A natural approach to childbirth

 

The medical view of pregnancy and childbirth has permeated our culture so that we have forgotten how our ancestors were born, thanks to which our species has survived for thousands of years. With the intention, presumably, to protect mothers and babies from misfortune and death, modern western obstetrics has forgotten Mother Nature, whose complex and elegant systems of birth are disturbed by obstetric interventions, although we are aware our inability to understand or control these elemental forces.

The medical interference in pregnancy and childbirth is well documented, and its negative consequences have been well studied. However, the medical management of birth-the time between the birth of the baby and delivery of the placenta-is, for me, the most insidious. At the time that Mother Nature has provided awe and ecstasy, we make shots, we examined the baby, umbilical cord clamping and throw it. Instead of body heat and skin to skin, we separated the baby from his mother and put her clothes. When the weather should be detained in the eternal moment of first contact, as mother and son learn to love, we hurry to remove the placenta and clean to go "next."

The medical management of childbirth in the last decade's taken a step further with the popularization of the "active management of birth" (see below) carries some risks for mother and baby. Although many of the interventions aimed at reducing the risk of maternal postpartum hemorrhage (PPH), which can be a serious matter, it seems that, as with the active management of labor, can actually bring many of the problems that supposedly wants to avoid.

Active management also creates specific problems for the mother and baby. In particular, the baby is deprived of half the blood volume that would be sent. This extra blood that should flow into the lungs, which begin to function at this time, and other vital organs, is discarded with the placenta, with possible consequences such as respiratory problems and anemia, especially when it comes to vulnerable babies.

The drugs used in the active management are documented risks to the mother, including death, and we know its long-term effects for the baby, especially given its importance, since they apply at a critical period for brain development.

The hormones in birth

As mammals we are, because we have mammary glands that produce milk for our babies, we share almost every type of birth with other mammals. We share the complex orchestration of hormones of childbirth, which occur in the depths of our mammalian brain to help us and ultimately ensure the survival of our offspring.

At birth, they help themselves three hormonal systems of mammals, each of which plays an important role in the delivery. The hormone oxytocin causes the uterine contractions of childbirth, while helping us to launch our instinctive maternal behavior. Endorphins, the body's natural opiates, produce an altered state of consciousness and helps us to transform the pain and the hormones adrenaline and noradrenaline (epinephrine and norepinephrine, also known as catecholamines or CAs), responsible for our fight or flight reflex, We provide the peak power we need to push and give birth to our babies during delivery, or second stage of labor.

During the third stage of labor-delivery-strong uterine contractions continue at regular intervals, under the strong influence of oxytocin. Uterine muscle fibers shorten, or retract with each contraction, gradually reducing the size of the uterus, which helps to detach the placenta from the uterine wall. The third phase is completed when the mother lights the placenta that nourishes the baby during pregnancy.

For the mother, birth is the moment he receives the reward of his labor. Mother Nature gives you a peak of oxytocin, the hormone of love, and endorphins, hormones of pleasure, that bathe both mother and baby. The skin to skin contact and early attempts to entrench the baby to the breast increases maternal oxytocin levels, strengthening the uterine contractions that will help it to loosen the placenta and the uterus to contract. In this way, oxytocin acts to prevent bleeding and to establish, in concert with other hormones, the close bond that will ensure care and protection by the mother and child survival.

At this time, high levels of adrenaline in the second phase, which have kept mother and baby with eyes wide open, ready for your first contact, will fall, and it takes a very hot environment to counter the cold , and chills, the woman feels when their adrenaline levels drop. If the environment is not well heated, or something distracting or annoying to the mother, high adrenaline levels will be maintained and will counteract the beneficial effects of oxytocin on the uterus, increasing the risk of bleeding.

Also, the baby is essential to reduce adrenaline and noradrenaline, which had risen to a peak at birth. If you separate the baby from his mother, these hormones can not be softened by contact with the mother and the baby can fall into a psychological shock, according to Joseph Chilton Pearce, will prevent the activation of specific brain functions nature had planned for this moment. Pearce believes that the separation of mother and baby after birth is "the most devastating event in life, and leaves us emotionally and psychologically maimed."

One wonders if the modern epidemic of stress, a term invented by researchers at the beginning of the twentieth century-and stress-related diseases in our culture, could be a consequence of these common practices at birth. It is plausible from a scientific standpoint that our hypothalamic-pituitary-adrenal (HPA) which regulates long-term responses to stress, immune function, and the reflection of fight or flight in the short term, is disrupted by the continued high level of stress hormones that occur when babies are removed from their mothers through routine.

Michel Odent, in its review of existing research on the "primal period" (the time from conception to the first year of life), concludes that interference or dysfunction at the time affects the development of our capacity to love, which is particularly vulnerable around the time of birth and is connected hormone oxytocin system. Jacobsen's research and Raine, among others, suggests that contemporary tragedies such as suicide, drug addiction and violent crime may be related to problems in the prenatal period, such as exposure to drugs, birth complications and breaking rejection of the mother.

Those who attend the birth in these moments have the crucial role of ensuring that women's reflections mammals are protected and reinforced during pregnancy, childbirth, and beyond. Ensuring unhurried and uninterrupted contact between mother and child after birth, adjust the temperature to comfort the mother, provide skin to skin contact and breastfeeding, and not take the baby for any reason, are impractical sensitive, intuitive and secure and help synchronize our hormone systems with our genetic fingerprint, so as to provide maximum success and pleasure for both mother and baby in the important role of parenting.

The baby, the cord and active management

Adaptation to extrauterine life is the main physiological task to be performed by the baby at birth. In the uterus, the placenta performs the functions of the lungs, kidneys and liver for our babies. Blood flow to these organs is minimal until the baby's first breath, when they are initiated major changes in the organization of the circulatory system.

The baby's body, blood flows from the umbilical cord and placenta and, while the lungs fill with air, blood enters the pulmonary circulation. Nature reserve ensures the cord and placenta, which provide the blood necessary for the pulmonary system and other organs.

The transfer of this pool of blood from the placenta to the baby occurs in a stepwise progression: the blood flows with each contraction the baby's birth, and some of this blood returns to the placenta between contractions. Crying slows the receipt of blood, which is also controlled by constriction of blood vessels in the cord. This indicates that each baby may be able to regulate the transfusion based on their individual needs.

The gravity affects the transfer of blood, which will be optimal if the baby's body remains at the level of the uterus, or below, until the umbilical cord to stop beating. This process of "physiological camplaje" usually lasts about three minutes, but can last longer or can be completed in just a minute.

This elegant, proven system that guarantees the transfusion of a blood volume optimal, but not the same for all babies, can not act if done the usual practice of clamping the cord within 30 seconds of birth.

Immediate clamping of the umbilical cord has been widely adopted by Western obstetrics as part of the complex known as "active management of birth." Active management includes the use of an oxytocic agent-a drug that, like oxytocin, causes the uterus to contract forcefully - usually administered by injection in the thigh as the baby is born and the camplaje immediate cord and "controlled cord traction"-that is, pull the cord to remove the placenta as quickly as possible.

Will inevitably act in haste, and that after a few minutes the oxytocic injection will produce very strong contractions that can trap the placenta if it has not yet risen, so have to remove manually. Also some believe that if the cord is clamped before the oxytocic begins to take effect, the baby will be at risk of receiving too much blood, pumped from the placenta by the powerful contractions caused by the drug. Research on methylergometrine indicates that the use of an oxytocic accelerates placental transfusion to the baby, but babies in this study did not receive too much blood. (9)

While the purpose of active management is to reduce the risk of bleeding of the mother, "acceptance and widespread application has not been preceded by studies evaluating the effects of depriving the newborn babies of a significant volume of blood." (10)

It is estimated that immediate clamping deprives the baby from 54 to 160 ml of blood, (11) which makes up half its total blood volume at birth.

Clamp the cord before the baby is breathing by itself does need to use blood from other organs to establish pulmonary perfusion (blood supply to the lungs). If the child was hypovolemic (have low blood volume), this limitation could be fatal.

If the baby is left above the uterus before clamping-for example, during a cesarean ¬ - the blood will flow back to the placenta by the action of gravity, so it is likely that these babies receive less blood volume than would be expected. The consequence of this may be an increased risk of respiratory distress. Many studies have shown that this common complication in babies born by Caesarean section could be eliminated if they facilitate placental transfusion.

Babies who are also clamps the cord immediately lose iron in the blood that are deprived. Immediate clamping has been associated with an increased risk of anemia in childhood.

These immediate aftermath of impingement were known in 1801, when Erasmus Darwin wrote:

"Another thing very harmful to the child that is tied and cut the cord too soon, there would always be left not only until the child has breathed repeatedly until the cord stops beating. Otherwise, the child is much weaker than it should be, because part of the blood that should reach the child remains in the placenta. "(17)

In one study, premature babies who were clamped the cord within 30 seconds needed fewer transfusions, less severe breathing problems, better oxygen levels, and indications of likely better in the long term, compared with babies who are had the cord clamped immediately. (18)

Some studies have shown an increased risk of polycythemia (more red blood cells in the blood) and jaundice when the cord is clamped later. Polycythemia may be beneficial, since if there is more red blood cells means more oxygen reaches the tissues. The possibility that polycythemia can return the blood too thick (hyperviscosity syndrome), which is sometimes used as an argument against delayed cord clamping, seems to be invaluable in healthy babies. (12)

Jaundice is almost certain when a baby gets its full quota of blood, and the reason is the collapse of the normal excess of blood to produce bilirubin, the pigment that causes yellowish appearance of a baby with jaundice. However, there is no evidence that this has adverse physiologic jaundice. (12) Indeed, jaundice, which is present in almost all human infants to a greater or lesser degree, can be beneficial for its antioxidant properties. (19-20)

The other disadvantage early clamping carries over, as it deprives the baby of oxygen-rich placental blood which nature has provided to supply the baby until breathing is well established. In situations of extreme distress, for example, if the baby takes several minutes to breathe, this reservoir of oxygenated blood can save your life, but paradoxically, it is customary to cut the cord immediately when it is necessary to perform neonatal resuscitation.

When the cord is intact, placental circulation acts as a conductor of any medication that is given to the mother, either during pregnancy, childbirth or delivery. Garrison (personal communication) reports that naloxone, sometimes the baby needs to counteract the sedative effect of analgesics administered to the mother during labor such as pethidine or meperidine (Demerol ® or dolantina ®), can be administered through mother during childbirth, so that the newborn baby wakes up in seconds.

The recent discovery of the amazing properties of cord blood, including stem cells it contains, stresses the need to ensure that all infants get their share in full. These cells are unique to this stage of development, and will migrate to the bones of the baby (bone marrow) shortly after birth, transforming himself into various types of hematopoietic stem cells, ie, generating new blood cells.

The collection of umbilical cord blood, which is being promoted to supply cord blood banks for the future treatment of children with leukemia, involves immediate cord clamping, and the baby was destined to be deprived of up to 100 ml of this blood belonged extraordinary. Perhaps this could be justified if it is practiced active management of childbirth, and if the umbilical cord blood cast off, but unfortunately, the donation of cord is incompatible with physiological birth (natural).

Active management and the mother

The active management of birth (oxytocin, immediate impingement and controlled cord traction) Represents Another step in Interference That Were Introduced in the mid-Seventeenth Century, When Physicians empezar Some male births to Attend Women and confined to the bed. At That Time, cord clamping Was started practicing to Protect bedding.

The first to pull the cord recommend Mauriceau Was in 1673, for fear That the uterus might close Before the placenta HAD eat out spontaneously. (21) In Fact, lying down, Which Is When He Attended increasingly taking the delivery Was a doctor, Was Likely less Spontaneous delivery of the placenta. In contrast, the vertical positions Women and midwives That HAD ADOPTED Traditionally Facilitated the fall of the placenta with the help of gravity.

The first oxytocic drugs Were Used as the alkaloids derived from ergot, a parasite of the cereal fungus. Midwives are Known to Europe in the Seventeenth and Eighteenth Centuries Used These alkaloids Called "ergot" Their farrier limited by toxicity. In the 1930s, ergot Was ergometrine refined, and by the end of 1940 Some doctors empezar using a preventive or Treatment for postpartum hemorrhage. (21) The Potential effects of the alkaloids derived from ergot include the Following: blood pressure increaser, Vomiting, headache, palpitation, cerebral hemorrhage, cardiac arrest, seizures and death Even.

Synthetic oxytocin, Which mimics the natural effects of oxytocin on the uterus of the pregnant woman, Was First record in the fifties, and has Almost Completely Replaced ergometrine, although it is using a drug Still Combines Both That (syntometrine) for Serious bleeding. The synthetic oxytocin Causes an Increase in the Intensity of Contractions, wheres ergometrine causes large tonic contraction, Which Also Increase the odds of trapping the placenta inside the uterus. Also Ergometrine interferes with the detachment of the placenta, Increasing the Risk of detachment is only partial. (22)

Recently, active management has Become "routine management of Women expecting a single baby by vaginal delivery in the maternity ward of a hospital" (23) Mainly by the results of Recent Hinchingbrooke trial, active management Comparing Against management "expectant" (Physiological).

In this trial, low INVOLVING Only Women at Risk of bleeding, Was Associated with active management of postpartum hemorrhage (more Than 500 ml) by 6.8% Compared to 16.5% in the expectant management (Physiological.) There Were FEW cases of Severe bleeding (more than 1000 ml) in Both groups: 1.7% in the asset management group, and 2.6% in the expectant management.

The authors note that, according to this, ten women would have to undergo active management to prevent one case of postpartum hemorrhage, and add:

"Some women may find worth taking a small personal risk of PPH of little importance compared with intervention in an uncomplicated birth, while others may prefer to take all precautions to reduce the risk of postpartum hemorrhage. ( 25)

In reading this study, one wonders how it is possible that almost 1 in 6 women suffer bleeding after giving birth "physiological" and if one or more components of western obstetric practices might not influence the high rate of bleeding.

Botha served more than 26 000 Bantu women over 10 years, and states that "the retained placenta occurred rarely, and never had to perform a blood transfusion for postpartum hemorrhage. (26) Women Bantu give birth squatting, both the baby and placenta, and nobody takes care of the cord until the placenta comes out by itself by the action of gravity.

There is some evidence that the practice of cord clamping, not practiced by indigenous cultures, contributes both to postpartum hemorrhage as the retention of the placenta, because a quantity of 100 ml (as described above) is retained within the placenta. This increases the volume of the placenta, so the uterus can not contract effectively, and is more difficult to expel. (27)

Other Western practices can lead to a postpartum haemorrhage: use of oxytocin for inducing or accelerating delivery (28, 29), an episiotomy, or other perineal trauma, forceps delivery, cesarean section or cesarean section-because of problems with the placenta See Hemminki (30).

Gilbert notes that PPH rates in her hospital (UK) doubled between 1969-70 and 1983-85, which increased from 5% to 11%, and concludes that "Changes in birthing practices in the last 20 years have resulted in an increase in postpartum hemorrhage significant problem. "(31) In particular, Gilbert relates the increased risk of bleeding with the use of oxytocin to induce or accelerate labor, forceps delivery , a D or an extended expulsion, and the use of epidurals, which increases your chances of prolonging forceps delivery.

As we see, western practices do not facilitate the production of oxytocin from the mother herself, or paying attention to reducing the levels of adrenaline in the minutes following birth, with the physiological function of increasing uterine contractions and minimize bleeding.

Cord clamping, especially if it immediately, you can have the extra blood trapped in the placenta back to back, through the placenta into the maternal bloodstream. This may generate an immune reaction that can be reactivated in a subsequent pregnancy, destroying the baby's blood cells cusándole anemia or even death.

The use of oxytocin, which intensifies the expansion or contraction in the delivery of the placenta, has also been associated with an increased risk of maternal hemorrhage and problems of blood group incompatibility. (34, 35)

The World Health Organization in its 1996 publication Care in normal birth: A Practical Guide says:

"In a healthy population (as in most developed countries), postpartum haemorrhage of 1000 ml can be regarded as physiological and does not require treatment other than the administration of oxytocin. (36)

In relation to the housing management of routine oxytocic and traction cord, WHO shows his caution:

"The recommendation of a policy would mean the benefits of this management would offset and even outweigh the risks, including rare but serious risks that could manifest itself in the future."

Decide on a natural childbirth

Deciding to avoid preventive oxytocin, late cord clamping (if they do) and illuminate the placenta for yourself requires some forethought, commitment, and have professionals who are comfortable and have experience with these practices.

However, a natural birth is more than this: we must ensure respect for the emotional and hormonal processes of the mother and baby, without forgetting that this is a unique moment. Odent Michel underlines the importance of not interrupt this time, not with words, and believes that the ideal is that the mother can feel observed and inhibitions in his first encounter with her baby. The level of non-interference is little common, even in the home or the homes of delivery.

The birth of lotus (lotus birth), the central theme of this book gives us the opportunity to "drill incencio slow" after birth, as the Canadian midwife Gloria Lemay, and gives our babies all physical and metaphysical benefits prolonged contact with the placenta. The birth of lotus, a good midwife, also isolates the mother and baby during the first hours and days, ensuring rest and reduce visits to a minimum.

The birth is a first encounter, and creates a powerful impression on the relationship between mother and child. When both are comfortable and have received no drugs, are fully present and alert, discover more about themselves and discover more about the sacred origins of our capacity to love.

The medical view of pregnancy and childbirth has permeated our culture so that we have forgotten how our ancestors were born, thanks to which our species has survived for thousands of years. With the intention, presumably, to protect mothers and babies from misfortune and death, modern western obstetrics has forgotten Mother Nature, whose complex and elegant systems of birth are disturbed by obstetric interventions, although we are aware our inability to understand or control these elemental forces.

The medical interference in pregnancy and childbirth is well documented, and its negative consequences have been well studied. However, the medical management of birth-the time between the birth of the baby and delivery of the placenta-is, for me, the most insidious. At the time that Mother Nature has provided awe and ecstasy, we make shots, we examined the baby, umbilical cord clamping and throw it. Instead of body heat and skin to skin, we separated the baby from his mother and put her clothes. When the weather should be detained in the eternal moment of first contact, as mother and son learn to love, we hurry to remove the placenta and clean to go "next."

The medical management of childbirth in the last decade's taken a step further with the popularization of the "active management of birth" (see below) carries some risks for mother and baby. Although many of the interventions aimed at reducing the risk of maternal postpartum hemorrhage (PPH), which can be a serious matter, it seems that, as with the active management of labor, can actually bring many of the problems that supposedly wants to avoid.

Active management also creates specific problems for the mother and baby. In particular, the baby is deprived of half the blood volume that would be sent. This extra blood that should flow into the lungs, which begin to function at this time, and other vital organs, is discarded with the placenta, with possible consequences such as respiratory problems and anemia, especially when it comes to vulnerable babies.

The drugs used in the active management are documented risks to the mother, including death, and we know its long-term effects for the baby, especially given its importance, since they apply at a critical period for brain development.

The hormones in birth

As mammals we are, because we have mammary glands that produce milk for our babies, we share almost every type of birth with other mammals. We share the complex orchestration of hormones of childbirth, which occur in the depths of our mammalian brain to help us and ultimately ensure the survival of our offspring.

At birth, they help themselves three hormonal systems of mammals, each of which plays an important role in the delivery. The hormone oxytocin causes the uterine contractions of childbirth, while helping us to launch our instinctive maternal behavior. Endorphins, the body's natural opiates, produce an altered state of consciousness and helps us to transform the pain and the hormones adrenaline and noradrenaline (epinephrine and norepinephrine, also known as catecholamines or CAs), responsible for our fight or flight reflex, We provide the peak power we need to push and give birth to our babies during delivery, or second stage of labor.

During the third stage of labor-delivery-strong uterine contractions continue at regular intervals, under the strong influence of oxytocin. Uterine muscle fibers shorten, or retract with each contraction, gradually reducing the size of the uterus, which helps to detach the placenta from the uterine wall. The third phase is completed when the mother lights the placenta that nourishes the baby during pregnancy.

For the mother, birth is the moment he receives the reward of his labor. Mother Nature gives you a peak of oxytocin, the hormone of love, and endorphins, hormones of pleasure, that bathe both mother and baby. The skin to skin contact and early attempts to entrench the baby to the breast increases maternal oxytocin levels, strengthening the uterine contractions that will help it to loosen the placenta and the uterus to contract. In this way, oxytocin acts to prevent bleeding and to establish, in concert with other hormones, the close bond that will ensure care and protection by the mother and child survival.

At this time, high levels of adrenaline in the second phase, which have kept mother and baby with eyes wide open, ready for your first contact, will fall, and it takes a very hot environment to counter the cold , and chills, the woman feels when their adrenaline levels drop. If the environment is not well heated, or something distracting or annoying to the mother, high adrenaline levels will be maintained and will counteract the beneficial effects of oxytocin on the uterus, increasing the risk of bleeding.

Also, the baby is essential to reduce adrenaline and noradrenaline, which had risen to a peak at birth. If you separate the baby from his mother, these hormones can not be softened by contact with the mother and the baby can fall into a psychological shock, according to Joseph Chilton Pearce, will prevent the activation of specific brain functions nature had planned for this moment. Pearce believes that the separation of mother and baby after birth is "the most devastating event in life, and leaves us emotionally and psychologically maimed."

One wonders if the modern epidemic of stress, a term invented by researchers at the beginning of the twentieth century-and stress-related diseases in our culture, could be a consequence of these common practices at birth. It is plausible from a scientific standpoint that our hypothalamic-pituitary-adrenal (HPA) which regulates long-term responses to stress, immune function, and the reflection of fight or flight in the short term, is disrupted by the continued high level of stress hormones that occur when babies are removed from their mothers through routine.

Michel Odent, in its review of existing research on the "primal period" (the time from conception to the first year of life), concludes that interference or dysfunction at the time affects the development of our capacity to love, which is particularly vulnerable around the time of birth and is connected hormone oxytocin system. Jacobsen's research and Raine, among others, suggests that contemporary tragedies such as suicide, drug addiction and violent crime may be related to problems in the prenatal period, such as exposure to drugs, birth complications and breaking rejection of the mother.

Those who attend the birth in these moments have the crucial role of ensuring that women's reflections mammals are protected and reinforced during pregnancy, childbirth, and beyond. Ensuring unhurried and uninterrupted contact between mother and child after birth, adjust the temperature to comfort the mother, provide skin to skin contact and breastfeeding, and not take the baby for any reason, are impractical sensitive, intuitive and secure and help synchronize our hormone systems with our genetic fingerprint, so as to provide maximum success and pleasure for both mother and baby in the important role of parenting.

The baby, the cord and active management

Adaptation to extrauterine life is the main physiological task to be performed by the baby at birth. In the uterus, the placenta performs the functions of the lungs, kidneys and liver for our babies. Blood flow to these organs is minimal until the baby's first breath, when they are initiated major changes in the organization of the circulatory system.

The baby's body, blood flows from the umbilical cord and placenta and, while the lungs fill with air, blood enters the pulmonary circulation. Nature reserve ensures the cord and placenta, which provide the blood necessary for the pulmonary system and other organs.

The transfer of this pool of blood from the placenta to the baby occurs in a stepwise progression: the blood flows with each contraction the baby's birth, and some of this blood returns to the placenta between contractions. Crying slows the receipt of blood, which is also controlled by constriction of blood vessels in the cord. This indicates that each baby may be able to regulate the transfusion based on their individual needs.

The gravity affects the transfer of blood, which will be optimal if the baby's body remains at the level of the uterus, or below, until the umbilical cord to stop beating. This process of "physiological camplaje" usually lasts about three minutes, but can last longer or can be completed in just a minute.

This elegant, proven system that guarantees the transfusion of a blood volume optimal, but not the same for all babies, can not act if done the usual practice of clamping the cord within 30 seconds of birth.

Immediate clamping of the umbilical cord has been widely adopted by Western obstetrics as part of the complex known as "active management of birth." Active management includes the use of an oxytocic agent-a drug that, like oxytocin, causes the uterus to contract forcefully - usually administered by injection in the thigh as the baby is born and the camplaje immediate cord and "controlled cord traction"-that is, pull the cord to remove the placenta as quickly as possible.

Will inevitably act in haste, and that after a few minutes the oxytocic injection will produce very strong contractions that can trap the placenta if it has not yet risen, so have to remove manually. Also some believe that if the cord is clamped before the oxytocic begins to take effect, the baby will be at risk of receiving too much blood, pumped from the placenta by the powerful contractions caused by the drug. Research on methylergometrine indicates that the use of an oxytocic accelerates placental transfusion to the baby, but babies in this study did not receive too much blood. (9)

While the purpose of active management is to reduce the risk of bleeding of the mother, "acceptance and widespread application has not been preceded by studies evaluating the effects of depriving the newborn babies of a significant volume of blood." (10)

It is estimated that immediate clamping deprives the baby from 54 to 160 ml of blood, (11) which makes up half its total blood volume at birth.

Clamp the cord before the baby is breathing by itself does need to use blood from other organs to establish pulmonary perfusion (blood supply to the lungs). If the child was hypovolemic (have low blood volume), this limitation could be fatal.

If the baby is left above the uterus before clamping-for example, during a cesarean ¬ - the blood will flow back to the placenta by the action of gravity, so it is likely that these babies receive less blood volume than would be expected. The consequence of this may be an increased risk of respiratory distress. Many studies have shown that this common complication in babies born by Caesarean section could be eliminated if they facilitate placental transfusion.

Babies who are also clamps the cord immediately lose iron in the blood that are deprived. Immediate clamping has been associated with an increased risk of anemia in childhood.

These immediate aftermath of impingement were known in 1801, when Erasmus Darwin wrote:

"Another thing very harmful to the child that is tied and cut the cord too soon, there would always be left not only until the child has breathed repeatedly until the cord stops beating. Otherwise, the child is much weaker than it should be, because part of the blood that should reach the child remains in the placenta. "(17)

In one study, premature babies who were clamped the cord within 30 seconds needed fewer transfusions, less severe breathing problems, better oxygen levels, and indications of likely better in the long term, compared with babies who are had the cord clamped immediately. (18)

Some studies have shown an increased risk of polycythemia (more red blood cells in the blood) and jaundice when the cord is clamped later. Polycythemia may be beneficial, since if there is more red blood cells means more oxygen reaches the tissues. The possibility that polycythemia can return the blood too thick (hyperviscosity syndrome), which is sometimes used as an argument against delayed cord clamping, seems to be invaluable in healthy babies. (12)

Jaundice is almost certain when a baby gets its full quota of blood, and the reason is the collapse of the normal excess of blood to produce bilirubin, the pigment that causes yellowish appearance of a baby with jaundice. However, there is no evidence that this has adverse physiologic jaundice. (12) Indeed, jaundice, which is present in almost all human infants to a greater or lesser degree, can be beneficial for its antioxidant properties. (19-20)

The other disadvantage early clamping carries over, as it deprives the baby of oxygen-rich placental blood which nature has provided to supply the baby until breathing is well established. In situations of extreme distress, for example, if the baby takes several minutes to breathe, this reservoir of oxygenated blood can save your life, but paradoxically, it is customary to cut the cord immediately when it is necessary to perform neonatal resuscitation.

When the cord is intact, placental circulation acts as a conductor of any medication that is given to the mother, either during pregnancy, childbirth or delivery. Garrison (personal communication) reports that naloxone, sometimes the baby needs to counteract the sedative effect of analgesics administered to the mother during labor such as pethidine or meperidine (Demerol ® or dolantina ®), can be administered through mother during childbirth, so that the newborn baby wakes up in seconds.

The recent discovery of the amazing properties of cord blood, including stem cells it contains, stresses the need to ensure that all infants get their share in full. These cells are unique to this stage of development, and will migrate to the bones of the baby (bone marrow) shortly after birth, transforming himself into various types of hematopoietic stem cells, ie, generating new blood cells.

The collection of umbilical cord blood, which is being promoted to supply cord blood banks for the future treatment of children with leukemia, involves immediate cord clamping, and the baby was destined to be deprived of up to 100 ml of this blood belonged extraordinary. Perhaps this could be justified if it is practiced active management of childbirth, and if the umbilical cord blood cast off, but unfortunately, the donation of cord is incompatible with physiological birth (natural).

Active management and the mother

The active management of birth (oxytocin, immediate impingement and controlled cord traction) Represents Another step in Interference That Were Introduced in the mid-Seventeenth Century, When Physicians empezar Some male births to Attend Women and confined to the bed. At That Time, cord clamping Was started practicing to Protect bedding.

The first to pull the cord recommend Mauriceau Was in 1673, for fear That the uterus might close Before the placenta HAD eat out spontaneously. (21) In Fact, lying down, Which Is When He Attended increasingly taking the delivery Was a doctor, Was Likely less Spontaneous delivery of the placenta. In contrast, the vertical positions Women and midwives That HAD ADOPTED Traditionally Facilitated the fall of the placenta with the help of gravity.

The first oxytocic drugs Were Used as the alkaloids derived from ergot, a parasite of the cereal fungus. Midwives are Known to Europe in the Seventeenth and Eighteenth Centuries Used These alkaloids Called "ergot" Their farrier limited by toxicity. In the 1930s, ergot Was ergometrine refined, and by the end of 1940 Some doctors empezar using a preventive or Treatment for postpartum hemorrhage. (21) The Potential effects of the alkaloids derived from ergot include the Following: blood pressure increaser, Vomiting, headache, palpitation, cerebral hemorrhage, cardiac arrest, seizures and death Even.

Synthetic oxytocin, Which mimics the natural effects of oxytocin on the uterus of the pregnant woman, Was First record in the fifties, and has Almost Completely Replaced ergometrine, although it is using a drug Still Combines Both That (syntometrine) for Serious bleeding. The synthetic oxytocin Causes an Increase in the Intensity of Contractions, wheres ergometrine causes large tonic contraction, Which Also Increase the odds of trapping the placenta inside the uterus. Also Ergometrine interferes with the detachment of the placenta, Increasing the Risk of detachment is only partial. (22)

Recently, active management has Become "routine management of Women expecting a single baby by vaginal delivery in the maternity ward of a hospital" (23) Mainly by the results of Recent Hinchingbrooke trial, active management Comparing Against management "expectant" (Physiological).

In this trial, low INVOLVING Only Women at Risk of bleeding, Was Associated with active management of postpartum hemorrhage (more Than 500 ml) by 6.8% Compared to 16.5% in the expectant management (Physiological.) There Were FEW cases of Severe bleeding (more than 1000 ml) in Both groups: 1.7% in the asset management group, and 2.6% in the expectant management.

The authors note that, according to this, ten women would have to undergo active management to prevent one case of postpartum hemorrhage, and add:

"Some women may find worth taking a small personal risk of PPH of little importance compared with intervention in an uncomplicated birth, while others may prefer to take all precautions to reduce the risk of postpartum hemorrhage. ( 25)

In reading this study, one wonders how it is possible that almost 1 in 6 women suffer bleeding after giving birth "physiological" and if one or more components of western obstetric practices might not influence the high rate of bleeding.

Botha served more than 26 000 Bantu women over 10 years, and states that "the retained placenta occurred rarely, and never had to perform a blood transfusion for postpartum hemorrhage. (26) Women Bantu give birth squatting, both the baby and placenta, and nobody takes care of the cord until the placenta comes out by itself by the action of gravity.

There is some evidence that the practice of cord clamping, not practiced by indigenous cultures, contributes both to postpartum hemorrhage as the retention of the placenta, because a quantity of 100 ml (as described above) is retained within the placenta. This increases the volume of the placenta, so the uterus can not contract effectively, and is more difficult to expel. (27)

Other Western practices can lead to a postpartum haemorrhage: use of oxytocin for inducing or accelerating delivery (28, 29), an episiotomy, or other perineal trauma, forceps delivery, cesarean section or cesarean section-because of problems with the placenta See Hemminki (30).

Gilbert notes that PPH rates in her hospital (UK) doubled between 1969-70 and 1983-85, which increased from 5% to 11%, and concludes that "Changes in birthing practices in the last 20 years have resulted in an increase in postpartum hemorrhage significant problem. "(31) In particular, Gilbert relates the increased risk of bleeding with the use of oxytocin to induce or accelerate labor, forceps delivery , a D or an extended expulsion, and the use of epidurals, which increases your chances of prolonging forceps delivery.

As we see, western practices do not facilitate the production of oxytocin from the mother herself, or paying attention to reducing the levels of adrenaline in the minutes following birth, with the physiological function of increasing uterine contractions and minimize bleeding.

Cord clamping, especially if it immediately, you can have the extra blood trapped in the placenta back to back, through the placenta into the maternal bloodstream. This may generate an immune reaction that can be reactivated in a subsequent pregnancy, destroying the baby's blood cells cusándole anemia or even death.

The use of oxytocin, which intensifies the expansion or contraction in the delivery of the placenta, has also been associated with an increased risk of maternal hemorrhage and problems of blood group incompatibility. (34, 35)

The World Health Organization in its 1996 publication Care in normal birth: A Practical Guide says:

"In a healthy population (as in most developed countries), postpartum haemorrhage of 1000 ml can be regarded as physiological and does not require treatment other than the administration of oxytocin. (36)

In relation to the housing management of routine oxytocic and traction cord, WHO shows his caution:

"The recommendation of a policy would mean the benefits of this management would offset and even outweigh the risks, including rare but serious risks that could manifest itself in the future."

Decide on a natural childbirth

Deciding to avoid preventive oxytocin, late cord clamping (if they do) and illuminate the placenta for yourself requires some forethought, commitment, and have professionals who are comfortable and have experience with these practices.

However, a natural birth is more than this: we must ensure respect for the emotional and hormonal processes of the mother and baby, without forgetting that this is a unique moment. Odent Michel underlines the importance of not interrupt this time, not with words, and believes that the ideal is that the mother can feel observed and inhibitions in his first encounter with her baby. The level of non-interference is little common, even in the home or the homes of delivery.

The birth of lotus (lotus birth), the central theme of this book gives us the opportunity to "drill incencio slow" after birth, as the Canadian midwife Gloria Lemay, and gives our babies all physical and metaphysical benefits prolonged contact with the placenta. The birth of lotus, a good midwife, also isolates the mother and baby during the first hours and days, ensuring rest and reduce visits to a minimum.

The birth is a first encounter, and creates a powerful impression on the relationship between mother and child. When both are comfortable and have received no drugs, are fully present and alert, discover more about themselves and discover more about the sacred origins of our capacity to love.