July 2004
3
Traditional
textbooks explicitly taught that the cord should not be clamped until the
infant was breathing
umbilical cord is clamped. Until the mid 1980s most textbooks taught this explicitly, and many encouraged waiting for pulsation of the cord to stop, as can be seen from the following quotes:
If the child be
healthy, and not have suffered from pressure,
&c. it will cry as soon as it is born, and when respiration is established, it may be separated from its mother
Churchill 1850, p 132 [36].
A strong healthy
child, as soon as it is born, will begin
to breathe freely, and in most cases cry vigorously. As
soon as it has thus given satisfactory
proof of its respiratory power, you may at once proceed to separate it from its mother by tying and dividing the umbilical cord. Swayne 1856, p 20 [37].
"The cord should not be tied until the child has breathed vigorously a few times. When there is no occasion for haste, it is safer to wait until the pulsations of the cord have ceased altogether." Lusk
1882, pp214-215 [38].
In cases of suspended animation, the cord should not be tied until it has ceased to pulsate, as there is a possibility in such circumstances, of a certain amount of placental respiration
" Leishman 1888, p 320 [39].
"Q: When an infant is born what is the proper treatment to adopt to severing the umbilical cord? A:
You must first assure yourself that the child is alive and breathing
" Corney 1899, p 5 [40].
"When respiration is established, let the infant
rest on the bed between the
thighs of the mother, preferably
on its right side or back, avoiding contact with the discharges, while the navel string is attended to. No
haste is necessary in tying and cutting
the cord, unless relaxation of the uterus, flooding, or some other condition of the mother, requires immediate attention from the physician." King
1907, pp260-261 [41].
"As soon as the child is born, its eyes are wiped, any mucus in the air passages is removed, and it is placed in a convenient position between the patient's legs.
The cord is tied as soon as it has stopped pulsating, and the infant is then removed."
Jellett 1910, p 350 [42].
"Normally the cord should not be ligated until it
has ceased to
pulsate
" Williams 1917, pp342-343
[43].
"
A compromise is usually adopted, in that the cord is not tied immediately after birth, nor does one wait till the expression of the placenta, but only until
the cessation of
pulsation in the cord, an average of five
to ten minutes." vonReuss 1921, p
419 [44].
