January 8, 2013 by Rebecca Dekker, PhD, RN, APRN
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Here at www.EvidenceBasedBirth.com and on my Facebook page, I receive many questions about the evidence for various labor and delivery practices. Unfortunately, due to my busy life as a professor and a mother of two, I don’t have time to write all the evidence-based articles that I would like. So that’s why I love to point people to evidence-based blog articles that other people have already written. Here are a few of my favorites!

Disclaimer: I agree with most, but not all, of the points listed in these articles. I probably would have written my articles in a slightly different style. But with that being said, I think these are reliable sources and that the authors cover the available research pretty thoroughly.

Q: What is the evidence for delayed cord clamping?

A: Nicholas Fogelson (the Academic OB/GYN) has a series of articles on delayed cord clamping. You can read his original article, a follow-up article, and if you have time you can watch his grand rounds lecture on YouTube. To sum it all up, delayed cord clamping has many benefits for both pre-term and term infants, although it does lead to a higher risk of jaundice. (The higher risk of jaundice is not surprising, really, since the breakdown of red blood cells contributes to jaundice, and infants who have delayed cord clamping have more red blood cells).

What does the evidence say about the timing of cord clamping? Credit: dsyzdek

What does the evidence say about the timing of cord clamping? Credit: dsyzdek

Q: My doctor says that my baby has to stay lower than my placenta if I want delayed cord clamping. Is this true?

A: Dr. Mark Sloan (a pediatrician) has written an article about this and other controversies related to delayed cord clamping . The short answer? No, the baby does not have to stay below the level of the placenta while the cord is still intact; it is perfectly fine for the baby to be in your arms!

 

Q: What is the evidence for letting the placenta come out on its own time versus giving Pitocin and putting traction on the cord?

A: Midwife Thinking wrote an interesting article about the evidence on this topic, explaining why the evidence suggests that “active management” (giving Pitocin and putting traction on the cord) may be more beneficial for most women who give birth in hospital settings. (To understand why I highlighted those two words— “most” and “hospital”—read the article!).

Q: Can you lead me to evidence-based research or randomized double-blind studies regarding placenta encapsulation?

A: As far as I can tell, no research on this subject exists!  Unfortunately, I can’t help you evaluate the research evidence if there is none to be had.

Q: I’m looking for information on epidurals. Can you help?

A: It’s not a blog article, but there is a great evidence-based resource about epidurals on Childbirth Connection’s website. The take-home point? Epidurals are highly effective at relieving pain but also carry many potential harms.

What are the potential benefits and risks of an epidural? Photo credit: beglen

What are the potential benefits and risks of an epidural?
Photo credit: beglen

 

 

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