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Re: Third stage, how long?From: Gail Graham (GA12L@aol.com)Sun Jun 25 02:59:00 2006
ApricotRex@comcast.net wrote: > Gail~ > Cord drainage as you describe is NOT physiologic as cutting the cord > before the placenta delivers is not as mother nature intends. You are > intervening as surely as I am when I hang on the cord and give feedback > to mom the moment I feel that characteristic lengthening (aka gentle > cord traction). What cord drainage? Once the cord stops pulsating there is very little cord drainage. It's not clamped because it doesn't need to be clamped. Many women don't want a lotus birth either so the cord is going to be cut shortly after the placenta is out and there is no benefit to mother or baby to keep it intact once it has stopped pulsating, therefore the intervention is negligible. In physiological third stage there should be NO cord traction gentle or otherwise. Surely you can see cord lengthening, you don't need to hold the cord to feel it. Much of what we do in midwifery can be ascertained by sight alone. For example, I don't do a v/e to confirm full dilatation. Watching women for over 10 years and 3 years as a student before that I know what external signs to look for and how a woman's behaviour changes during labour.
> I find your tone interesting. You seem like you are stating an absolute Absolutely nothing is written in stone. One has to adapt if or when the situation changes. However, physiological can become active management but not the other way around. Once an oxytocic is given active management must be followed. Read the Bristol Third Stage trial, it was fundamentally flawed due to the 'mix and match' approach and then look at the Hinchbrooke trial and spot the difference! Midwives here MUST be competent and confident in both methods. As for me stating an absolute truth, well, my dissertation was all about the third stage therefore I think I speak with some degree of knowledge. But as we all know women are individuals and one size does definitely not fit all. Gail
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