Chronology of understanding and traditions in childbirth

  • William Harvey (1653)
    Pulsations of the umbilical cord provide evidence that a baby taken from the
    womb of its deceased mother is still alive

  • Charles White (1773)
    Transition from fetal to neonatal circulation cannot be expected to always
    take place immediately at birth.

  • Erasmus Darwin (1801)
    The placenta provides the fetus with oxygen, an urgent on-going need.

  • Traditional textbooks (1801-1986)
    The umbilical cord should not be cut until pulmonary respiration is
    established.

  • Beginning of a change in opinion (1950)
    Williams Obstetrics, 1950 edition.

  • Virginia Apgar (1953, 1958)
    Evaluation of respiratory depression in newborns - clamping of the cord
    within one minute to preserve the "sterile field" for suturing. "Slow delivery"
    was still widely practiced.
-                                                                                    How many prospective
  • Current protocol                                              parents have any idea
    Clamp the cord within 30 seconds after birth.     that this protocol is
-                                                                                    the current standard?
  • Recent reconsideration
    Wait a minute, or two, or more before clamping the cord.