Day 3 - Birth Basics - Transcript

Let's go ahead and get started. Um, if you're new to me, welcome. And it's really good to meet you. Um, I'm Nicole. So I'm a pregnancy coach. I'm a birth Doula and childbirth educator. I am super passionate about all things, birth and pregnancy and if you're in my group, you've heard me talk and talk and talk about all kinds of stuff about pregnancy and birth. So personally I have two kids. I had a c section, I had a VBAC (vaginal birth after cesarean) and now I'm pregnant with my third. I'm due next month. So pretty excited and just my own birth experiences have taught me a lot and kind of shifted my whole focus in life aside from my children of course, but like my business side. So, um, that's kind of what got me into this business. Um, and feel free to join the group if you're not already a member.

So you will find it from Nichole joy page. You can join the empowered moms group. That's kind of where I hang out. So I go live in there regularly talking about all kinds of things. Um, I do weekly digital Doula live where I talk q and a and answer questions. Um, so yeah, join us. It's Super Fun. But like I said, we have a lot to cover today. So let's go ahead and get started. So today is day three and we're going to be talking. The big topic is pushing, um, and there's of course more. So let's move on.

Okay. So here's our agenda for the day. We're starting with transition. I'll explain what all this stuff is, laboring down rapid labor, pushing and then delivering your placenta and your umbilical cord.

What is transition? Basically it's when your body is transitioning from the first stage of labor to the second stage of labor. And we talked about day one and day two covered the first stage. So if you miss that again, I will post them so that it's available for everybody. Um, so now we're talking about transitioning and when you're in transition, your contractions are reaching the length of about 90 seconds to two minutes and they're getting closer together. So now they're closer to like two to three minutes apart and they're more intense. This is also when you're in transition, your cervix reaches 10 centimeters dilation and we talked a lot about, um, dilation and early and active labor class.

So I would suggest going back and checking that out too.  Then this period is pretty short, so a lot of first time moms have longer first stages of labor, but then when they reached transition, things tend to pick up pretty quickly. So the average is about an hour or under an hour. Um, during this time too, a lot of moms feel tired, exhausted because labor may have gone on several hours. Um, they also feel restless, irritable, and very. When I say consumed with coping efforts, I mean a lot of moms when they're in transition are very inward focused. And so they're very, you know, I'm kind of in their own, in their own labor world, in transition, pushing world in their bodies, in their heads.

And it's really hard to, at the moment, to kind have outside conversations because you're very consumed by what's going on. Also your body is releasing adrenaline hormones at this time, which is that fight or flight response for a lot of moms. And so I've heard a lot of moms that even say things like, okay, I'm done. I don't want to do this anymore. They think they can get up and walk away and like, stop. It's that fight or flight adrenaline. Which is pretty funny, right? But that's just the hormone and it’s affects. A lot of moms say they feel nausea, vomiting, hot flashes, chills. Those are all super common. And if you talk to midwives, midwives actually like seeing those signs because it means that something is happening. Baby's coming. Those are just some common things that a lot of moms report feeling.

The benefits to having that adrenaline rush. So we've talked fight or flight, but the benefits of that is it gives you more strength and energy if you were tired from a long labor, that adrenaline will give you a boost and some strength. What can your partner do during transition to kind of help you cope? Whatever your coping practice has been thus far in the labor and however it's shifting contraction to contraction, and we talked about kind of some of those company practices yesterday. He can, he or she can help you to maintain that. And so you'll probably be pretty verbal and pretty honest about what's working and what's not. I like this, I don't like this, don't do this, don't touch me, whatever.

And you know, you can kind of let your partner know to kind of follow your cues, hear encouraging words are really nice at this point I'm talking to you, you know, gentle touch, warm damp towels on your abdomen are quite nice. And then if you're warm, you're nauseous, you're hot and sweaty, maybe a cool washcloth on your forehead, on your chest, and then when you have that break like two to three minute break in between contractions, rest, trying to just relax and take it easy and rest until the next contraction and kind of gauge where you're at, how you're feeling and what feels like it's working well and let whoever's supporting you know, what you're enjoying, what they're doing or what's not working.

Okay? So I want to talk about this laboring down. It’s not something that's commonly referenced out there in the birth world, um, when you're in the more progressive like natural birth world maybe, but it's not a super common thing to hear. So you may or may not have heard of it. Sometimes it’s referred to as the rest and be thankful period. So I feel like the most common hospital protocol statement is, okay, you're at 10 centimeters dilated, it's time to start pushing, right? So you're kind of waiting for that magic number, 10 centimeters. You're fully dilated, but that doesn't mean that just because you've reached 10 centimeters dilation, that it's time to start pushing. Your body might not be ready. There can still be other things happening during that time and after you reached 10 centimeters for like an hour or even up to two hours that the baby's not coming out just yet, and it doesn't mean that your labor has stalled.

There's this laboring down that not all moms experience, but some do, and it's basically giving your baby a chance to continue to descend on his own or on her own and to rotate because baby does a lot of rotating during birth and I'll show you a slide later on or what that looks like. Um, meanwhile, your vaginal tissue is continuing to stretch and loosen, which is what you want, right? You want it to be as loosened stretch as possible to let the baby out without tearing you on the way out, right? It will go back. It's a lot easier for it to go back if it hasn't had trauma, right? So don't be concerned with that. It's better to give it time, so unless there's a medical issue and you're having a low risk pregnancy and a low risk birth, unless there's a serious medical concern, if your body is going through this laboring down phase, um, were contractions even appeared to have stalled out, let it be.

There are moms that will even sleep for an hour or two or take even a 15 minute power nap once they reach 10 centimeters and it's entirely normal. Your body is giving you a chance to take a rest and take a break before you start pushing because pushing can be a challenge. It's strenuous. A lot of work for some women, right? So if you are experiencing this, embrace it as long as there's not a medical problem. So just wanted you to be aware of that because I feel like not a lot of people really discuss this. I think a lot of medical facility protocols are to be quicker and they want things done quickly. I'm more a fan of kind of slowing down if possible.

Rapid labor is not super common, but there are some moms who experience something called rapid labor and it's basically your entire labor is under six hours. It's usually second, third time moms. So generally not first time moms. If you're not a first time mom, if you think you may be having rapid labor, you'll want to contact your provider sooner and you might not even have any of the early stages of labor. So you might progress pretty quickly too.

Pushing, which I think is what we're all here to talk about because a lot of first time moms especially I'm pushing is one of those things that you've never done it before. And it's scary to think of because you don't know how to do it. You don't know when to do it. And then you hear all these stories, right? So one to kind of put some information out there to help you understand it a little bit better. So it's the second stage of labor. And then your average first time mom pushes for two to three hours, Fyi, just a fun little fact. What's happening during the pushing stage, your contraction intensity might actually decrease, so they might not be as intense while you're pushing, and then the length of time in, in between, your contractions might actually increase. So there might be more space.

Again, it doesn't mean that your labor is stalling out, right? In and of itself. Um, you, like we mentioned in the fight or flight with the adrenaline, you might have more clarity, energy, optimism, you know, um, it's time to push, right? And you might even feel the urge to push and I believe yet that's next.

Let's talk about the urge to push. So I have a kind of funny picture here of this pregnant moms sitting on a toilet, um, because I think the urge to push can be easily compared to having a bowel movement and, and pooping, right? Let's just think about that for a minute. You're using a lot of the same muscles, the pelvic floor muscles when you push the baby out that you use when you poop.

So a lot of moms like to sit on the toilet because it's that same position, it's that same movement. Your body is comfortable in that position and when they're listening to their bodies instincts, um, it feels very comfortable and that's an easy way to do that pushing, right? And when the baby's pushing down there and you feel that pressure, um, it, a lot of moms compared to feeling like they have to go. So, um, whether or not you'll feel the urge to push, not all women have it, um, but it could be impacted by what position you're in, whether or not you've had pain management meds. So if you had an epidural, you probably won't feel the urge to push unless of course you kind of stopped pumping the drugs in and you try to let them wear down a little bit.

When you get closer to pushing, you might feel something, um, and then where your body and your baby are in the process so it could just mean that you're not quite there yet. So not everybody has the urge, but if you feel it, um, it really is an ideal situation to push when you feel the urge to push. And then of course I talk a lot about slowing down and so what's the rush allow your body to kind of do its thing. Allow the hormones to do their thing. Allow your baby to come out when he's ready. And in the absence of a medical emergency, just kind of let your body open up, right? All right? So delayed pushing, um, this kind of, um, you know, ties into what we talked about for laboring down. So you may consider delayed pushing, um, you know, if you're at 10 centimeters, maybe you want to give yourself more time for the baby to descend and an option might be to push when your baby's head is crowning.

So, um, you know, you'd actually wait until her head is right there coming out of your vagina. And then if you don't feel the urge to push, this would be a good alternative as to wait until the baby's crowning, so delaying pushing, and again, if you have had an epidural, you might not feel the urge to push. So if you've had an epidural, this could be an option for you to delay until the baby's head is cramming. And of course, again, this assumes that there's no other medical emergencies or complications. Right? Okay. So now let's talk about coached pushing. Coached pushing is what I think a lot of moms experience when they give birth. And you know, um, most American hospitals, especially depending on what part of the country you're in. I talk a lot about how kind of the South East tends to be so very, very different.

Um, then as you kind of move out, you know, west and really northwest or even the midwest is a very different birth culture. But I think something that's super common and a lot of hospitals is this coached pushing. So you'll hear your doctor or your provider and your nurse tell you when to push, um, you know, and kind of giving you instruction on how and when and what mom could commonly will do in a coached pushing situation is hold her breath and bear down for several seconds. Um, and so it may be used if delayed pushing isn't an option. So if you're in, if there's some kind of distress or there's some kind of possible medical thing going on and the baby may appear to be showing signs of distress, your provider might be more comfortable with you doing coached pushing and really getting things, you know, I'm getting you to start really being strenuous on your pushing and grinning and bearing down, right?

Um, it might also be used if the spontaneous pushing isn't working well. So if you're trying to trust your instincts and let your body get and it's not really working and you're feeling frustrated or something, your doctor might jump in and say, well, let's try, you know, we'll guide you through it a little bit. Um, it's certainly not something that you have to do. So, you know, it's one of those things, um, you can have this discussion with your provider at your prenatal appointments. Um, and again, something that I kind of always think about is, um, you know, there are women who have birthed that, um, are paralyzed, right? And their body can still birth a baby. Um, so your body can do it. Um, so as long as there's not an emergency situation, if you want to not, you know, if you want to delay or take your time, it's an option to you.

Okay. So kind of the next step past that would be prolonged and forceful pushing. And this is where the mom would hold her breath for 10 seconds, so longer than the last step. So this is even longer of like really, really forceful pushing. Um, so again, this is something that might be used if the spontaneous pushing isn't really working well, um, or if the baby's distress and needs to come out quickly. Um, and if you've tried changing positions and it's not helping. So I'm certainly, if you were doing other things and it appeared not to be working, you'd want to be switching positions. If you get to this point, I'm still be trying to change positions and if that's not helping your doctor might recommend doing this to try to avoid having a cesarean. Um, and they may be trying to avoid having to use other interventions. So again, it can be kind of one of those things. Maybe you consider it like a last resort option. Right?

Okay. So some of the problems with that prolonged and forceful pushing instead, it's exhausting. It is exhausting for mom. That is, it's a lot of work. Your whole body is going into this, um, this forceful pushing and moms get very tired. It's, um, it can overstretch your pelvic ligaments and your muscles. You have to be very careful as well. Um, and then you experience in a more moms experience, perineal tearing or vaginal tearing when they're prolonged pushing. Um, then if, as you know, as opposed to if they did a delayed pushing and kind of allowed things to happen more naturally, a lot of moms also experienced in urinary incontinence later on. So after, after birth, if they've done some kind of prolonged pushing, um, concerns with the baby's heart rate, failure of the baby to rotate or descend because as I'll show you later during birth, the baby is still rotating and descending and coming down your vagina, your birth canal.

And so if he's not quite ready and he's not right, and, you know, in best position you're pushing down on him, um, to kind of, you know, enforcing when he's not quite ready, which can cause the distress. Right? And then if you're on your back, which is super common protocol and hospitals, um, American hospitals, it can decrease the oxygen to the baby and drop your blood pressure. Um, which you know, could be an instance that leads to an episiotomy. And we mentioned that in a prior class, but just to kind of reminder, an episiotomy is when your doctor performs a surgical incision to cut your vaginal tissue open to get the baby out more quickly. Um, because this, you know, the signs of distress, it's not great.

Okay. So pushing positions. So yes, you can push in other positions, not just on your back in the hospital. Um, I think the biggest thing is to kind of listen to what your body's feeling and trust your instincts and kind of get in positions that feel right to you. Um, I know that's, it's kind of challenging to do because I don't think a lot of us are taught to really listen to our bodies and follow our own intuition and our own instincts. But this is a really important time to do that. And then if you need help, you know, your partner, your Doula, your nurse, whoever's there supporting you can help you get into different positions, um, physically, right? And then changing positions can actually help Labor to progress and to help maybe get in the right position. So if you think about it, like there's not a whole lot of space inside your uterus and baby can get really cramped and almost stuck, you know, on certain things.

And especially if you haven't been seeing a prenatal chiropractor to keep things as, as open and flowy really as possible down there, the baby can get really cramped and so when you're moving around and if you're listening to your body's instincts, it creates some space and can help give the baby just a little bit of space to move and to get in a better position so that Labor can progress more quickly. Right. Um, so I've, you know, talked to a lot of moms that even sometimes just switching to laying on their side and inclining their bed a little bit or standing up and moving around or getting on hands and knees, things like that. Can be super helpful to kind of get things moving. So I would suggest, you know, keeping that in the back of your head that you can change your position, especially if you haven't had an epidural.

If you haven't had an epidural, you should be free to move about and do whatever. Right? Um, but if you've had some kind of epidural or other type of drug that is causing you to stay in the bed, no, that you can still switch sides and we talked about that yesterday too. Um, okay. So let's, let me show you a couple of pushing positions. So squatting is pushing position that a lot of women really like. I'm here, I'm doing this kind of supported squat. So this scarf that, this is actually my doula. Um, and so we're using a rebozo scarf and it's used commonly labor. I talked about it in day two's video, so this is kind of supportive. So it's giving me something to hold onto and it gives the pregnant mom something to hold onto during her squat.

And it's really good for opening up your pelvis. Um, and it's working with gravity to help the baby come out. So yesterday we talked about this too, about, you know, kind of, um, the problem with laying on your back. So when you're in this vertical position, you've got gravity working to your advantage to help the baby come down. I will say one thing about squatting before I move on. Squatting is great for these things. Um, but FYI, you know, I'm big on talking about vaginal tearing and squatting during pushing can mean a greater incidence of vaginal tearing. So I'm telling you how great squatting is, but I'm also telling you that it can increase your chances of tearing your vagina, right? Let me try to, um, let me try to break it down just a little bit. So squatting during the Labor is not going to tear your vagina because your baby's not coming out. So it's not what some moms like to do is squat throughout labor because it's helping everything to open and helping the baby to come down. And then what they might do is say, okay, when it's time to push and he's coming out or she's coming out, I'll lay on my side or I'll switch to a different position that's more optimal to prevent tearing. So that's just something to think about. Not everybody tears when they squat for pushing, but I wanted you to be aware of that too.

Okay. And then squatting in bed. So if you've had the epidural, um, some hospitals will let you use this squat bar and when you're in the bed you can actually be, you know, kind of inclined, maybe not as, as upright as she is, and she's clearly not pushing because she has her pants on. So when you're pushing, you don't really have pants on. But I wanted to show you what it looks like, um, to be squatting in that squatting position with the bar. And so if you've had a epidural, this is something that they could probably get you to do if you incline your bed a bit and then you hold the bar again, it is really good for widening the pelvis and using gravity to your advantage. I do cover those things in the vaginal tearing workshop as well. We go into a lot greater detail there though.

Okay. Here's another pushing position. Um, this is also my doula and if you guys have seen this picture quite a bit because I really, really like it. Um, it just covers so many things that a lot of us are familiar with. Um, so this mom, I'm obviously not me, but this is my doula working with one for clients. It has allowed us to use her photo and so she is, she just got an epidural and so she's in a side lying position. She's in bed but she is laying on her side and it's a great pushing position and especially if you've had epidural and um, you can't see it all that well in this photo, but she's actually got her legs wrapped around her peanut yoga ball and I talk about that a lot in day two as well.

This is a great option for pushing hands and knees. Again, this mom is probably not in the pushing stage because she has pants on and she's not at a hospital or you know, she doesn't appear to be in a birth center. She looks like she's doing yoga, but I'm. A lot of moms really like pushing on their hands and knees. It's a great position for pushing. It's really good for low back pain. But, but let me kind of show you with my mouse if you can see. So back here at the back of her spine, you know that at the bottom of your spine and your pelvis is, is it kind of curves back there. And so when you're in this position, it's a lot easier for the baby to kind of go past that curved bottom part of the spine.

So let me see if I can show you really quick. It might be a little hard to see because it's video or the image of me, the video of me as small, but we'll, we'll get there. So here's your pelvis and we talked about this yesterday too. This is what I'm talking about. This little piece back here. So this is the back of your pelvis and your spine. And so if I turn this, see how the bottom part is kind of angled. So if you're laying flat on your back, this is going up. So the baby has to travel up against gravity to get out. So this mom, when I flip it over, this mom is like this, so her back of her spine is up here and this little bone that the baby has to go around to come out of the pelvis is now appointed this, see how it's pointed so the baby can easily go past that bone and come out, um, without fighting gravity. So I hope that kind of visual helps a little bit. Um, it was super, super helpful for me to kind of see that. Um, it was hard for me to visualize looking at the woman, but then seeing the pelvis, you're like, okay, it makes sense.

Okay. So here's another image I'm pushing position example. She's semi sitting with an epidural. So this woman has an epidural you can see because she has the pump in her hand, so that's the epidural pump. Um, she looks really pretty for being in labor. She got her curls on her lipstick on. Totally. Okay. Glam it up if you want. She looks good. Um, but she is sitting, but she's in a semi sitting position so she is somewhat in kind and not completely on her back. So again, if you're having an epidural, maybe consider, you know, something like this.

Now I do want to talk about laying on your back because I want you to be aware of the issues that, um, you know, can come with laying on your back. So the issues are, like I just said, and display it for you. You're working against gravity. So when you're laying on your back like that, your baby is kind of traveling this way and having to go up to come out of your vagina. That's not ideal. It's absolutely not ideal. Um, what's also happening, just like during pregnancy, you're not supposed to lay on your back for a long time because of the weight of your uterus and it happens during birth to, so the uterus wait is compressing your major blood vessels, right? And that can affect the baby's oxygen supply and it can make you feel kind of dizzy and kind of queasy. So why do a lot of doctors or hospitals prefer you to be on your back if the, all of these things are true? Um, well, not all of them do. Some of them are a little more progressive, um, and respect women's bodies a little bit more and understand the physiological process of birth a little bit more. But for those that still are in this older lay on your back to push the baby out mentality, it's a lot easier for the doctor to see everything that's happening in your vagina from that angle. So it's very convenient for them. It's not ideal for you or for your birth. Just going to say that.

Okay. And now I want to talk a little bit about what the baby's doing during this pushing phase. I have a really great video that I'll share with you guys too. Um, and I'll add it as a, as a link to this video that shows this kind of what this image shows, but it's a video version of showing the baby rotating and birth and coming out, which I think is just fascinating. And it's like one minute. So during this process, the baby's descending down, right? She's moving down, coming down into your birth canal. I know it feels like she's right there on your pelvis at the end of pregnancy and she kind of is, but she still has a way to go to get out. Um, she's also rotating into the optimal position which is occupant anterior position, so where the babies actually facing your back, so her back would be to your outside.

Um, and then her head usually is facing down when it comes out. And let me show you, so you, this again, because I think it's kind of helpful. So pelvis right? Here's your pelvis. So when the baby's coming out back to the front of you to see his back is to the front of you or her backups to your front, somebody comes out, it's going to come out a little, go back in, come out, a little, go back in, come out, go back in. So I think a lot of moms and dads are kind of surprised at first because they don't realize that the baby does that, like kind of has, had, had a little and coming back in, in the head out and coming back in. And they're doing that for a reason, right? When they're doing that, they're helping your vaginal tissue to stretch.

Once the babies head actually crowns and is coming, then they're completely coming out. So once their head is out, and again it's hard to explain this and seeing it in the picture, but I'll share the videos you can see because it's like, it's, it's amazing. Once their head is out they actually turn again and so the baby turns sideways so that their shoulders can pass through the widest part of the pelvis. So at first their head, you know, their head is what is it like from back to back to front and I have a really wide head so this width has to pass through at one angle and then when that's through they turn so that now they're shoulders are passing through the width of the wider part of your pelvis. So I hope that kind of makes sense. Explaining it and now we've got a picture and I'll follow it up with the video. So once the shoulders come out, the rest comes out pretty easily and pretty quickly. If you've watched birth videos online, you've seen that, you know, the baby kind of trickles out after the shoulders come out because everything else is smaller and squishier and the bones are smaller, right? So it's a lot easier for everything else to kind of come out.

Alright, so now the beautiful placenta and if you don't know about a placenta, this is a brand new organ that your body made just for this pregnancy and just for this baby or sometimes their shared if there's twins or multiples, but generally, you know, for singletons or single babies, you know, your body makes this brand new organ, which is super cool and it looks kind of gross in the picture, but I guess after two of my own babies, um, it doesn't bother me anymore. So this is actually my placenta and for my second, and this was my midwife, amazing. Love her. And so she held it up and kind of gave me a little anatomy lesson. So I like to include this picture because it's just kind of personal and I had a really big placenta and a very long umbilical cord. Um, so let's talk about delivering your placenta.

So this is the third stage of labor and after the baby comes out, you know the umbilical cord is still connected and so your uterus will continue to contract not as strong, not as intense it, you probably won't even feel it because of the rush of hormones that you experienced after the baby comes out. Most women don't even feel the uterine contractions when the placenta is being delivered. So your placenta will separate from your uterine wall and then be delivered on its own. And it's usually within about a half an hour. So, um, a lot of hospitals, a lot of American hospitals, the protocol is to administer to the mom through her IV. Most moms don't even realize they have this done, um, to reduce the chance of postpartum hemorrhage. So it is an effective way of reducing postpartum hemorrhage. However, does everybody need pitocin in order to prevent postpartum hemorrhage?

No, because going back years and years and years, did they have pitocin for every single mom who gave birth to prevent postpartum hemorrhage? No. And were a lot of them perfectly. Okay. Yes. So, um, this is again, one of those discussions you can have with your provider if you really don't want to use pitocin and you're not going to be using it throughout your birth, maybe you don't want to use it after birth either. And so this is a discussion you can have like, okay, if, if nothing has happened or if we are seeing more blood, you know, and there's a concern of hemorrhage or sign that there may be hemorrhage or the placenta is not coming out on its own within a certain amount of time that we're comfortable with. Yes. Then I'm okay with it. Or maybe, um, maybe you're fine with the protocol. Um, so yeah, just think about, I think what works for you.

Um, and just be aware that it is protocol for a lot of hospitals if you having, if you're being a dose and you're getting pitocin anyways, it's probably not that big of a deal. But if you're not and you don't want to, you know, um, put it in your birth plan. It's in the birth plan template that I have. Like, it's one of the options that you can pick your preferences. So if you don't have my birth plan template and let me know and I'll make sure you get a copy of it. Um, it's editable and you can change whatever. And it's very, um, so one thing else I want to say about pitocin is there was a study done and I'm happy to share the link if anybody wants to read this study. So there was a study done on pitocin. It actually, this was kind of a byproduct finding of this study.

Um, it wasn't for this purpose, but what they found in this study was that women who use pitocin either during birth for this or right after for their placenta, had a greater chance of experiencing postpartum depression. So the percentages were 32 to 36 percent. So for women who did not have a prior history of depression, and they use pitocin during birth, 32 percent of them, uh, you know, they had a 32 percent greater chance of experiencing postpartum depression. Now for women who did have a history of depression, they had a 36 percent greater risk of experiencing postpartum depression. So again, you know, this study isn't commonly referenced, but I am happy to share the link if anybody wants it. Um, you know, just something to keep in mind, you know, and that doesn't mean that if you have to pitocin, you're going to have postpartum depression, you know, for you it may be very different because you can look at it the other way. You might be 60 something percent chance that you won't get it, but it's just one of those personal things and I want you to be aware of kind of protocol and just know, um, you know, know your options and know, know that you could have a choice. Right?

I will say too, if there are signs of hemorrhaging, then pitocin is an effective way of stopping and reducing the postpartum hemorrhage. So if you are experiencing that, I'm not knocking pitocin at all. I'm just letting you know that, you know, kind of heads up. Okay. So let's talk about all this little nugget. Let's talk about umbilical cord clamping and cutting. So that's kind of the next thing, right? So your placenta comes out. Um, and again I'm going to talk about hospital protocol because I think it's important to know what usual protocol is. A lot of moms are super surprised that they weren't aware of some of these things before birth. Um, but protocol for most hospitals is to cut the cord pretty immediately, right? So as soon as the baby comes out, cut the cord. I'm an alternative that a lot of moms really like now is to delay cord clamping.

Um, why would you do that? So in general, because when the baby is born, the placenta still has one third of the baby's blood in it. So blood is being, is going back and forth between the baby and the placenta via the umbilical cord. Right? So if you cut it too soon, the placenta is still holding a lot of the baby's blood. Uh, so let's. So. Okay. And then leaving the court to pulse until it's clear. So you can see this little guy is pretty clear right here. So it looks like he may have done delayed cord clamping, I don't know who this baby is, this is a paid, you know, stock photo that I'm using. I like that it's a clear cord. Um, and that's indicating once it's gone clear, it's indicating that the blood has stopped pulsing, right. And at the baby's getting as much blood out of the placenta as possible.

Okay. So more on a delayed cord clamping of why you would do that. I liked this picture because this mom just had a water birth and so her baby is covered in Vernix, which is this like super power stuff, birth stuff, that baby, they're basically like sitting in and you're in your uterus and it's really, really good for them. Not all babies have that much vernix but this little guy is covered in it and I love it because it's so good for them. I don't want to go off on that because that's for the newborn class and we'll do that another day. Um, but you know, his little umbilical cord is still there. And so I wanted to talk a little bit more about the benefits and risks of delayed cord clamping. So first for the benefits, um, because of all the blood transfer to the baby, you have increased iron levels in the baby's blood for several months.

Now, if any of you have other children, you may remember going to the pediatrician around a certain point in the baby's life, six months, maybe a year where they start to say, okay, now you want to start adding iron to the baby's diet, right? Um, because a lot of babies did not have delayed cord clamping, so a lot of them tend to have lower, um, attend to have signs of anemia or lower iron levels. And so if you finish, if you allow the blood to finish the transfer, um, and allow that time, um, there are lower instances of anemia, right? And then improved early breathing in the baby and faster and easier placenta delivery because it's smaller, all the blood is out of it. So it's easier for it to come out of your body. Now, the main risk of delayed cord clamping, really the only risk is jaundice.

You haven't, your baby has an increased risk of getting jaundice. And I want to explain a little bit about what jaundice is so that you understand the risk. So jaundice is related to how the baby's body breaks down red blood cells, if the baby has more blood because they finished getting all the blood out center, they have more blood cells and so if they have more blood cells, um, you know, breaking them this, this jaundiced and breaking them down, it's, it's of course it makes sense, right? So, um, they're there how they kind of treat jaundice, I don't know if you're familiar, but putting them under the warmers is certainly doable. Even being skin to skin can help. A lot of moms feel like the risk of having jaundice doesn't outweigh the benefits. So the benefits would outweigh this risk of jaundice.

Right? So it's really a personal thing. It’s entirely up to you, of course. It's something that, again, I would discuss with your provider during your prenatal visits, even during your hospital tour. Find out what their protocol is for how long they wait, and then if you want something different than their protocol, put it in your birth plan, just so what's out there and you don't have to remember in the moment. Um, I know there's a lot of pushback from women's sometimes about birth plans. It's not so much about being stuck to this plan, it's more of just making sure you have a list of everything that you want, what your preferences are. No matter what happens with the birth, you still have a right to have preferences, right? Um, and so, you know, unexpected can happen, but knowing that all of your wishes, all of your preferences are listed out so that you don't have to try to remember and verbalize and explain to everybody in the moment and remind them it's there and let your partner be the voice for it.

And you just enjoy what you're doing. So I also noted here that ACOG recommends delayed cord clamping for 30 to 60 seconds at least. So who's ACOG? Um, if you're not familiar, it's the American College of obstetricians and gynecologists. So it’s a reputable organization that puts out a lot of great information for OBs, and they actually do recommend delayed cord clamping. I also want to tell you that I have another video that I want to share with you guys. It's not mine, but it's this amazing childbirth educator. Um, and she has this great demonstration video. There's no way I could've done it on this with this little tiny video of me, um, but it's a great visual to kind of see exactly how much blood is being transferred to the baby if you delayed cord clamping. So I'll share that with you guys because I think it's super helpful.