33 responses to “Bedside Assessment Stabilisation (Basics)”

  1. Debbie

    What are they going to do next? Bathe the baby in a little tub while the cord is intact? :P Debbie

  2. Samantha

    It sounds to me like it’s not for healthy term babies.. I don’t think it’ll save lives that would have been lost but I’ve often thought that it would be great if there was a way to keep prem babies cords intact when they need resuscitation. They are currently taken to a different room which is awful for baby and mother. I think it could help in a less than ideal situation but totally agree it has no place at the birth of a healthy term baby.

  3. Gorgia

    But isn’t this about vulnerable babies who would normally be taken away? Its not to be used for healthy newborns? That is what I understand it to mean as its a life saving device…

  4. VW

    As someone who had a baby born with an APGAR of 3 in the hospital (homebirth transfer), whose cord was cut simply because the resus table was bolted to the wall on the opposite side of the room, I actually appreciate the effort behind this invention. Should it routinely be used on healthy babies right after birth? No, of course not. They should get unlimited amounts of skin-to-skin and ‘delayed’ cord clamping. But I would very much have appreciated being able to see my baby when they worked on her, and not having her cord cut when she was having trouble breathing from a collapsed lung.

  5. suzanne

    what they really should be coming up with is way to treat these babie while keeping them on they’re mothers. the more skin to skin they get the better and quicker they recover.

  6. Carrie

    I hear what you are saying, but as a hospital midwife I see this as a step in the right direction. First we have to convince those who set the policies that keeping the cord intact is a good idea. A “device” that makes that possible is just what is needed. Once this becomes commonplace and the benefits of the placenta as a source of oxygen are evident, then I can see the movement towards resuscitation on the mom’s belly. Until then, people are hindered by NRP procedures and good ole ‘standard of care’.

    1. Hayley

      I totally agree, Doctors love new toys and this one will at least get them moving in the right direction.

  7. Claire

    Well, I suppose it would be a good idea IF IF IF it is only used for resus – but I don’t see that happening. It is a darn sight better that the baby is still attached to their mother during resus, than being cut off from their life source, and stolen away to the other side of the room. But still, I just don’t trust ‘em to do best for baby.

  8. Meg

    I think that subconsiously many who are drawn to work with birth do so because they want to feel close to babies (with the exception of some fantastic people like yourself Lisa who are actually there for the mothers). The mother is simply in the way of a feeling of closeness with the baby. Now with the basics trolley, regardless of how totally wrong it feels to be separated even a millimetre from her baby, Mum will have no right to complain because after all, S/he was “right there” the whole time. Creeps.

  9. Jackson Digney

    While I am totally in the “baby stays with mum, skin to skin at all times” camp, you could look at this from the point of view that at the very least they are heading in the right direction, couldn’t you? Not everyone chooses to learn (or is lucky enough to be exposed to people that point them in the right direction) that theres a way about birth other than blindly following the “good doctor”. At least for these people, there are at least one or two little tiny steps being made in the right direction in general practice?

  10. Laura

    I completely agree Lisa! This trolley misses the point completely. It’s just one more invention down the road of thinking that a controllable box is safer for baby than the mother’s body. It also kills me how we gobble up little crumbs like this. It reminds me of the doula movement. It’s not a popular attitude I’ve got, but as much good as doulas can do for mothers, the doula profession takes something that should belong in the non-professional (love and support from friends & family) and makes a special place for it to be performed by strangers. Not only that, but it puts a bandaid on a system that is just bad for mothers and babies. Instead of demanding better treatment, the focus is on hiring a doula who can’t actually solve any of the problems she is expected to.

    So instead of demanding that babies remain in their mothers arms, now we have this wonderful device that throws a crumb out while still removing the babe from its mothers embrace, encourages unnecessary suctioning, and continues to tell the mom loud and clear that only the professionals are qualified to care for her baby.

  11. Danielle

    I didn’t think they even did delayed cord cutting in a tertiary hospital (certainly both my undesirable experiences!). My first being preterm at 32 weeks and the second being breech (after a retained placenta and 3L PPH with my first there was no homebirth option for that one either!) I ended up at the tertiary hospital with both. They “have” to clamp the cords quickly otherwise it’s too hard to get the blood out of the cord and then send it to the blood gas analysis machine so they can store the records incase you try to sue the hospital later… and the only reason I know this is because of the prac I did when I was a student midwife at the same hospital (thankfully I don’t work there now so I don’t “have” to practice this way). They just do it and don’t even tell the parents!
    It is so interesting looking at the ideas Men get about birth and helping bonding… just give the baby to it’s mother damn it! (Thankfully, I got the skin to skin before BOTH my babies needed resuscitation… and not until AFTER the first APGAR was poor… not emerge from me and straight to the resus trolley… which would probably happen if it was conveniently located like this over rated expensive contraption! :o O

  12. Sarah Buckley

    I disagree with you Lisa. Currently babies that need resuscitating in hospital have the cord cut so they can be taken to the resuscitate on the other side of the room, This invention gives the opportunity to resuscitate the baby with the cord intact. which is ground-breaking for hospital birth.
    And for women giving birth in hospital, the tiny beds are not adequate to place a baby needing resuscitation next to the mother, and although I agree that the best place to resuscitate a baby is on the mother’s body, I think this is not going to be part of the hospital system in the hear future.
    Babies born in hospital are more likely to need resuscitation for many reasons including that women with high risk pregnancies will be giving birth in hospital, including by caesarean where this could also be used and also because of the drugs and interventions used in hospital that can affect the baby at birth.
    The baby resuscitated with the cord intact has as you know major benefits- they get 100ml or so of their own blood that an early clamped baby misses, and that will fill all teh organs of the baby and make the transition to breathing easier….all of which will hugely benefit the resuscitation process, It may in fact be all that is needed for some babies.
    If the baby is very unwell and needs CPR, this is much easier to do on the flat surface that this provides.
    For the mother it means she can see her baby all the time, her baby is not disconnected from her,
    The other thing I love about this invention is that it puts delayed cord clamping on the agenda for hospital birth, This is actually part of the intention- it was invented by David Hutchon and Andrew Weeks who have been promoting and publishing information aimed at shifting the hospital practice and policies around early clamping. And as the comments show, this is not routinely practiced and many in fact many Drs don’t realise how important it is for the baby, (See my article http://www.sarahbuckley.com/leaving-well-alone-a-natural-approach-to-the-third-stage-of-labour ) .
    (BTW If you are wanting to convince a Dr that delayed clamping is safe and advantageous, I’d suggest you refer them to Andrew Weeks paper in the British Medical Journal)
    Thanks, Sarah

  13. Christa

    This is a bit off topic, but I felt I needed to respond to Laura’s comments regarding the doula “profession”.
    To the contrary, I do not see being a doula as a profession. Granted there may be other doulas who do but I think Dr Christine Vose summed it up well by saying:
    “Birth belongs to all women… not just those who have trained for years as midwives… Part of the problem with the medicalisation of childbirth was the weakening of the role of the midwife. However, a bigger problem was the divorce of ordinary women from helping each other during the birth process. This created generations of … women who had never been near a birthing woman and who feared the process of childbirth, women who still believe they need medical interventions for birthing their babies.
    The Doula is the ordinary woman who is reclaiming her place beside other ordinary women who are birthing their babies. It is true – she now has the advantage of undertaking a short training to gain insight and skills but she remains an ordinary woman.”
    The important thing is that women (and partners) have support at their birth. For those who do not have a friend or family member who can provide that support, they can call on a doula. Doulas fill a gap, they don’t take over a role that is already taken.
    If the doula has done her job properly, she won’t be a stranger at the birth, and I for one, have remained friends with all my “clients” (for want of a better word).
    I also believe that doulas are a part of the process of demanding better treatment, because we are out there trying to spread the word about informed choice etc, which sadly, so many women are unaware of. I also make it clear to clients that I have no real power in the birthing room with respect to the medical staff – only the mum and dad can speak for themselves and I can strengthen them and “back them up”/try to make sure they are heard etc. I actually feel my role is more about preparing the couple for the birth so they can take ownership of their birth experience and choices during the pregnancy and birth.

    Anyway, enough of my rambling, suffice to say I believe doulas are valuable, please don’t write us off! :)

    1. Meg

      here here, Christa. Families who have undergone generations of poor birth and postnatal care no longer know how to care for birthing and postnatal women. Doulas are so important in this respect. Keep up the good work!

  14. Jodie Cole

    Hi there Lisa, was wondering what you charge to be an independant midwife? We live in the Riverland (Loveday), three hours from Adelaide. This is our second IVF baby. We are due on father’s day Sept. 3rd. Look foward to hear from you. Jodie

  15. Janet

    I completely concur, Lisa. Next they’ll be inventing these amazing bottles that you strap onto the woman’s chest so she can be hands-free while she bottlefeeds her baby! Yay yay yay! No more trying to prop up a bottle, no more being unable to eat because both your hands are tied to the damn baby feeding it, no more dropping the bottle, wowsers so many Benefits! Of course, you could just use your boobs, but who’s making money from that?

    Put the baby on the mother while keeping the cord intact?! That’s craaaazy talk! Continued oxygenation from the normal source while a compromised baby makes the switch from in utero to earthside?! Where’s that machine that goes ping? We need one! Looks like our society will basically let the medical d00ds package anything and sell it to us and we’ll praise them for it. Makes me sad. Women are so grateful for crumbs when we should be eating the whole organic, homemade, brown bread sandwich as is the birthright of us and our babies. Glutenfree for those who prefer it, naturally.

  16. Jackson Digney

    Wow, who’d have thought a baby table would elicit so much comment!! You dont have to buy one Lisa! I reckon Carly is the BEST “Bedside Assessment, Stabilisation and Initial Cardiorespiratory Support trolley” money could never buy!! She does everything all in one plain unit – manages the babies resps and heart beat, provides the correct temperature (automatically too, bet that contraption doesnt do that!) AND you can still work on the baby and stuff…….how cool is that!!

    PS – sorry you missed out on freshly baked pumpkin scones this morning! I’m pretty sure Hannah enjoyed them though!

  17. suzanne

    Cause this is going to be SO popular amongst doctors who won’t admit delayed cord clamping is beneficial lol. I was told I had caused my son’s severe jaundice by delayed cord clamping and continuing breastfeeding (he was not prem). Doctors refuse to believe otherwise, to the point where they refused to look into other causes of my sons jaundice, so excuse me if i find it difficult to believe that such a trolly will be even considered.

  18. Hannah

    I wish you could like comments. Janet and Jackson have hit it right on the head. I especially like the bit about the pumpkin scones.

  19. Hannah

    Haha Janet Jackson.

  20. Helen Cahill

    I have seen many a baby resusc. on the bed attached to Mum over the past 5 years or so in hospital. It’s not even questioned now. If a paediatrician is at the birth they seem quite happy to observe a baby from a distance whilst it is lying on the mother’s chest even when problems are anticipated before the birth hence I don’t see any need for this contraption. After all the vast majority of baby resusc involves only bag and mask/neopuff ventilation which just involves connecting to an oxygen source and I have seen the resusc trolley brought over close to the bed if needed.

  21. Hayley

    I agree with you, skin to skin is so much better, but I think this may help in the hospitals. Many doctors don´t share your understanding of birth, so expensive toys might be just the thing to raise awareness about the need for delayed cord clamping. I bear the scars of immediate cord clamping so I think it would be great if even one small step can be taken towards making birth more like it is supposed to be. As a midwifery student though I love your videos of resuscitation in the mothers arms, you are an inspiration to me. Do you just use the board between the mom´s legs if you need to do heart compressions? or why do you use it?

  22. Breanne Sproule

    Actually I think this is a great idea. Of course if the baby is well enough to go straight on the mother then that should happen always….but my daughter was born not breathing and I am upset to this day that the first thing they did is cut the cord in order to take her the 2 and a half feet to the warmer to be resuscitated. This could have been done next to me with this new cart so that the cord could have stayed intact. She needed that blood and she didn’t get it.
    People are laughing about this “trolley” but really it can be good for some situations. Even better if they could have resuscitated her on my chest but the point is that we can’t change everything overnight and it is better to have the cord attached and be closer to the mom then to be several feet away in a warmer. Even if the baby only needs to stay on this cart for like a minute….(my daughter was resuscitated in about 30-45 seconds) it would be much less stressful for the mother knowing the cord was intact and being able to see the baby.

  23. meena

    I really resent that you refer to doctors as being stupid on this site.
    I am sure you would be grossly offended if they referred to midwives and nurses in the same terms.
    I am saddened by this as it is totally unprofessional and you are giving women the idea that doctors are something to be avoided, or that they have no part to play in pregnancy or birth.
    There are many situations where a woman will need the care of a team (including doctors) during the pregnancy and sometimes before during and after the birth.
    There are good and bad in every profession, I would love to tell you the horror story of the midwife who attended my birth and the following law suit that resulted following her “care” I thanked the Lord for doctors on that day I can tell you.
    Without the “stupid doctors” intervention both me, and my baby would be dead.
    The midwife has since been struck off and not before time, there are thousands of midwives out there who spout total rubbish and who have the professional standards of a rock, and who endanger the lives of women and babies every day by discouraging women when they are vulnerable to avoid essential medical care, or decline tests or treatment when it is really needed.
    I think you should stop making sweeping statements and giving women the impression by implication that doctors are stupid, uncaring, unable to follow research, unable to identify with women, that they dont listen or that they are somehow the enemy or that they are less capable than you, or that a birth supervised by a doctor is going to have an unhappy outcome as this is not the case.
    Pregnancy and birth are not illnesses and anyone who thinks that doctors are only there to deal with illness and disease has a pre-historical attitude to the medical profession and no understanding of the role, abilities and work of the different professionals in the field.
    Just because some entrepreneur has invented a medical device to assist women to be able to get a better view of their babies when they are being resuscitated in hospital doesn’t mean that all doctors are somehow subhuman or lacking in care, kindness or ability