Here is an article about a baby born on an Air New Zealand Flight which I picked up from Sarah Stewarts blog.
The Air New Zealand plane was approaching Auckland International Airport when the woman went into labour and gave birth soon afterwards.
A couple of nurses on the flight tended to the woman and used shoe laces to tie off the umbilical cord but were not able to save the life of the baby.
Paramedics met the plane and took the woman to Auckland’s Middlemore hospital.The baby was understood to have been six weeks premature and the mother was 34 weeks pregnant — within Air New Zealand ‘s guidelines for flying when pregnant.
I wanted to comment on this because I hope the baby was stillborn at 34 weeks and they didn’t cut the cord creating the problem. If the baby was still born why would they try to cut the cord even if they felt it was the right thing for a live born? You’d think they would all be too upset to worry about that.
I hope that they post explaining what really happened. It goes to show the lack of knowledge surrounding the third stage in general and the ridiculous belief that after the baby is born you MUST get that cord cut. How we have forgotten about physiological birth in the rush to try and get rid of risk and control it.
Addendum
I have totally made it. Once more I am brought up on a totally ridiculous blog with bizarre commentary.
Barrett appears to be suggesting that death from prematurity can be prevented by delayed cord clamping. This is absolutely mind boggling. First of all, to the extent that there is any benefit to delayed cord clamping, it is in preventing anemia of prematurity. To my knowledge, there is no scientific evidence showing that delayed cord clamping is a treatment for hypoxia, let alone prolonged hypoxia.Second, even if delayed cord clamping were to decrease hypoxia, the placenta stops functioning and is expelled in a matter of minutes.Third, if delayed cord clamping is a treatment for prematurity, why did the overwhelming majority of premature babies die before the advent of modern medicine?Talk about willful ignorance. If the baby did die from prematurity, it died because there was no equipment or personnel available to perform an expert resuscitation. In fact, the baby died in exactly the same way that a homebirth baby needing an expert resuscitation would die. This is the part that homebirth midwives cannot seem to absorb. Their techniques and fetishes (like delayed cord clamping) DON’T improve neonatal mortality. Homebirth INCREASES neonatal mortality; it doesn’t lower it.
What a klutz. 34 week babies are not still born due to prematurity. Still born is still born regardless to gestation.
My comments were that in the ignorance of unnecessarily cutting a cord it is possible to compromise a baby when doing it with no knowledge of the physiology. If a baby is born with a heart rate then it is alive, without the ability to resus it’s the only thing keeping the baby alive in the absence of resps and my wondering was hoping that cutting off the only supply a baby has didn’t create a worse problem. The fact that the cord keeps pulsing has never been denied in any piece of research. Plus the poster obviously doesn’t realise that if it isn’t an active 3rd stage the the placenta in the main doesn’t separate for 10/15 mins at least. Not always because there is no absolute.
Just to recap, still born is still born. The article said the baby was still born. That means not born alive.
At 34 weeks babies are mainly born in a great condition, keeping it warm and oxygenated until it could receive treatment would have been a very different issue to being born dead.
The ignorance seems to be on the side of the poster and not myself. This issue has nothing to do with homebirth whatsoever.
What a shame that a legitimate question with no prejudice either way could be changed into a tirade of bizarre and personal insults.
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Oh, how funny, you picked up on the same issue – the mad rush to go cutting cords at ‘emergency’ births. I agree that there is an amazing amount of ignorance about this topic – I have run a couple of workshops for ambulance drivers and police, and the cord is all they seem to worry about.
Are you not jumping the gun a little bit as the sketchy details do not tell us when the cord was cut, not to mention the fact this incident happened in mid-flight and irrespective of the baby taking breaths or not it even 10 or 15 minute of having the cord attached sadly wasn’t going to make a difference in this situation. I applaud the nurses who assisted this woman and tried to resuscitate the baby in less than ideal circumstances. As pointed out it is oxygenation that is important and it’s likely that a detaching placenta as it’s done it job is going to give little, if any oxygenation is going to get to the baby that way so resuscitation which might well entail cutting the cord so they can do it properly is what is required.
If you acknowledge that the baby was in fact still, what possible difference would cutting the cord make? I think that is where the confusion is coming from. Why give even a passing thought to the timing of cord cutting in regards to a dead baby?
Hi Michelle, you don’t have to cut the cord to do resus properly.
The details of the article do say the baby was still born.
The facts of cord attachment are, if you have a pulsing cord but no resps the baby has an apgar of 1 which is alive.
No pulsing cord no heart rate, no resp apgar is 0 baby not alive.
at 34 weeks most babies will live with little or no intervention from anyone.
If you catch up with all the latest research it says that room air is sufficient for resus on a live baby.
The observations I gave on the article were valid and given in full knowledge of all research. In a physiological 3rd stage it is unlikely that a placenta will detach in the minutes following birth unless it has premature separation which in itself is a reason for a demise.
The obstetric reason for cutting the cord early is bleeding, as shown with the trials that didn’t deal with an fetal issues. (Britstol trial and Hinchingbroke trial.) In the absence of any equipment the best thing to do is leave well alone.
Either way unfortunately it wouldn’t have helped the baby if he/she wasn’t born alive.
Wow, the quote from the other blogger about your post is RIDICULOUS!!
I agree with you 100% if the baby was still born why were they rushing to tie off the cord??? I would think there would be other things to worry about/attend to. Anyways, it will be interesting to hear the full story.
a very interesting case the third stage can be difficult and especially for the untrained. I commend these nurses for doing the best they could in difficult and stressful circumstances. They would be judged as first aiders or good samaritans and not nurses.
Recently my daughter-in-law had a BBA in which the cord snapped, she was quick thinking to grab the babies end, and then was taken to hospital with the placenta insitu – Alls well, that ends well.
I expect that my comments will be dismissed by some because I’m a homebirth midwife, but I would like to agree with Lisa, in challenging the practice of early clamping and cutting of the cord.
Whether this baby was stillborn or died in the minutes after birth does not seem to be clear in the newspaper story. The discussion about what to do with the cord at birth is another matter.
The point I would like to make is that I am shocked at the rudeness of the post quoted by Lisa from the blog http://homebirthdebate.blogspot.com/ , and signed by Amy Tuteur MD. That site claims to be “a forum for supporters and opponents to debate
the safety of homebirth”
How can anyone debate the issues in the presence of unfounded generalisations about homebirth midwives, their “techniques and fetishes”, and the claim that “homebirth INCREASES neonatal mortality”?
No. Not true.
Why cut the cord at all? Why was it mentioned in the original article? It makes it sound as if as soon as the baby is born, the umbilical cord becomes toxic, and the best thing to do is to clamp & cut it before it harms the baby. As far as I know, there is no harm that can come to the baby from leaving the cord intact. At worst, an intact cord does nothing bad, and at best it may help save a baby's life.
I'm not aware of any "research" that shows a difference of NMR with an intact cord in premies, but just because they haven't studied it, doesn't mean it doesn't happen! Of the studies I've seen, most have been limited in size to less than 50 infants, so neonatal death would probably be not statistically significant even if it did happen in one group but not the other.
And, I hate to break it to the ridiculous blogger (I know who she is!), but the fact that drugs to combat infection, improve lung function, stabilize premature hearts, etc., exist now when they didn't back 100 years ago doesn't mean that keeping an intact cord has no benefits. Talk about your willful ignorance!
Besides, I can't tell how many stories I've read of home-birth midwives who *are* expert in neonatal resus and carry their own tiny equipment. I'm thinking of one such story right now in which the EMTs had to use the midwife's equipment because they only had adult sized, and it didn't fit the baby.
But here is a link to the GentleBirth website “Umbilical Cord Issues” page, which has lots of discussion as well as several links to research. And this site has several links as well, including one to a study that concluded that delaying cord clamping by 30 seconds in preterm neonates resulted in less “dependence on supplemental oxygen” for these babies. But this site has even more links and discussion. Though it’s been a while since I’ve read through it, I remember it was very excellent. I’ve looked up several more studies, which were fascinating, and uniformly suggested that delayed cord clamping was either beneficial or at least not harmful, for either term or preterm babies.
I’ve also read sometime in the past (but haven’t come across it right now) about research done on monkeys who were clamped at birth, and subsequent brain injury. It was difficult to read the scientific research, because they killed the monkeys deliberately — made me quite uncomfortable. I remember that they asphyxiated the monkeys with and without clamping the umbilical cords, to show the difference in how long they were able to survive with an intact cord.
-Kathy
P.s., Go to my site and search for the name of the ridiculous blogger — I think you may be surprised at what I found that she said about C-sections, and other things. Cheers!
Stand tall, stand proud Lisa,
if all this blogger has to resort to are personal attacks and wild statements that are clearly without foundation, you obviously have her on the back foot.
Your blog is one of the best on the web, I love it!
Lisa your website and your wisdom are a wonderful resource for those of us interested in optimising the health of birthing women and their babies.
The website of the blogger who attacks you is filled with bile and personal attacks and with a view of childbirth both natural and not so that is so blinkered it is frightening.
Thank you for standing tall in such an admirable and positive way!!