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Physiological birth, Placental transfusion

Responses to Mother and Baby–Positioning After Birth

A recent article Mother and Baby – Positioning After Birth has been the most ‘shared’ article to date and generated some interesting discussions online.

A follow-up post is being drafted with information about the scientific research on gravity, placental transfusion and cord clamping.

In the meantime, below are some responses to the ‘Positioning’ article where women discussed gravity, placental transfusion and cord clamping, waterbirth, instincts and interventions in the third stage of labour. Be sure to read the original article first!

MOTHER AND BABY – POSITIONING AFTER BIRTH  (opens in new window)

Mother and babe on bed

  • What a beautiful picture!

 

  • hmm, —– did come out floppy, but i kept calm and held and rubbed her and made eye contact, it was like no one else was in the room with me. but yes very interesting observation…i wonder if there would be differences if the mother was completely alone?
  • This made me cry. I birthed my baby on all fours (in hospital) and he was slid under me. I held his hands and looked at him and spoke to him. Then they took him because they were concerned about his resp rate. We did “delayed” cord clamping (maybe 2 mins, I’m not sure but I did ask if it had stopped pulsing and they said yes but that could be bs). I have beaten myself up for the last 20 months thinking “why didn’t I just pick him up while he was there, then they might not have needed to take him, his breathing might have been better with skin to skin…” To know what I did was normal behaviour has just rid me of some of my guilt. Plus the fact I had nowhere to sit up (in bathroom) anyway and couldn’t stand because I was too lightheaded. Thank you for sharing this.
  • very cool. Of all the similarities that I have considered between human births and that of other mammals, I never considered that minute of pause and the benefits gravity would have on blood flow. Really starting to look forward to [giving birth again]
  • That’s how it happened in both of my UCs. The baby came out onto the ground and I sat back and touched and looked at her but did not feel compelled to pick her up immediately. It didn’t occur to me that there might be a physiological reason for it.
  • Wow, I hadn’t really thought about this, but it rings true for me. I gave birth on my hands and knees, leaning forward and my little boy landed behind me. I turned round and was looking at him, and my husband picked him up and he and midwife encouraged me to turn round and hold my baby. Now that I think back, I don’t think I was ready. I kind of felt in shock – I always put this down to the really powerful FER [fetal ejection reflex] I experienced, but now I think it may have also had to do with being rushed to lie down with my baby on my chest before I was ready. Food for thought…Thank you for sharing this.
  • I experienced this with my own 2 home births and as a doula and antenatal teacher it is something I discuss and see with clients. So true!
  • I find this so interesting. When I gave birth, I was on all fours. My husband delivered our daughter and then she was placed on the floor underneath me. My first instinct was to look down at her, but I was met with calls of ‘pick up your baby’ from my midwives. Interesting that my natural instinct was not to pick my daughter up straight away.
  • this makes SO much sense! great article!
  • I experienced the shock/what to do in my hospital births. Lying there while they rubbed the baby on my chest. In my UC I scooped the baby out of the water and just sat there and looked at him for a minute (I guess?) I don’t know how long it was but I rubbed him, talked to him until he started breathing, then wrapped him up in a towel. It all felt far more natural since I was alone & uninhibited.
  • This is really interesting. I’ve had two homebirths, one UC and one midwife attended and for both of those I felt the need to just be still and take it all in immediately after the birth, but with both I was encouraged to put baby to breast (friends at UC) and to talk to my baby. I have a very strong desire to birth completely alone next time.
  • THANK YOU for that post! I felt so attached to my baby during pregnancy, while birthing, and immediately after birth, but I did not pick her up right away either. I felt so bad! I had her on all 4’s into my midwife’s hands. I immediately asked for her… well, I DEMANDED her LOL!! She gave her to me immediately when she came out, but it felt like forever to me because I Wanted her so fast (showing me that I did have that connection). BUT, I still let her sit on the bed under me (still on all 4’s) while I stroked her head. My body told me to wait. I never knew why. Now I do! I wanted her, and once I knew she was safe and with me, it was time for us to experience that transition.
  • I don’t like the negative they put with waterbirths. I’ve had one and watched many many others. I’ve never seen what is described here.
  • With my first (hospital birth) I was on my knees and the OB laid my baby on the delivery table. I had a brief chance to gaze at him and it felt very natural. I wish it could’ve lasted without interference. My second was born unassisted, again while on my knees. The baby’s father and I simultaneously caught him. Afterwards I held him, but down low. Not sure that it was instinctual so much as because of reading articles like this though.
  • Interesting post. Whilst I thought there was a weird unjustified negativity towards water birth, I completely agree with all the other points made in this article. It seems that almost ALL birth attendants truly have difficulties with leaving birth ALONE. The birthing mother really should be the one to decide when she embraces her baby. I really loath all of the unnecessary chatter and (often almost) patronizing demands “to pick up your baby” that you sometimes see in homebirth videos. This really highlights why solo birth resonates with so many women.
  • I birthed my baby boy at home in our bathtub. I was the one who caught him and I brought him immediately up to my chest (I was squatting), and wanted to cuddle him right away! I didn’t want to give him up to birth the placenta! I wanted my babies right away in my 3 hospital births too… my 2nd I actually reached out my arms immediately and said, “give me my baby!”
  • I birthed at home (squatting) and picked up my child straight away. I´m concerned about baby getting cold if not picked up straight away and using her energy to keep warm instead of using it to initiate breastfeeding and bonding. I´m also concerned that oxytocin release levels will be smaller (form not being skin-to-skin and getting cold which inhibits oxytocin release) which may lead to more bleeding and longer before placenta releases and effect bonding and the “falling in love”-hormones in an negative way. If this had been in hospital and mom didn’t pick up baby the midwife would rub baby and put blankets around her, which would lead to that all the good amniotic fluids and vernix would come on blankets instead of mom. The fluid and vernix is meant to be on mom, so baby can recognize mom and when baby crawls to breast, baby makes a trail of her own smell, which will help her to recognize the breasts next feed. I felt the article failed to mention these concerns. What are your thoughts?
  • Very interesting. One thing I was really looking forward to with our UC was an undisturbed third stage. I really don’t like how managed it was with my first and second children – particularly my second. I don’t really even remember it.
  • I noticed a lot of differences this time around and was amazed. I delivered on my knees for the second time and my hubby caught our daughter. He did hand her to me right away, so I didn’t get to look at the cord and such, but I just held her for a while. I stood a bit in the shower, sat some, and stood some more…just doing what felt right. I had a few gushes of blood during that time as the placenta detached. Before, I’d been immediately led to bed to lie down, causing the blood to pool inside and leading to very uncomfortable uterine massage. This time, my bleeding has been the lightest of all three deliveries by far, I didn’t have to massage my uterus as nursing helped it shrink well enough (I just checked it every once in a while) and it wasn’t filled with blood to expel. Being undisturbed during labor allowed me to experience the fetal ejection reflex as my body delivered our daughter without any active assistance on my part. I didn’t tear or even have any swelling. This recovery has been so amazingly easy on me. Baby came earlier than expected this time, so we didn’t handle the cord like I’d planned, but she did get her full transfusion. The cord was left alone for a few hours, then we tied it off and cut it. We had been planning a lotus birth. I just wasn’t able to care for the placenta and cord myself and my hubby and mom weren’t prepared to do it either. That’s really my only disappointment with the birth, but I’m ok with it. Anyway…in general, I think that it’s best to allow the mother to fully tap into her instincts. When something isn’t sitting well with her, there’s generally a good reason. So, whether she wants to pick her baby up right away or she takes a few moments to simply process what just happened, as long as it’s what she’s feeling led to do I think it’s great.
  • This is such an interesting article. It seems to me that when we witness the birth of an animal, we know that the mothers instinct tells her what to do. Yet, when a human mother gives birth, people question their instinct.
  • I did exactly that with my first ♥ just looked down and stared at him ran my fingers along his body – my second was born the the shower so i turned around and held him straight away, my 3rd i was on my back in an ambulance and he was put on my chest (never doing that again!) my first was the best by far!
  • i was a bit disturbed by the doc/midwife in that last clip
  • Interesting, but I birthed my third in that same position but my experience was that I wanted to hold him close right away.
  • Well that makes a lot of sense. First birth was hospital / “managed” 3rd stage. Second and third both I had a weird sense of “wait, what do I do, get down” after each. Second birth (UC, watched by my partner) I caught myself from standing, and then got low to the ground and just held him down low on my knee and checked him over for ears, eyes, nose, mouth, toes and fingers, WOOP and genitals! then his dad says, let’s get you and him cleaned up, so I held him up to me and that’s when he started to squawk :/ The placenta passed about 45 min later. Third baby I solo birthed in water, got out immediately and crouched low on the ground, and assumed the same position as with #2, taking a knee, with one foot on the ground, baby on my knee leaning over my hand while I examined her. The placenta passed while we were there, down low, and shortly after is when I felt like I wanted to go to my bed, so I called for my friend out in another room, she came in, quietly picked up the towel with the placenta on it and followed me and baby to the bed, where we snuggled in and napped. That baby did not squawk until she was 4-5 hrs old, when I needed to go pee, and only then momentarily. Just writing this out I think I discovered something new and amazing that I hadn’t known before. WOW! shivers. Also, thank you very much for the warning on the last clip, I can’t watch that sort of thing anymore.
  • It’s absolutely true that other mammals take their time to look and touch and very gentle check over their babies visually and physically. One woman said she felt bad that she didn’t want her baby passed immediately to her because ‘that’s how it’s done’….well it’s not how it’s done for everyone…birth attendants must remember not to project their perfect births or preferences on to others. I have never had a desire to catch my babies and I almost constantly hear doulas complaining that mws shouldn’t be receiving women’s children…it should be her or her partner. Well neither of us wanted to do that…just like the woman who wants to soak up her babe visually first…..is that so bad?
  • I recently had a wonderful hospital VBAC and I ended up in the exact same position as the mum in the photo. My daughter was pushed through my legs by the midwife and I think I picked her up at first then put her straight back down again! I felt like I didn’t really know what I was doing?! It was like a dream really, I was overcome with so many emotions and I was shaking. But it was great to *see* her – I saw her take her first breath and I announced her sex to the room. I never had the experience with my first birth as it was a section.
  • I wanted to catch my own (and I did) and it was a wonderful feeling! but i think i wanted that partly to prevent her being whisked away from me (like first time) and all and sundry from poking and prodding at her….Whether or not mws “should” be receiving babies is a different kettle of fish completely, I think…. I’d rather not be the last person in the room to touch my baby, but that’s just me
  • good point! that is the one small thing that did bother me about this last birth.. it was my second homebirth first one in the water.. I was on all fours then they awkwardly had me move so I could hold her and since I guess I wasn’t delivering the placenta right away they had me move out of the tub.. the cord was short so it was even more awkward trying to get out while I was still attached tot he baby so they cut her cord I don’t think it had stopped doing its job yet.. it bothered me a bt but other then that everything else was perfect.
  • no my instincts were telling me that I had to be the first person to touch my boy and I had to be the first person he saw – it was such an overwhelming feeling. I breathing him into my hands and then lifted him onto my chest as I needed to smell him
  • That second vid is great. The last one was disturbing and I was clenching my toes!
  • The second vid made me cry, she was amazing, and the last one was a bit full on grabbing at the baby like that, I bet she had few stitches after all that pulling!!!
  • Beautiful photo, don’t agree with all the observations (a mum talks to those around her and doesn’t gaze at babe, never met a mum who did this?),do agree with delayed cord clamping and love her story
  • I had my first bub in the water and my midwife asked me as I was pushing, whether I wanted to catch the baby myself. I said, no. I felt all I could do was to concentrate on getting the baby out, I didn’t feel I could also catch her. I was very happy to pass that responsibility to my midwife whom I trusted. My second was born at home – unexpectedly (had planned another birth centre water birth). I was on hands and knees this time and my mother caught him and passed him through my legs (still had my pants around my ankles. My instinct was to take and cuddle him immediately. I sort of fell back and leaned against the couch to gaze at him. I don’t think letting him lie on the floor would have felt right to me. In my experience it is more a matter of not having the energy to move, change position or pick up the baby. I was so exhausted after pushing my babies out, that I literally didn’t have the strength to change position. But I DI have the desire to. So yes, the help of someone to change position was very much appreciated.
  • I had the same need to hold my DS as close as possible and smell him. I refused to wash all of the vernix off him for days coz I just needed to smell that. I can still remember it exactly and it will be 3yrs next month♥ FYI I gave birth in a hospital with a MW, no drugs etc, delayed cord-clamping, physiological third stage and they actively encouraged me to move around into whatever position I wanted both during and after birth. the only time they asked me to be still was for stitches. So there are hospitals that are great for this, just look around. PS was such a great hospital that they even gave me info on keeping placenta attached till it falls off, or eating it etc.
  • That last vid made me cringe! Why oh why were they trying to pull that baby out by it’s head?!
  • I can totally relate. I’ve often thought about this moment initially after the birth. My 2nd bub was born at home. Our midwife arrived a few minutes after her birth. I was in such a ‘birthing zone’ & I was so focused on the birth that I kinda forgot it was a baby that was arriving! I felt so relaxed and happy in those first seconds. I was in a totally “ahhhhh that feels good zone”! It was a totally instinctive birth, free from all interference. I was almost a little shocked when my teary partner placed our tiny new person in my arms! For whatever reason, I believe it was all part of the natural process. I felt safe, relaxed and totally wiped out!! My partner caught our baby, so maybe this is part of my relaxed state? I’m not sure how I would have responded had a been alone or if it was my hands who first touched her? interesting!
  • “A mother gives birth on all fours, and remains in this position (breathing, moaning, crying, rejoicing, hiding her face) once her baby is born – followed by an instant chorus around her to “move”, “pick up your baby”? – (Sometimes others physically move the woman to lift her head up, move her knees and pick up the baby.) ~~~ That is EXACTLY how it happened for me
  • What a beautiful photograph!
  • This rings true. After —– was born my entire body felt locked into the position it was in. Had I been the wild animal out in nature (sans birth attendants) I definitely would have taken a few minutes to uncramp my entire body before figuring out how to scoop her out of the goo.

 

  • Q: So why do you seem kind of ‘against’ water birth? Or is it just the thought that the attendants scoop baby out , etc?
    A: I do see how the article has an overall ‘tone’ that seems negative towards waterbirth – this wasn’t intentional- I suppose what I was trying to refer to is that when a baby is born in water, there is no option but to respond quickly to the baby and lift up out of the water. And this is most often mother-directed, perfectly spontaneous, natural and provides instant skin-to-skin. The question ultimately being posed is would the mother or attendants have lifted the baby (above the placenta and as quickly) if the same birth happened on land? Personally, I believe that waterbirth has many protective factors (enhances hormones of labour, reduces interference from attendants esp with cord, assists mother to move freely and optimally and avoid tearing, reduces pain). The reading I have done on placental transfusion, effect of gravity and waterbirth indicates it does have an impact on the baby’s transition (slower), which may make things a bit tricky if the baby is under-perfused. From a purely personal point of view, if my baby was born in water but was pale and floppy or had a lot of liquid, I would want help to get out of the water ASAP and lower baby while touching/stroking baby to encourage contractions – perhaps even gently milk the cord if I thought baby may require resuscitation. But this may or may not be instinctive – it would no doubt be influenced by the research I focus on. I hope that explains where I was coming from? For the vast majority of babies that have delayed clamping, being held above the placenta does not reduce the overall amount of blood transfused to the baby. The problems arise when there is immediate clamping, especially if the baby has been lifted upright first. But when babies are below the placenta studies have shown the placental transfusion can almost be complete within 30 seconds – so it makes sense that this would be advantageous if blood volume/oxygenation was initially a problem for the babe (ie shoulder dystocia, compressed cord during second stage, very large baby with significant compression in birth canal etc) Ref: Yao – placental transfusion studies – Mercer – blood volume studies Thanks for asking me this question :)
    (Response: Makes complete sense :) thanks!! )

About Kate Emerson

Kate Emerson is a clinical student pursuing her interest in neonatal transitional physiology and clinical cord clamping practices. Please visit www.cord-clamping.com to read more.

Discussion

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  1. Pingback: Mother and baby–positioning after birth « Delayed Cord Clamping - February 29, 2012

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