In unexpected situations like a rapid home birth or in remote areas without immediate medical assistance, emergency umbilical cord cutting is an extreme measure. It is undertaken only when professional medical help is unavailable and there’s an immediate, serious risk to the baby or mother. The primary goal in any birth scenario is always to secure timely professional medical care.
When to Consider Emergency Cord Cutting
Emergency cord cutting should be considered in rare circumstances when immediate transfer of the baby or mother is impossible without it, or if the cord itself poses a dangerous obstruction. Examples include the umbilical cord wrapped tightly around the baby’s neck, impeding breathing, or a placental abruption causing severe bleeding for the mother and depriving the baby of oxygen. In such cases, rapid intervention may be necessary.
It is not necessary to cut the cord immediately if the baby is breathing and crying well, and medical help is en route and expected soon. Delaying cord clamping for at least 30 seconds to a minute, especially for preterm babies, can be beneficial, allowing for increased blood flow and oxygenation from the placenta to the baby. For term babies, delaying clamping until the cord stops pulsating, within 1 to 3 minutes, can provide benefits such as higher hemoglobin and iron levels. The cord can remain attached to the placenta for a period without harm to the baby while awaiting medical professionals.
Essential Supplies for Emergency Cord Cutting
Essential supplies focus on clamping or tying and cutting, with an emphasis on cleanliness. You will need two items for clamping or tying the cord, such as sterile umbilical cord clamps, thick string, or even shoelaces. If using string or shoelaces, these should be sterilized by boiling them in water for at least 20 minutes.
A sterile, sharp cutting instrument is needed, such as a new razor blade or a pair of clean, sharp scissors. Maintaining a clean environment is important to reduce the risk of infection. While not always available, sterile gloves and antiseptic solution for cleaning the cord area are also beneficial.
Step-by-Step Guide to Emergency Cord Cutting
Before attempting to cut the cord, ensure your hands are thoroughly cleaned with soap and water, and wear sterile gloves if available. Begin by placing two clamps or tightly tied strings on the umbilical cord. The first clamp or tie should be placed approximately 2 to 3 inches (about 5 to 7.6 cm) from the baby’s abdomen.
The second clamp or tie should be positioned about 2 inches (about 5.1 cm) away from the first clamp, towards the mother. This creates a safe space for the cut. After securing both clamps or ties, carefully cut the umbilical cord between them, making a clean incision away from the baby. Avoid pulling on the cord during this process.
Immediate Post-Cutting Care
After the umbilical cord has been cut, immediate attention should be given to both the newborn and the mother. For the baby, ensure they are kept warm, through skin-to-skin contact with the mother, and confirm they are breathing effectively. Observe the umbilical stump for any bleeding; a small amount of oozing can be normal, but active bleeding requires immediate attention. The cord stump should be kept dry and clean to prevent infection, and diapers should be folded down to expose the stump to air.
For the mother, monitor for the delivery of the placenta if it has not yet occurred. The placenta delivers naturally within 5 to 30 minutes after the baby’s birth. Watch for excessive vaginal bleeding, which could indicate a postpartum hemorrhage. Seek professional medical attention as soon as possible for both mother and baby, even if the emergency steps were successful.