Babies on a plane!! (and also cord clamping)

Specialties CNM

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The other night I had a nightmare that I was on a plane with a woman went into labor :eek: (do these bizarre medical dreams happen to anybody else??) In my dream, I was trying to help deliver this baby and desperately thinking back to my maternity clinicals.

When I woke up, I realized that I had a question about cord clamping: even if you're in an emergency, non-hospital situation, you have to find some way to clamp the cord ASAP, right? Otherwise, I'm guessing that the newborn is going to hemorrhage through the umbilical arteries into the placenta. How the heck would you do that? Just hold pressure?

I know that this is a ridiculous scenario that I will almost certainly never be in, but it got me thinking. Figured I'd ask the experts! Thanks for sharing!

I know I shouldn't be watching the ridiculousness of I didn't know I was pregnant. But I get irritated everytime I watch a unplanned unassisted homebirth and the 911 operator is telling the to find a shoelace or something to tie off the cord with *facepalm*. I'm screaming at the TV. But then this is why I avoid almost anything birth related on TV, except Call the Midwife.

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I know I shouldn't be watching the ridiculousness of I didn't know I was pregnant. But I get irritated everytime I watch a unplanned unassisted homebirth and the 911 operator is telling the to find a shoelace or something to tie off the cord with *facepalm*. I'm screaming at the TV. But then this is why I avoid almost anything birth related on TV, except Call the Midwife.

Lol me too!! Leave that cord alone!!!!

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Also, for a seriously wonderful explanation about why delayed cord clamping is not inly safe but hugely important check out this video by Penny Simkin:

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Specializes in hospice.
Lol me too!! Leave that cord alone!!!![ATTACH]18729[/ATTACH]

Oh my....I may or may not have watched several episodes of a Baby Story while acting like that.....

When I was trying really hard to have a VBAC I had to stop watching that show. It was sucking my will to live.

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Easy. Don't cut the cord.

In a perfect situation, deliver the baby to mom's chest and cover with warm blankets and stimulate it to cry to clear it's airway if needed. In about five minutes the placenta will want to deliver... keep it connected to baby. No hemorrhage and baby gets what it needs, especially if you're unequipped to deal with it bleeding out the vessels or it needs resuscitation. The vessels physiologically clamp themselves shortly after birth anyway.

Apgar10, BSN-RN (and licensed midwife)

Seriously, awesome responses everybody! Thank you!!! Next time I have a medical dream/nightmare about babies on a plane, I'll know what to do!

I feel like my nursing program medicalized the birth process dramatically. So glad to hear that CNMs are taking it back to the basics, and advocating for the preparedness of women's and babies bodies (in most circumstances).

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I know I shouldn't be watching the ridiculousness of I didn't know I was pregnant. But I get irritated everytime I watch a unplanned unassisted homebirth and the 911 operator is telling the to find a shoelace or something to tie off the cord with *facepalm*. I'm screaming at the TV. But then this is why I avoid almost anything birth related on TV, except Call the Midwife.

I would wager that the reason behind it is the off chance the placenta doesn't deliver. It happens. Not good for Mom

But no sense in both of them going down.

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I can't get Samuel L. Jackson out of my head now. All I can hear is "motherlovin' babies on a motherlovin' plane!"

Thanks, OP for a cool post.

(Darn -- you beat me to it! :))

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Specializes in Reproductive & Public Health.
I would wager that the reason behind it is the off chance the placenta doesn't deliver. It happens. Not good for Mom

But no sense in both of them going down.

Timing of cord clamping has no real effect on the length of the third stage, maternal blood loss, or on the risk of a retained placenta. Sometimes delaying cord cutting will slightly lengthen third stage because it is harder to meddle with the placenta when it is still attached to baby lol.

I've clamped quickly in order to better manage a hemorrhage. But you don't need to clamp the cord early just in case. When I did homebirths, most of the time I would delay clamping until after the placenta was born . There's no evidence to support that as the ideal; it was just the easiest way to manage things. In the hospital, I try to wait at least five minutes (assuming I don't need to clamp earlier for a medical reason).

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Specializes in Postpartum, Med Surg, Home Health.

The show string comment, I graduated nursing school in 2008 and the instructor specifically used this example---that a shoe string could be used to tie off a cord if we ever found ourselves in a situation delivering a baby outside of the hospital. They also taught us that when baby delivers you should hold in at the same level as the placenta so that the blood does not go too much in any one direction (either baby or placenta) for fear of baby getting too much blood or losing too much blood. Is this not the case anymore, or this is not being taught in school anymore?

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Specializes in OB.
The show string comment, I graduated nursing school in 2008 and the instructor specifically used this example---that a shoe string could be used to tie off a cord if we ever found ourselves in a situation delivering a baby outside of the hospital. They also taught us that when baby delivers you should hold in at the same level as the placenta so that the blood does not go too much in any one direction (either baby or placenta) for fear of baby getting too much blood or losing too much blood. Is this not the case anymore, or this is not being taught in school anymore?

No, it's not the case. You don't need to tie off the cord if the baby is vigorous and healthy, and you don't need to worry about the blood going "too much in any one direction" (I would brush up on neonatal cardiac physiology).

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Specializes in L&D.

One of our OB docs tells the parents that delayed cord clamping leads to increased RBC in the baby, leading to increased jaundice. She says for a normal term baby, she prefers not to delay cord clamp, but that it is beneficial for pretermers......Any thoughts?

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Specializes in Community, OB, Nursery.
One of our OB docs tells the parents that delayed cord clamping leads to increased RBC in the baby, leading to increased jaundice. She says for a normal term baby, she prefers not to delay cord clamp, but that it is beneficial for pretermers......Any thoughts?

Proportionally, it probably does benefit pretermers more than it does full-termers, but it's not by by default harmful to full-termers.

Delayed CC increases total blood volume, not just red blood cells. The OB's concerns are a bit unnecessarily magnified IMO.

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