Puppies & babies

Cutting the Cord

It’s a tricky business, leaving that watery world where oxygen comes through an umbilical cord and entering this dry world where we need lungs to stay alive. But all mammals do it. Surely the “hand-over” from placenta to lungs has been pretty well worked out over the eons.

It has been. When a baby is born, his oxygen source doesn’t change immediately. He lands outside his mother – limp, blue, still using his lifeline of the past nine months to supply him with oxygen. He’s limp because he’s had a pretty dramatic trip and is unaccustomed to gravity. And he’s blue because he’s been blue for 9 months, not because he needs to be resuscitated. A uterus is a low-oxygen environment, and he is well designed to live in it… blue. But after a few moments or many minutes, while oxygenated blood continues to course to him from his placenta, he begins to stir in his mother’s arms and take his first breaths. Because she is holding him, his knees and feet knead her stomach. Those breaths and kneading motions and the full delivery of blood to the baby all cause uterine contractions and signal the placenta that its job is over. The cord stops pulsing, the placenta detaches, and the baby is launched. It is a gentle, smooth transition, controlled by the baby’s condition, which happens quickly for some babies, over many minutes for others. Clamping the cord early deprives him not only of oxygen but of as much as half of his normal blood supply.

Oddly enough, “delayed cord clamping” in modern terms means only 30 to 120 seconds! Why the rush? Hard to say. A desire to reduce the drug load in the baby’s system? Habit? Separate hospital teams for mother and baby? The cost is considerable: a baby who is cut completely from one oxygen supply before the other is established, and a baby who must start life with far less blood than normal, increasing his chances of anemia, hypothermia, and other problems. As one perceptive nurse said, “We cut the cord because we have to resuscitate the baby. And we have to resuscitate the baby because we cut the cord.” What do other primates do about the cord? Nothing much. They often eat the placenta, but the cord is left alone until well past all function. Human mothers, too, seem instinctively reluctant to bother the cord.

Baby and placenta were engaged in a quiet, continuous conversation throughout pregnancy, with the umbilical cord as telephone line. It is thought that the baby signals the placenta when he is mature enough to be born, by circulating specific chemicals. “Failure to progress,” for instance, is not a failure at all; it is the uterus doing its very best to protect the baby until he is fully mature and the mother is in a place where she feels safe enough to give birth. “Failure to progress” is a triumph of Mother Nature over modern obstetric pressures.

Mother Nature has a tough time standing up to the pressure of clamps and scissors, though, and a prematurely severed cord is one of those mistakes that can’t be undone. Insist ahead of time – firmly and repeatedly – that the cord be left alone until all pulsing has stopped… or that you be provided with research-based evidence for doing otherwise. There doesn’t seem to be any!