Options for the Third Stage of Labor
“Another thing very injurious to the child is the tying and cutting of the naval string too soon; which should always be left till the child has not only repeatedly breathed, but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a part of the blood being left in the placenta which ought to have been in the child.”
-Erasmus Darwin (Charles Darwin's father), 1801
No, cutting the cord really isn't part of the third stage of labor. However, since it is usually done so closely to birth, perhaps sometimes it is considered to be. Clamping the umbilical cord early deprives the baby of as much as 54-160 milliliters of blood, which represents up to half of a baby's total blood volume at birth. In addition, early cord clamping has been linked to anemia in infancy. Sometime after the baby is born, a substance within the umbilical cord, called Wharton's Jelly, expands and causes the cord to cease pulsation, which is usually seen as the best time to cut the cord.
Decide if the cord cutting battle is one that is important to you. If for some reason your caregiver is reluctant or unbudging on the issue, perhaps you can offer a compromise. One I have seen work well is asking the doctor to wait at least five or ten minutes before cutting the cord. If this issue is very important to you, you may, or course, refuse to let the cord be cut until you say.
The Birth of the Placenta
Now, on to the actual third stage of childbirth, birthing the placenta. Most women don't realize they might have any decisions at all about how the placenta might come out. What you must be aware of is that many care providers perform what is known as "controlled" cord traction, or pulling the placenta out by the cord.
This poses many risks to mom, the worst being postpartum hemorrhage that can result in a complete hysterectomy or death. Remember that the birth hasn't ended jut because the baby is here. The placenta still must be born and we must protect its entrance into this world.
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