Delayed Cord Clamping or Premature Cord Amputation?

by Asheya on December 20, 2011

The language we use to discuss care has connotations that often leave echoes in our subconscious, unknown to us.

As I was reading Melissa’s post on Delayed Cord Clamping, it struck me: when we use the word delayed, it almost has a negative connotation to it (think of ‘delayed development’ or ‘delayed reaction’).

Also, regardless of whether the word ‘delayed’ has a negative connotation or not, what’s happening is that the term is referencing immediate cord clamping as its basis, making immediate cord clamping seem normal.

In fact, any clamping or cutting of the cord is an intervention: strictly physiologically speaking, the cord does not sever itself until after it has dried.

If we want to frame this procedure in a new light, using physiological birth as the basis (and therefore the ‘normal’ for any comparison), we should actually call delayed cord clamping and cutting ‘premature cord amputation.’ And clamping and cutting immediately at birth should be ‘premature pulsing cord amputation‘ or better yet ‘cutting off the lifeline.’ It’s not just early cord clamping; it’s premature, before the time is right.

Notice how the word ‘amputation’ changes your perception of what is happening when the cord is severed.
And think about the words ‘late’ and ‘early.’ Late is associated with laziness and death (the late so and so). Early is associated with being on time, being ahead of the game, being prepared. And notice your reaction to the word ‘premature’ and think about how a maternity care provider would perceive this word.

I requested premature cord amputation for all three of my children, calling it of course delayed cord clamping. I think the doctor waited a minute or two to amputate my first son’s cord, but I’m not sure. For my daughter and my son born at home, we waited a few hours after the birth to amputate the cord. I didn’t do a lotus birth, where I carried the placenta around for days until the cord fell off naturally.

Studies clearly show that waiting until the cord has stopped pulsing before amputation has huge benefits, as Melissa discussed in her post. As far as I know, there are no studies about lotus birth, but I imagine this has benefits too, for parents who are willing to work around the placenta.

If health care providers and parents feel the need to amputate the cord at all (which some don’t) that amputation should be done with the least harm to the baby. All activities after the birth of the baby should be designed around the concept that it is normal, healthy, and very beneficial for the baby to remain attached to the placenta.

If we begin to frame cord amputation as an intervention, regardless of when it is done, and the natural drying of the cord and eventual separation from the placenta as the physiological process and therefore the basis for any comparison, perhaps we can start to shift not only our own thinking about this issue, but care providers’ thinking as well.

Stay tuned for my next post: on resuscitation, keeping the cord intact, and how to advocate for yourself (and make change!).

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