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essay on delayed cord clamping
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“The imperative of implementing delayed cord clamping to improve maternal and neonatal outcomes” is an article written by Nicola Holvey, who is a student midwife at the university of West London Wexham Park hospital. The article was published in 2014 by the British Journal of Midwifery. In the article Holvey argues why delayed cord clamping of neonates should be implemented as a standard practice in hospitals. This article is a well written, informative article that outlines the positive effects of delayed cord clamping with supportive research that contributes to Holvey’s argument.
Delayed cord clamping is a heavily debated practice among physicians and obstetrical staff around the world. Once a baby is born they remain attached
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Holvey explains that the reason physicians have chosen not to make delayed cord clamping part of their standard practice is because in certain scenarios, delayed cord clamping may not be the best option. When a baby is born there are certain characteristics of the labor and birth process that may interfere with the ability to perform delayed cord clamping. In the event that the baby needs immediate intervention to become stable the baby must be moved to a designated resuscitation area where medical professionals can gain access to certain types of equipment. In this situation the cord would be clamped immediately. Holvey states that the main reason physicians do not practice delayed cord clamping is because there is not enough research done about the risks it poses to infants and the mothers. In the event of an emergency, the time it takes for the extra blood to pass to the baby may be crucial. Early in the article Holvey answers the question she presents to the reader in the beginning, she gets to the point of her article early on which intrigues the
Cord clamping is a procedure where a baby’s umbilical cord is clamped and cut. This procedure clamps off the baby’s arteries and vein contained within the cord, which can immediately halt circulation depending on when the clamps are applied. Cord clamping might be done prior, during, immediately after or hours after birth. When cord severance is performed a plastic clamp is also applied to the remaining cord to prevent blood loss from the baby. I chose this topic because it is very interesting to see the differences between early cord clamping and the delayed cord clamping process. There are a few differences that I have found when doing my research on how delayed cord clamping can benefit the baby.
The Support of Research of that Privation in Infancy will Have Adverse Effects on Later Development
... in place in delivery rooms to better sterilize the environment to eliminate viruses and infection which would further risk bleeding for mother or infant and thus lead to increased time in the NICU.
Neonatal Palliative Care should be considered for newborns with a debilitating or constraining condition, because the rate of survival for these extremely preterm and sick newborns are low. When palliative services need to be considered, parents and family members should be counseled and educated on the services, although making a choice of this magnitude to withdraw life sustaining measures will leave a void in the hearts of many. Potential is lost and dreams are torn apart which leaves parents and family members to lament the loss. Instead of endure the pain of the loss, the family wants to hold on to the infant, when the best thing to do will be to let go.
Neonatal nursing is a field of nursing designed especially for both newborns and infants up to 28 days old. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team. These are trained professionals who concentrate on ensuring that the newborn infants under their care are able to survive whatever potential life threatening event they encounter. They treat infants that are born with a variety of life threatening issues that include instances of prematurity, congenital birth defects, surgery related problems, cardiac malformations, severe burns, or acute infection. Neonatal care in hospitals was always done by the nursing staff but it did not officially become a specialized medical field until well into 1960s. This was due to the numerous advancements in both medical care training and related technology that allowed for the improved treatment and survival rate of premature babies. According to the March of Dimes, one of every thirteen babies born in the United States annually suffers from low birth weight. This is a leading cause in 65% of infant deaths. Therefore, nurses play a very important role in providing round the clock care for these infants, those born with birth defects or other life threatening illness. In addition, these nurses also tend to healthy babies while their mothers recover from the birthing process. Prior to the advent of this specialized nursing field at risk newborn infants were mostly cared for by obstetricians and midwives who had limited resources to help them survive (Meeks 3).
There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.
The nurse immediately started to intervene by turning the patient onto their left side. This intervention did not work; therefore the nurse turned the patient onto her right side and applied 10L of oxygen to the patient via a facemask. Also, the nurse opened her fluids wide. After turning the patient from side to side the fetal heart rate returned to normal. This initial decel lasted four minutes and had a nadir (lowest point) of 85bpm. As this was happening the physician and two residents came into the room, because the fetal heart monitor alarms at their station as well. Once the fetal heart rate was back to normal the physician asked the nurse to continue monitoring the patient closely. The fetal heart rate remained stable for about thirty minutes until 8:20am when the heart rate began to have late decels. A late decel is defined as “A late decel is defined as “a gradual (onset to nadir >30 seconds) decrease in FHR, with the onset, nadir, and recovery of the deceleration occurring after the beginning, peak, and ending of the contraction, respectively” (Miller, 2012). The nurse began to intervene again by turning the patient, applying an oxygen mask at 10L, and opening the fluids to run wide. This time the nadir reached 50bpm and the physician knew he needed to act fast. At 8:34 the physician artificially ruptured the patient’s membranes and applied a fetal scalp electrode. “This
It is highly possible that something could go wrong causing the child to suffer. In the early stages of this new technology what would happen if something unexpected was to occur? Would the staff in charge of taking care of the fetuses be able to change settings on an instrument supporting the fetuses? In the rare event of a power outage or a natural disaster would a generator kick in fast enough to support these fetuses? These questions are all things that would have to be dealt with in the early stages of this new technology as well as in later stages. Supporting a life is not something that can be left unattended at any time.
In this time having a cesarean was very dangerous for the mother and the baby. In some cases, a cesarean would lead to
In the United States one in eight births are preterm (“Funding for Premature Related Research”).Premature means that the baby is born early, which is any baby born before thirty-seven weeks but health problems are usually only a problem for babies born before thirty-four weeks (“Funding for Premature Related Research”). Premature births are the leading cause for neonatal deaths and half of all premature births have no known causes (Lynch and Dezen). Babies who survive prematurity face multiple health problems including cerebral disease, vision and hearing loss, mental retardation, and lung problems (Lees, Reynolds,andMcCartan). Obviously with so many premature babies being born today, with so many unknown neonatal deaths in premature babies, and with all of the health problems for premature babies, there is a problem that must be addressed.The government needs to further fund research for the care and prevention of premature babies to prevent unnecessary death and health problems, cut costs in the long run, put previous findings into effect and reduce parental stress.
Many women today are doing more C-sections, also known as cesarean, than they are natural. Whether the reasons being because it’s more convenient or that some moms did not really have a choice, the percentage is still growing. “The cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009; 50.0% of the increase was attributable to an increase in primary cesarean delivery (National Partnership for Women & Families, 201.)” There are many things to consider when deciding which is the right or safer choice. With both choices comes risks for the baby like, possible respiratory problems with a C-section. The mom has many risks to worry about for herself as well, like possibly hemorrhaging. There is also the recovery and the long-term effects that a woman has to put into consideration. They both have their pros and cons that should not be taken lightly.
A neonatologist has many tasks and responsibilities before, during, and after the birth of an at-risk newborn. If there is reason to believe there are going to be complications with a birth that would cause negative side effects for the infant, a neonatologist will be brought in to help. In these high-risk situations, a team effort is required and the neonatologist takes the lead position. The neonatologist will be responsible for advising the parents on what to expect during and after labor. After the infant is born, the neonatologist has to find a method to properly care for the baby. Because most premature babies have a low birth-weight, their lungs need to be supported and they need to be kept warm. During this whole process, the neonatologist interacts with the parents to keep them updated on their baby’s condition (Weaver, 2009).
Between five to ten percent of all infants are born more than two weeks before their due date due to several factors that include infections, illness, poor nutrition, or complications during the pregnancy. Fetal monitors are used in the cases of C-sections because there is a much higher risk of detecting the infant’s distress and therefore can go in more quickly to remove the baby from the uterus. When the mother is under general anesthesia, which is rare in the United States, the mother is not aware of any kind of pain or even the birth of her child. When the mother has spinal anesthesia she has no feeling from the waist down. Sometimes, the best indication that the baby is in distress is the mother- an unfamiliar pain occurs or something else could be a sign of problems.
Vered, N., Nadir, E., & Feldman, M. (2012). Late better than early elective term cesarean section. Acta Paediatrica, 101, 1054-1057. doi:10.1111/j.1651-2227.2012.02772.x
Cesarean birthing method can be voluntary as well as involuntary. When a cesarean is chosen in advance it is usually because the mother has a history of infection, which could be transmitted to the baby when it is delivered through the birth canal; the mother has severe to...