Wednesday, February 23, 2011

Just for Fun!

Okay, everyone! Ready for some uber-fun activism?

The buzz on the street lately has been about shoelaces.

Why shoelaces?

Because shoelaces are what 911 operators tell parents to use to tie umbilical cords during precipitous births (births that were not intended to be at home but happen there anyway due to a rapid labor).

The quote from the currently used script is thus:


“Listen carefully and I’ll tell you exactly what to do next. Without pulling on the cord, tie a string (shoelace) tightly around the umbilical cord, about 6 inches from the baby.”

Ooh. Has anyone thought about the hygiene of the average shoelace? Or about the wisdom of immediate cord clamping in the first place, considering the stockpiling evidence that non-physiologic (i.e. premature) cord clamping is harmful to the child anyway?
First of all, check out this post by the ever-wonderful Navelgazing Midwife on what exactly is lurking on your average shoelace:


Then, the excellent paper by Dr. Nicholas Fogelson on the benefits of physiologic cord clamping (i.e. waiting for the cord to stop pulsing naturally so that baby gets all of his blood supply) vs. the risks of immediate cord clamping (unfortunately still the standard of care:

Then, while you're at it, take a second to "like" these groups on Facebook (if you haven't already):

Leaving A Baby's Umbilical Cord To Stop Pulsating (Delayed Cord Clamping)

Save the Shoelaces

Jill at the Unnecesarean recently published the 9-1-1 protocol so that we could see it:


The Shoelace Protocol

(Must say, as a side note, that I'm impressed with their breech protocol.)

She then published the website link to the people who write these protocols (see her entry "Changing 9-1-1Protocol Standards for Childbirth"). Here it is:

Emergency Dispatch

And here is their contact page. I got the four email addresses available and sent them the following letter:

***

To Mr. Freitag, Ms. Page, Mr. Massengale, Ms. Vanbeuge and others concerned,

I am writing to you with a proposal/request for change in the 911 protocol regarding directions for precipitous childbirth, specifically regarding the “shoelace protocol.” If I have written to the wrong location, please forward to the correct persons.

To the best of my knowledge, the current protocol reads (regarding tying off the umbilical cord):

“Listen carefully and I’ll tell you exactly what to do next. Without pulling on the cord, tie a string (shoelace) tightly around the umbilical cord, about 6 inches from the baby.”

I would like to propose the following:

(1) That a shoelace or string not be recommended for use.
(2) That cord clamping not be recommended at all.

Point #1: That a shoelace or string not be recommended for use.

I submit the following article for your examination:

http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2010/6/19/those-darned-shoelaces.html

The point being that used shoelaces are filthy and infested with bacteria and should have no place on a baby’s umbilical cord.

Point #2: That cord clamping not be recommended at all.

There is increasing evidence that clamping the cord while blood is still flowing from the placenta to the baby is both unnecessary and harmful to the baby. There has been a flood of articles in the news over the past six months on this issue, which I am sure you have seen, so I will just submit the following by obstetrician Nicholas Fogelson:

http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/

In summary, it is safer for the baby and much more hygienic if the cord is simply left to finish its delivery of blood to the newborn, rather than being unhygienically and prematurely clamped, which both keeps the baby from receiving his entire blood volume and introduces the possibility of dangerous pathogens onto the umbilical cord. In that case, the cord can simply be cut with sterile instruments by emergency services when they arrive, which is healthier in both ways for the newborn (and also gives less trouble to the parents).

Please feel free to contact me regarding either suggestion.

Sincerely Yours,
Diana J.

****

So, if you're interested in helping to promote change on a national level, have at it! Here are the emails that you can copy and paste into an email:


'scott.freitag@emergencydispatch.org'; 'carlynn.page@emergencydispatch.org'; 'Dave.Massengale@emergencydispatch.org'; 'arabella.vanbeuge@emergencydispatch.org'

Just send them a note making the following points:

(1) If you are going to clamp a cord, a shoelace is not a good choice.
(2) In any case, immediate cord clamping is neither necessary, healthy or safe.

And that scripts need to be changed to reflect modern research rather than outdated dinosaur-practices!

I love letter-writing for positive change!!!

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