July 2004
2
Umbilical cord clamping, a human invention
Waiting for the first breath, a long tradition
Waiting for the first breath, a long tradition
Shunts in the heart supply
sufficient circulation to the
lungs for growth during gestation
but divert the greatest volume to the
placenta to receive oxygen. Once pulmonary circulation and breathing are established, these shunts close, but they may remain open with the newborn infant's heart continuing to pump blood through the umbilical arteries for a period of time up to several minutes after birth [8]. Placental respiration therefore does not cease immediately after birth, unless the cord is clamped.
2. Umbilical cord clamping, a human invention
•
Clamping of the umbilical cord at
birth is a human invention, and it
has long been the subject of
controversy [9-35]. The potential danger of umbilical cord clamping was explained by Charles White in 1773, also indicating how long this controversy has gone on. White
recognized that time was required
for the changeover from prenatal to
postnatal circulation, and that
placental circulation should
continue during this transition:
"The common method of tying
and cutting the navel string in
the instant the child is born, is likewise one of those errors in practice that has nothing to plead in its favour but custom. Can it possibly be supposed that this important event, this great change which takes place in the lungs, the heart, and the liver, from the state of a foetus, kept alive by the umbilical cord, to that state when life cannot be carried on without respiration, whereby the lungs must be fully expanded with air, and the whole mass of blood instead of one fourth part be circulated through them, the ductus venosus, foramen ovale, ductus arteriosus, and the umbilical arteries and vein must all be closed, and the mode of circulation in the principal vessels entirely altered
- Is it possible that this wonderful
alteration in the human
machine should be properly brought about in one instant of time, and at the will of a
by-stander?" – White 1773, p
45 [9]
3. Waiting for the first breath, a long
tradition
It should go without saying that
a newborn infant must be
breathing before the
