Re: [ozmidwifery] Orthodontist

[Lois J Wattis]

Hi Sheena, when I worked in the hospital system I frequently saw obstetricians and midwives rush to clamp and cut a nuchal cord before the birth of the baby's shoulders, and the consequent rush to resuscitate the baby with equally panic-stricken parents watching on.  The usual explanation was that the cord needed to be cut to allow the baby to be born safely.   If there had been any dystocia the baby would be in even deeper trouble with a severed umbilical cord.  In reality of course, leaving it alone would have reduced or eliminated the need for resuscitation as it continued it's job as lifeline during the baby's transition to extra-uterine life.    Now I don't routinely feel for nuchal cord (women usually find this painful too), and simply unravel the baby if the cord is entwined.  Most births I attend are water births, and the nuchal cord tends to loosen in water as the baby is born anyway.    I have experienced one occult cord during a water birth.  I had my hands lightly on the baby's head as it was born, and felt the cord on the underside, which I would not have known about if I had not had my hands on.  It was NOT pulsating.  Rather than wait for the next contraction I urged the woman to push her baby out right away, which she did, and the cord re-established pulsations.  The baby's apgars were 3 and 7, but he recovered well and paed review confirmed he was fine.  I am convinced his 'lifeline' saved him, assisted by our resuscitation efforts immediately after the birth with cord intact.     Trust your instincts as you venture into your first year as a midwife.  You will see many practises you know are not evidence based.  Build your own knowledge and experience base, and be brave in challenging practises that are out of date.  Best wishes, Lois             ----- Original Message ----- From: Sheena Johnson To: [EMAIL PROTECTED] Sent: Wednesday, May 26, 2004 9:00 PM Subject: [ozmidwifery] Orthodontist Hi   this is not mid related, but I am stuck, and was wondering if any of the midwives in Adelaide could recommend an orthodontist for my daughter? I am having trouble finding one that comes recommended, don't really know enough people over there. Could you email me off list? Actually, I do have a midwifery question. Since I am starting my grad year and am beginning to assist at births unsupervised, I was wondering how many people on the list routinely remove the cord from around the babies neck if it is there, and how many don't.Do you even check? What is the frequency of cutting before the shoulders are born?   I feel that if there is no obvious obstruction of labour and there are signs of progress, ie restitution, the shoulders follow the head etc. then we should probably not bother about removing the cord, what do others think?     Thanks, Sheena Johnson [EMAIL PROTECTED]