everyone except her mother.  Her son had high bilirubin levels, and
she was regaled with "we told you so" remarks.  For many months, I felt horribly uneasy
about having given any advice.  Her son is now two years old, and clearly precocious,
much to my relief.
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Posted: February 27, 2006
(a work in progress)