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Re: Birth PlansFrom: Arthurfree@aol.comSun Jun 22 12:21:06 1997
In a message dated 97-06-22 05:18:24 EDT, Dr. Lisse writes:
<<
But I digress, I do believe in the reasoning that if the baby is below
the level of placenta some blood may flow towards the baby,
though I doubt it plays any role at all.
>> Though I (unfortunately) have NO reference, I was taught in training that an extended time to cord clamping with the infant below the perineum was a risk factor for hyperviscosity and neonatal jaundice (do to increased rbc breakdown in the newborn period). Too much rbc mass is a greater and much more frequent problem than too little in the newborn - at least in my well fed US population. As for birth plans, I generally honor the patients wishes when reasonable (and most are). However, mom is completely clear on the fact that when for whatever reason the process is no longer low risk, we will have a quick discussion and probably depart from the birth plan. When presented properly I've not seen dissatisfaction with this approach. However, when we clearly have a choice of method of management, I also include mom in the decision. The only conflict I've seen here have been due to the dad's input (sounds a little like congress legislating about reproductive rights, eh?). Arthur Freeland Warrensburg Missouri
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