Unexpected home birth: let’s keep our shoelaces on…

A woman whose husband recently called 999 when he realised that their baby was going to be born at home – unexpectedly, after a relatively fast first labour – was given some interesting advice. “Take one of your shoelaces out and get it ready to tie the cord with”, he was told by the person on the other end of the phone. So he obediently did just that.

The midwives who later cared for the family were a bit dismayed. It was not the first time they had heard this advice being given, and they are trying to get to the bottom of where it is coming from. Because it’s clearly not logical, for several reasons.

Firstly, if a baby is coming so quickly that it will arrive before a professional attendant can, then the chances are that everything is going to be fine, in which case the best course of action is to focus on keeping mum and baby together and establish that everyone is breathing. Including (and perhaps especially) dad, co-mum or whoever else is there as it happens. Sure, there are other things that a midwife would check if they were there or on the other end of the phone, but the vast majority of births will go really well (and often better) if we don’t interfere with them.

A key element of why we would leave the cord alone is because babies need a minute or two after they are born to ensure that they get their full complement of baby’s blood from the cord and placenta. This point is backed up with loads of research and I’ve written about the illogical nature of cutting the cord quickly if you would like to know more about that. So the primary reason that you wouldn’t want a shoelace involved is that the shoelace could get in the way of a physiological process that is healthy, normal and designed to happen in the minutes after a baby is born.

But let’s ponder on an imaginary scenario in which, just hypothetically, one decided that there was a good reason to tie off and cut the cord; where the benefits of doing so outweighed the disadvantages. Now I have to say that, off the top of my head, I can’t think of what this circumstance would be, because any help or resuscitation that the baby needs can be given while the cord is still attached, but I’m open to the possibility that there might be a situation in which immediate tying and cutting of the cord could be useful.

So we’re in that imaginary situation, where we need something to tie the cord, and we’re in somebody’s home. We need to find something that can be used to tie something else, and ideally we need to find something clean.

If you’re reading this at home, could you please look up and look around? What would you pick?

I’m looking around right now. I’m a crafter, so I’ve got lots of bits of ribbon and some nice organic wool, which I reckon is fairly clean. (We’ll ignore for a moment, if it’s OK with you, the fact that our cat thinks all the knitting in the house belongs to him. I’m confident I could put my hands on a ball that he hasn’t yet kneaded into kitty bread.) There’s a fairly new ball of string in the kitchen, and quite a few clean cloths and towels which I could easily cut or tear a strip off. Twine in the cupboard, a couple of bandages in the first aid kit and yes, I can see my husband’s shoelaces, but they would be pretty low on the list of things I would want to tie around my fresh, new baby’s cord. Maybe it’s just me, but I don’t think so. I think that most people, if asked, could easily put their hands on a relatively clean piece of string, ribbon or fabric. And I am going to argue that, even though birth isn’t sterile, any of those things would be better than a shoelace of unknown provenance.

The husband in the original story agrees with this, by the way, but for slightly different reasons. He’s more miffed because he unnecessarily sacrificed a decent shoelace out of his best (and most expensive) trainers.

And let me just put on record that I salute the bravery of anyone who has caught their baby at home and happened to use a shoelace in the process. I sincerely hope you get bought lots of beers while you tell that story for the next twenty years. I’m absolutely not criticising innovation or the decisions that people make when they are in a pickle and do what they think they saw happen on the telly after picking up the first string-like thing that comes to hand. But I am wondering why this advice is being given out by the health service. The staff themselves are probably just saying what they have been told to say. But surely we could do better by teaching critical thinking skills and asking people to reassuringly tell partners who end up in this situation to stand by, watch, breathe and cuddle rather than have them thinking that birth is an emergency which necessitates the sacrifice of their trainers.

photo credit: Hendrik Wieduwilt DSC_0902.jpg via photopin (license)

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