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

[adventure_rn]

The other night I had a nightmare that I was on a plane with a woman went into labor (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!

[Chapsi]

My fourth baby came quickly and was an unplanned unassisted home VBAC at 42.5 weeks. I was getting ready to leave when my water broke and I started pushing involuntarily and she was born 5 min later (most amazing birth ever). All I did was stimulate her, sit down with her skin to skin, call my midwife, and then start breastfeeding. My placenta slid out on its own and my bleeding was totally stable. My midwife arrived 30 min post birth and took care of us at home (I had lots of newborn and l&d experience at the time).

Definitely NO cord clamping necessary. Definitely no dirty bacteria- encrusted shoe laces to tie off the cord, yuck! Just keep baby warm and with its mama and watch mom's bleeding.

[Chapsi]

Unless the provider is milking the cord (which is a no-no), physiologic cord clamping is not shown to cause polycythemia. I did notice, as a former newborn RN, that the hematocrit of babies increased from an average of 45% to about 60% and babies did appear more ruddy when our OBs began routinely delaying cord clamping for at least a minute after birth. That's great for babies' transition, circulation, iron stores! In the rare case when we did see polycythemia (too many RBCs), partial exchange transfusions fixed it (taking some blood out and replacing with volume (saline)... This was not common at all.