Unexpected home birth: let's keep our shoelaces on...

A woman whose husband called the emergency services 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 began trying to get to the bottom of where it was coming from. Because it’s clearly not logical, for several reasons.

Why this is bad advice

First, 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 bit of time 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. That is, where the benefits of doing so outweighed the disadvantages. This would be something really rare, like there being a tear in the cord. Which hardly ever happens.

What would you pick?

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 my house 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).

The decisions that we make about our pregnancy and childbirth journeys can shape our experiences, health and lives, as well as those of our families. But those decisions can be complex. This book is a guide to the different perspectives and approaches that exist, and it offers tips, tools and ways of thinking which will help you make the decisions that are right for you.

There’s a fairly new ball of string in the kitchen, and quite a few freshly laundered cloths and towels which I could easily cut or tear a strip off. Twine in the cupboard and a couple of bandages in the first aid kit, which are even sterile. 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, though 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.

Where does this come from?

So let me just put on record that I salute anyone who has caught their baby at home and happened to use their shoelace in the process. It wasn’t your fault. I sincerely hope you get bought lots of beer/wine/gin while you tell that story for the next few decades. I’m absolutely not criticising innovation or the decisions that people make when they are in a pickle. They 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 appalled that this advice is being given out by the health service.

We know that the staff are following a script. It’s based on poor information, and people are trying to change that. Sadly, bureaucracy takes an age to change, which is why I will be regularly reposting this until it does.

But surely we would 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.

Please believe me when I say that birth is not an emergency which necessitates the sacrifice of your trainers.