Valerie Gommon Midwife’s Blog

Archive for the ‘National Institute for Health and Clinical Excellence’ Category

The idea that the umbilical cord should not be cut immediately after the birth but left to pulsate giving the baby extra blood, oxygen and stem cells is not a new idea to myself or many of my colleagues.  I have long believed that the baby should remain “attached” via the umbilical cord to his/her mother and my usual practice is to await “delivery” of the placenta before asking the mother or father to cut the umbilical cord.  I believe that early cord clamping interferes with the normal physiology of birth.

Recently Dr David Hutchon, a retired consultant obstetrician from Darlington, wrote in the British Medical Journal that maternity staff should wait for several minutes before cutting the cord and has also called for further research into leaving the cord intact.  http://topnews.co.uk/216535-expert-calls-hospitals-change-practice-clamping-newborns

The National Institute for Health and Clinical Excellence (NICE) still advocates active management, which includes early clamping and cutting off the cord. These guidelines mean that doctors and midwives are sometimes reluctant to change their practice.  This is despite the fact that both the World Health Organisation and the International Federation of Gynaecology and Obstetrics advise doctors to refrain from early cord clamping.

In summary, it is definitely worth thinking about whether you would prefer your baby’s umbilical cord to be left to pulsate and indeed possibly left intact until you have delivered your placenta.

Midwife Gloria Lemay also comments on this issue on her website.

www.gentlebirth.org/archives/lateClamping.html

The National Institute for Health and Clinical Excellence (NICE) are suggesting that midwives carbon-monoxide test women to check whether they are smoking – http://bit.ly/bTmg83.  Is this helpful or “policing”?

NICE suggest that every expectant mother should be tested during her pregnancy to enable smokers to receive advice on quitting.  Whilst this might be a positive intervention there is also concern that some women may not engage with midwives if they are seen to be “policing” and judgemental.  It is certainly something that will need careful consideration and sensitive handling as many hard-to-reach clients are also smokers and it would be easy to alienate these women further.

The NHS has made huge attempts to help women stop smoking http://smokefree.nhs.uk/smoking-and-pregnancy/

A baby born to a smoker is:

  • Twice as likely to be born prematurely
  • More likely to suffer from placenta problems around the time of birth
  • Three times more likely to be underweight at birth (even if born on time)
  • More likely to be a victim of cot death.

Whatever stage of pregnancy it is never too late to give up – you and your baby will benefit immediately.  You can call the NHS Pregnancy Smoking helpline 12pm to 9pm, 7 days a week 0800 169 9 169



Twitter