Saturday, November 20, 2010

Wonderful Stuff!

When I get more than 20 tabs open in my internet browser, I know that I need to blog so that I can clear them up and stop frustrating my husband! (He's a one-tab sort of guy.)

So here goes!

This will be quick, though, because today is Lepkuchen Day! (see my other blog for more information) and I have a ton to do to get ready.

To start, an article on my pet subject (physiologic cord clamping, known popularly as delayed cord clamping):

Don't Clamp Umbilical Cords Straight After Birth, Urges Expert

The gist of it? Basically that the research community is realizing that immediate cord clamping (i.e. baby is born and cord is clamped within 10 seconds, still the normal practice in U.S. hospital) is not healthy for baby.

I am so thankful this is finally getting some media attention!

"Write About Birth" has written up a nice little summary of the article (the original article from the British Medical Journal, that is):

British OB questions premature cord clamping

Good stuff!

The one thing I find frustrating about this is the following (from the first article I linked):

"Obstetricians and midwives should wait a few minutes before clamping the umbilical cords of newborn infants so that babies are not harmed by the procedure..."

Okay, okay. I know it's progress, but couldn't we move straight to the logical conclusion? If clamping the cord before it stops pulsing is unnatural and unhealthy, let's just move to the end-conclusion right now - waiting to cut clamp the cord until it is totally done pulsing, not just waiting "a few minutes." I can just see new hospital protocol - "The cord shall be clamped and cut three minutes - not four or five, but three - after the birth." It seems that progress must always be made in grudgingly tiny increments.

However, progress is progress, and I am overjoyed to see it.

Also, from "Write About Birth" - a fascinating look at the language of childbirth:

Why Natural Childbirth is Not a "Great Accomplishment"

Absolutely fascinating. I never would have thought of those points. Definitely also check out the article she links to - "Watch Your Language."

Really good stuff!!

Also, from the Huffington Post:

Women Speak Out About What's Gone Wrong with the United States Birthing System

Can I say that I LOVED this article? Way to go!!! Thank you for writing!

On the subject of shoulder dystocia (a fascinating topic), the following three videos from a Midwifery Today Conference:

Shoulder Dystocia I

Shoulder Dystocia II

Shoulder Dystocia III

I have always found shoulder dystocia (a birth emergency in which the baby's anterior shoulder is impacted behind the maternal pubic bone, and which can cause injury to the baby if mishandled or death if is not resolved quickly) a fascinating subject. Why? Well, (1) it's equally an emergency at home or in hospital (because it's too late for a cesarean), and (2) it's an emergency in which natural childbirth - and thus a mobile mother - is a HUGE bonus, and (3) the best resolution is usually through the Gaskin Manoever, which was named after midwife Ina May Gaskin, who brought the procedure to the United States.

I have also found the subject of shoulder dystocia rather amusing, because obstetric textbooks often ignore the Gaskin Manoever (which is basically hands-and-knees for the mother) in favor of more severe - and gruesome! - procedures, such as the symphysiotomy (cutting the pelvis open by cutting through the connective tissue of the pelvic bone - OUCH!) or the Zavanelli Manoever (shoving the baby back up the vaginal canal and doing a cesarean - very bad results due to trauma to the baby and time from emergency to birth). Turning a mama over on her hands and knees is much more pleasant - and effective!

Oh, and if you want to see something screamingly funny, try this video - it is actors portraying (with the use of a model) a shoulder dystocia in-hospital. I'd be laughing if it wasn't so sad - get the mother off her back!!! The incidence of shoulder dystocia is drastically reduced in upright, mobile and unmedicated mothers.

There's probably more, but I am OUT of time! Off to make delicious Lep Kuchen! Happy weekend, everyone!


  1. Thanks for these links!

    Yeah, I drive my husband crazy with all the tabs I have open (and we have separate computers!!). But then, he drives me nuts with his full inbox -- hundreds of emails he **hasn't even read**, much less hundreds of emails he has read and will never read again, but won't delete.

    If you share the computer, you can use two different browsers (e.g., you could use Mozilla Firefox while he uses Internet Explorer or Google Chrome), so you can have "his and hers" browsers, and then he can't complain about your open tabs. [Well, yes, he can. My husband has been known to use my computer on occasion, and close out my tabs for no other reason than that he just doesn't like *my* open tabs. Sigh...]


  2. Kathy, this is CREEPY..... Either our husbands are channeling the same wavelength (mixed metaphor), or they're identical twins. My husband drives me NUTS with his "full inbox -- hundreds of emails he **hasn't even read**, much less hundreds of emails he has read and will never read again, but won't delete." And I drive him nuts with my open tabs! The dual browsers has been under discussion lately. LOL!!!! :)

  3. LOL -- I would say "maybe they were twins separated at birth," but my husband *is* a twin, and was not separated from his twin brother. ;-) [Plus, far too much family resemblance between him and his family, and my kids and his family and their cousins, to even give it the briefest of consideration.]

    I just posted a question as my f/b status the other day, about how many emails people keep in their inbox, and only females responded. All but one said that they keep a "neat 'n' tidy" inbox, and most said that their husbands drive them nuts with their full inboxes, with hundreds of unread messages. The one friend that said *she* was the one with the unruly inbox said that her husband has a neat-and-tidy one. :-)

    Then another friend said that she keeps a neat inbox, but drives her husband nuts with all her open tabs, and said something about "female multi-tasking." I thought of this post, and knew I had to comment. :-)

    You are not alone!!


  4. Thank you for linking to me! I'm glad you liked my article. Thanks for sharing the info about shoulder dystocia too, very interesting.


  5. OB textbooks don't ignore the Gaskin maneuver, they just call it by the Obstetrician that described it before Gaskin was born - McRoberts.

    McRoberts and Gaskin are anatomically the same thing, except that in McRoberts the pt is supine and in Gaskin the patient is prone. The hips and pelvis are doing the same thing in both positions.

  6. Hello, Dr. F! I can't tell you how excited I am to have you visit my blog!!! Thanks for stopping by!

    I see your point about the equivalency of Gaskin and McRoberts; however, at least from a hearsay point of view, I have heard substantially better results coming from Gaskin than McRoberts. Perhaps this is because Gaskin mums are, by necessity, unmedicated and are able to maintain better mobility to aid dislodging of the fetal shoulder? Or from coccyx mobility? Or just the widening of the pelvis from an upright position? The last estimate I heard said that a prone position decreased the pelvic diameter by 30% (though I may be abusing terms here, or statistics). Perhaps some commenters on this article who are more up on things like this can comment. I, alas, am not an expert in any sense (though I hope to be some day). Can you comment on this, Dr. F, or do you see equal results between Gaskin and McRoberts in your practice?

    Again, thanks for visiting! And you need to update your blog more frequently - I love hearing what you have to say!

  7. Oops! For "prone" substitute "supine" on that last post.

  8. Dr. F., my understanding of the Gaskin maneuver, is not specifically the mother's positioning of her legs in doing it, but the moving of her body itself. The Gaskin maneuver is described as turning a mother over -- if she's on her back, to turn her to hands-and-knees (which has never in my mind seemed to indicate "turning her on her hands and knees, and then positioning her in a crouch so that her knees are pointed towards her ears"; nor does the description of McRobert's Position sound similar in any way to the description of the Gaskin maneuver), but also that if the mother is already in hands-and-knees, to turn her over on her back. Ina May has said that it is the large movement of the mother's body that helps to loosen the baby's shoulders, rather than the specific "end position" of mom being on her hands and knees.

    While McRoberts may allow for the same type of pelvic widening that occurs in the Gaskin maneuver, and would seem to be much easier to perform on a woman with an epidural, I don't see much if any similarity. And speaking as someone who has given birth without drugs, I'd much rather try the Gaskin maneuver first, than McRobert's position, which I can only describe as appearing to be extremely uncomfortable.


  9. Hey, guys! This conversation was so interesting that I decided to carry it over into a new post. Here it is:


I love to hear from you! All kind and thoughtful comments will be published; all inconsiderate or hurtful comments will be deleted quietly without comment. Thanks for visiting!