"All that is necessary for the triumph of evil is for good men to do nothing" Edmund Burke, 18th century Philospher.

"A long habit of not thinking a thing wrong gives it a superficial appearance of it being right." Thomas Paine

"The welfare of humanity is always the alibi of tyrants." Albert Camus

"Choice is the essence of ethics: if there were no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose." Margaret Thatcher, March 14, 1977

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair

Explaining the Cause

I am a practicing obstetrician who is a strong supporter of patients rights to informed consent and refusal. I believe a patient has the right to choose her own path given true and not skewed informed consent. Following that tenet, just as a woman should be able to choose to have an elective c/section she should be able to choose not to have one, as well. The American system of hospital based obstetric practice has been eroding those choices for women for quite some time. Due to concerns of economics, expediency and fears of litigation women are being coerced to make choices that may not be in their best interest.

I have had a long relationship collaborating with midwives and find the midwifery model of care to be evidenced based and successful. I was well trained at Cedars-Sinai Medical Center in the mid 80's to perform breech deliveries, twin deliveries, operative vaginal deliveries and VBACs, and despite evidence supporting their continued value, hospitals are "banning" these options. Organized medicine is also doing its best to restrict the availability of access to midwives.

Home birthing is not for everyone but informed choice is. Medical ethics dictates that doctors have a responsibility and a fiduciary duty to their patients to provide true, not skewed, informed consent and to respect patient autonomy in decision making. Countries with the best outcomes in birthing have collaboration between doctors and midwives. This is not what has been happening in the hospitals of America. Its time for a change and the return of common sense.

The midwifery model of care supports pregnancy as a normal function of the female body and gives a legitimate and reasonable alternative to the over-medicalized model of birth that dominates our culture. Through this blog I hope to do my part to illuminate what is wrong with our maternity care system and what is right with it. I do not expect all to agree and that is OK. We must all understand that given honest data it is not always reasonable to expect two people to come to the same conclusion. Our differences should be respected.

Sunday, September 20, 2009

More Thoughts About Early Cord Clamping

Thanks to my Facebook Friends for this article:

Cord Clamping Danger to BabiesShare
Wednesday, July 1, 2009 at 5:11pm
By Lucy Johnston HEALTH EDITOR, Daily Express Weekend – Dec, 16, 2007

CLAMPING a newborn baby's umbilical cord too soon after birth can lead to oxygen deprivation and may explain the dramatic rise in autism, scientists have warned.

Groundbreaking research suggests the routine practice of cutting the cord quickly after delivery may reduce an infant's supplies of oxygen and nutrient rich blood in the crucial minutes before they start breathing.

Specialists now believe that in vulnerable infants this is leading to brain hemorrhaging, iron deficiencies and mental impairment, including autism, a mental condition characterized by extreme loneliness and a desire for sameness. Experts say this now affects up to one in 100 children … a sevenfold rise over the past decade.

Last night. David Hutchon, consultant obstetrician at Darlington Memorial Hospital who has studied the effects of cord clamping said: "Babies are being put at risk by clamping the cord too quickly.

"The blood and oxygen supplies in the baby are rapidly decreasing during the minutes after birth. Infants need an increased blood volume to till their lungs and the rest of their organs that are coming into use.

He added: "In susceptible infants, early cord clamping and the lack of blood to the baby increases the risk of brain hemorrhage and breathing problems. This could help explain the rise in autism. Why are we doing it?"

He added that he considered the modern practice of early cord c1amping to be "criminal" in particularly vulnerable and undernourished infants. And he said, "Obstetricians are more likely to clamp early than midwives. It is perhaps significant that autism seems to be more prevalent in babies who were delivered by an obstetrician.”

Umbilical cords are now clamped almost immediately ... before 30 seconds in many hospitals because over the last 20 years doctors have increasingly believed this could reduce the risk of mothers bleeding to death.

However: a growing number of experts, including Mr Hutchon, believe the risks to the baby outweigh the potential harm to the mother. They say at least three minutes should elapse before the cord is cut to allow the mother's blood from the placenta to continue to flow into the baby until its breathing is more established.

Their theory is borne out by recent research. In one major study, involving more than 1,900 newborns and published in the Journal of the American Medical Association, delaying cord clamping for two minutes reduced the risk of anemia by half and low iron levels in the blood by a third.

Eileen Hutton, assistant dean of midwifery at McMaster University in Hamilton, Canada, who carried out the research, said: "These benefits extend beyond the early neonatal period."

Another study carried out by Andrew Weeks, and published in the British Medical .Journal had similar findings: Dr Weeks, senior lecturer in Obstetrics at the University of Liverpool and practicing obstetrician at Liverpool Women's Hospital, told the Sunday Express: "I delay the cutting of the cord. This is especially important for premature babies who have fragile blood vessels. The lack of blood supply could theoretically lead to autism.

"There is evidence to show it [immediate clamping] can damage a baby but none to show it can benefit."

Patrick O'Brien, spokesman for the Royal College of Obstetricians and Gynecologists said: “The latest research does suggest parents should be given a choice and it should be discussed routinely in antenatal classes.”

Birth injuries caused by immediate clamping of the umbilical cord are explained and discussed fully at the following web sites:


G. M. Morley MD FACOG

Email obgmmorley@aol.com

I gave a PowerPoint presentation on cord clamping injuries at Darlington
Memorial Hospital on September 24, 2007.


1 comment:

  1. You probably have heard about this before, but I recently went to a presentation about fetal surgery. The surgeon talked about a technique called EXIT: Ex Utero Intrapartum Therapy, which uses the placenta as a bypass machine. The surgeon is able to operate on the baby to stabilize and correct the problem before clamping the cord. I think it was in cases such as a cervical teratoma. So if this form of delayed cord clamping works in such severe cases, I don't understand why every baby can't have this benefit as they are transitioning from intrauterine life to life on the outside. It makes such sense!