Those two things do not fit together. I can see it, too. I'm southern. I chit chat. People tell me things. Odd topics get related. We talk about who our people are. We make connections. It's like a game.
Abita Mardi Gras beer--does it get much better? Well, if you get to talk to an EMT about catching babies because of it, yes.
Here's how it happened--I'm at the grocery store checking out. The cashier is ringing up my beer, so we naturally start talking about beer. We both agree that we really enjoy a nice flavor. She likes an apple beer and Southern Pecan, so I tell her that Lazy Magnolia Brewery's other good one is Indian Summer.
We both agree that plain old beer now tastes like pee.
"Oh," I say, "Excuse me, that was vulgar."
"I'm an EMT. That's nothing," she says with a smile.
I tell her I'm a doula so pee and bodily functions in general don't phase me. I've blotted bubbles of meconium (this is normal with breech babies as they get squeezed down like a tube to toothpaste) off a breech baby's bum as she was being born and wiped a pushing mama before. It's just not a big deal.
"That's one thing I haven't had to do yet--deliver a baby."
Hmmm, me either, but opportunity is calling my name. I tell her that precipitous births are usually pretty safe and healthy. All you really need to do is catch. She says that's what she's been told.
The one thing in EMT births that always bothers me is how the cord is handled. I've heard 2nd hand and from EMTs that telling parents to tie off the cord with a shoelace is still in the script. Yikes! Why not whip off that shoelace and flush it in a dirty toilet a few times. It might clean it up a bit. I cannot think of many things that get nastier than and old shoelace.
So, I smile and say that other than catching, put baby right onto mom's bare chest and leave that cord alone (that might have come out more as a threat). It's still giving baby oxygen as long as it's pulsing. She is interested. She didn't know that.
The main myth I aim to dispell about cord clamping is backflow--the blood being transferred from placenta to baby will not backflow! It is being pumped, so it is pressurized. Now, gravity can affect how much is pumped in or out, but immediately clamping for fear of the blood draining out of baby is absurd. The actual reason we clamp immediately comes from the days of twilight sleep and general anesthesia--the drugs used to knock mom out were so dangerous to baby that getting baby away from the influence asap was critical. What else does that tell us? That pain medications given to mom quickly cross the placenta and affect baby? Yes indeed. This same reason is why narotics like stadol, nubain, and fentanyl are not used near the time of birth. They are known to negatively affect baby's breathing.
I quickly tell her that blood backflowing is a complete myth and that there is a substance called Wharton's jelly that beings to naturally stop the flow within the cord usually about five minutes after birth. I reminded her that unless you have a NICU handy, it's not a good plan to cut off baby's source of oxygen. It creates a problem where there was none and buys you time to get to safety.
All of this transpired in about 3 minutes. It was kind of neat. I might find a baby-friendly set of emergency birth instructions to pass her the next time I'm shopping. I should probably keep a set* in my doula bag. The workbook we use in class has a page for emergency birth. It doesn't happen all that often, and I would never ever use them to replace an actual birth attendant (midwife or doctor). I am in no way, shape, or form qualified to catch a baby. I would in an emergency if I had to, but I would not encourage an intentional "oops-we-didn't-make-it-to-the-hospital." It's all about using evidence-based practices. They improve safety and outcomes no matter where you are.
The first of 3 grand rounds videos:
http://www.youtube.com/watch?v=W3RywNup2CM
http://summaries.cochrane.org/CD004074/effect-of-timing-of-umbilical-cord-clamping-of-term-infants-on-mother-and-baby-outcomeshttp://www.midwiferytoday.com/articles/neonatalresus.asp
https://www.youtube.com/watch?v=W3RywNup2CM&feature=kp
http://www.mothersofchange.com/2012/01/whartons-jelly-miracle-tissue.html
*It was frustrating to see this ACNM PDF referenced all over the place and not easy to access in full form. Do not use in place of a care provider, but in the event of a precipitous birth or other emergency, it's a good one.
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