A BABY’S TRANSITION FROM THE WOMB TO THE OUTSIDE WORLD
Consider the impact on the baby’s transition ...
Drugs to relieve pain in labourConsider the impact of opioids such as Pethidine by injection, and epidural and spinal-epidural anaesthetics.
Clamping of the Umbilical CordConsider the increased volume of blood, and reduced risk of anaemia, to the baby when we delay the clamping of the cord.
The cord may be around the baby’s neck at birth, and some attendants will clamp and cut the cord before the baby’s shoulders are born. Consider alternatives.
Consider the impact on the baby when cord blood is collected for stem cell harvesting.
Skin to skin placement at birthConsider the newborn baby’s ability to stay warm when kept naked against mother’s skin immediately after birth. This practice is important in temperature regulation of the newborn, as well as bonding and initiation of breastfeeding soon after birth.
Suction of the newborn at birthConsider the impact on the baby of suction in the mouth, nose, trachea and stomach. Note that there is no evidence that a vigorous, mature infant is helped by suction, even if there is meconium in the amniotic fluid.
Resuscitation of the baby using OxygenCurrent research questions the value of using Oxygen, rather than room air, during resuscitation of the baby who is not able to breathe independently immediately after birth.
BreastfeedingConsider the importance to the baby of unlimited access to the mother’s breast as she or he learns to breastfeed, and consider the amazing protective and nutritional properties of breast milk.
There is a strong body of evidence in favour of protecting, promoting and supporting the natural processes in birth, and the baby’s transition to life outside the womb.
Birth is a time of enormous change for a baby. The transition from life inside the mother’s womb, to life in this world, requires many important natural or physiological changes to take place. The baby’s lungs need to expand and take in the air, providing oxygen and taking away carbon dioxide. The baby’s heart needs to redirect the blood so that the circulation to the placenta is shut down, and the blood is directed to the lungs. The baby needs to maintain normal body temperature. The baby needs to obtain food. These functions, and many more had, in the womb, been managed naturally via the placenta and the mother’s body.
The vital changes take place naturally at birth when mother and baby are well. Over time many interventions into the birthing process have been adopted by midwives and other birth attendants. Some interventions in certain situations are life-saving, while others are not based on evidence for improved outcomes for mother or baby. Practices that are common in maternity settings today, that may have an impact on the baby’s transition to life outside the womb, include:
- the use of medicines (drugs and natural substances) in labour
- mechanical suction of the baby’s airways
- early clamping of the umbilical cord
- separation of mother and baby
- strategies to keep baby warm, and
- methods of resuscitation of a baby who is not breathing at birth.
In this INFOSHEET we draw attention to various practices. We encourage parents who are seeking maternity care that supports and promotes the natural processes and wellness to discuss these and any other issues that are important to you with your primary caregiver. You can seek to ensure that the midwife or other professional who is attending you in labour understands your wishes for the care of your baby during the transition from the womb to the outside world.
This INFOSHEET is based largely on a published paper, ‘Evidence-Based Practices for the Fetal to Newborn Transition’ (Mercer et al 2007), which provides a review of the relevant literature.
Natural birth is a mother’s own resource
Pregnancy, birth and breastfeeding are natural biological processes. Most women and babies are well during this time, and will be able to proceed through spontaneous unmedicated labour, and give birth to a healthy baby who breastfeeds and thrives naturally. In fact, unless there is a valid reason to interfere, the natural biological processes are the safest for both mother and baby.
There are many aspects of birthing which are un-knowable, and your birth plan should allow for and support your informed decision making at all times. Women who know and trust their midwife or doctor may be more confident in making decisions than those who do not know their primary carer.
Reference: Judith S Mercer and others, 2007. Evidence-Based Practices for the Fetal to Newborn Transition. J Midwifery Womens Health 2007:52(3)262-272
ps. A question has been asked about delayed cord clamping and the possibility of jaundice in the baby.
Evidence from research has been summarised in the Cochrane Reviews http://www2.cochrane.org/reviews/en/ab004074.html