A revelation that every birth worker needs to know about gravity and placental transfusion

medium_10344483104At last!  A study evaluating the tradition-based tenet that newborn babies who are still attached to their umbilical cord need to be kept at the same level as the placenta … a position that is awkward and that either interferes with mother-baby contact or leads to the umbilical cord being cut earlier than is ideal.

And the results?

Show that it makes no difference at all.  So we can add ‘hold newborn babies at the level of the placenta until their cords are cut in case too much blood drains into or out of them’  to the notion of placental insufficiency, the idea that a labouring woman’s cervix needs to open by one centimetre an hour and all of the other theories that are not supported by evidence.

The study was recently published in the Lancet.  A team in Argentina looked at normally-born, vigorous newborn babies who were held either at the level of the vagina or on their mother’s abdomen or chest.  They were weighed immediately after birth and then again after their cord had been clamped, and the researchers then looked for any differences in the two weight measurements, which acted as a measure of the volume of blood that was transferred to the baby from the placenta.  There was no difference between the groups in this respect.

In a linked commentary, Raju (2014) notes that the introduction of delayed cord clamping into practice has been sporadic, and suggests that one reason for this is the logistical problem of practitioners feeling they need to hold babies at the level of the introitus until their cords have been cut.  At this point in the birth of a new family (and here I am paraphrasing Raju), pretty much everybody else in the room, including the baby, wants the baby to be skin-to-skin with its mother.  We can only hope that this evidence will make a difference.  Then, we can get on with researching the related areas which Raju mentions, one of which I was delighted to see get a mention, because this is another topic close to my heart: resuscitation with an unclamped umbilical cord.

 

More on placentas, cords and all things related in Birthing Your Placenta. Now updated!

Raju TNK (2014).  Delayed cord clamping: does gravity matter? The Lancet, doi:10.1016/S0140-6736(14)60411-6

Vain NE, Satragno DS, Gorenstein AN et al (2014). Effect of gravity on volume of placental transfusion: a multicentre, randomised, non-inferiority trial.  The Lancet, doi: 10.1016/S0140-6736(14)60411-6

photo credit: Anne Worner  via photopin cc

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