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Unplanned Cesarean Birth. A warrior’s path.

tor-019.jpgCaesarean birth is not everyones first choice when planning the type of birth we’d like. For many women it is the very last type of birth they’d opt for. So when we are faced with our least favourite choice, the thing we’d worked so hard to avoid, our worst fear, what do we do? How can we cope with the disappointment of a birth that’s so far away from the birth that we’d dreamed of that it resembles a nightmare? What went so dreadfully wrong, and who can we blame for this travesty? As a midwife and mother who’s first baby was born by unplanned caesarean I’d like to explore these questions further.

A less than ideal birth?

Why does a less than ideal birth have to mean less-than? Could our less than ideal birth leave us feeling less than complete? If our bodies apparently failed to give birth, or we didn’t get to do the things we’d planned to do when greeting our babies, is there a sense of failure? I certainly remember feeling that my body had failed to birth my first child, and that I’d somehow failed to be there for her immediately after birth. These are very common but totally irrational thoughts as we try to make sense of how our plans went so wrong. There must be someone to blame, and that someone must be me. But our brains must be so confused at this time, as I was obviously not slacking by needing a life-saving caesarean, then haemorrhaging and being unconscious for hours after. Where does that self-blame come from? Wherever it comes from it is misplaced in the case of unplanned caesarean.

How can we even think that we are to blame for things going wrong? I can joke about it now, as it’s approaching 23 years since my baby and I nearly died. I can see rationally that my caesarean was a life-saving measure, and that my daughter shows no signs of the early neglect she may have suffered. But do you know what? It still hurts to think of those lost hours when we were not together.

Best laid plans

Like many women I’d prepared for a homebirth, but of course I knew as a midwife that anything could happen. It just wouldn’t happen to me, as I was so well prepared. I watched all my plans evaporate when labour didn’t progress and I transferred to hospital for analgesia and augmentation. A catalogue of nightmarish scenarios ensued, and my baby was found to be presenting by the brow (forehead, instead of the back of the head coming down first). Of course trying to force a malpositioned baby through a pelvis for hours is never a good idea, so my body haemorrhaged after my caesarean and I was returned to surgery. Postnatal depression inevitably ensued, marring a majority of our first year together. It just didn’t make sense. I’d done everything so right. How could it go so wrong?

 Are birth plans worth the paper they’re written on?

I’m not sure one can actually plan a birth, knowing that birth is inherently unpredictable. I think writing a birth plan is a good exercise in looking at and discussing your birth preferences with your birth partner. It can also be a useful communication aid for your midwife to read whilst you are busy birthing and not able to fully express your wishes. Beyond this it is of very limited value. If you do write your birth preferences down please just write on just one side of A4 paper, use bullet points, and try not to be too outcome orientated. What I mean by this is do not write “I am having a homebirth, vaginal birth” etc as these are never guaranteed. Its fine to write “I hope I’ll have a homebirth” or “I’d prefer x to y if I require pain relief” or how you’d like to spend the first moments with your baby if possible. Please do keep it short though, as I’ve heard doctors joke that women with long, inflexible birthplans are bound to need medical interventions! So plan all you like, but your baby may have an entirely different plan of it’s own. I do believe that all babies do their best to come out the way we have planned, but some get stuck, some run out of energy, and if left to a natural conclusion some babies and women would not survive the birth process. Nature doesn’t always get it right despite our best efforts, and timely caesarean surgery saves lives.

Less of a birth=less than a woman?

Why should we feel “less than” if we’ve accepted life saving surgery, albeit unwillingly? As a midwife I see so many different types of birth, and not one has more worth than another. All women are strong, beautiful and powerful in their birthing. This transformational state has equal value whether it is long or short, painful or ecstatic, vaginal or abdominal, surgical or physiological. Each birth brings forth a baby as well as the birth of new parents who need to start their parenting journey in an empowered way. It is a true rite of passage, where we are presented with obstacles and challenges, so we can discover how courageous and strong we really are. When women are well supported in their births they get to see their strengths and triumphs, and start their journey to parenthood in a joyful way. Without support and explanation they may be left feeling disappointed or even traumatised by such an unplanned outcome.

So how can we lessen the impact of unplanned caesareans and enable women to feel strong and empowered in their birthing? It’s important to have continuity of midwife, or a doula if possible. Research has shown that continuity of carer leads to better outcomes. Women can empower themselves by learning assertiveness phrases and asking for everything to be explained, so they are in charge of the decision making. They can organise 2 good birth supporters, who will support their choices, and be able to help practically as well as emotionally after an unplanned outcome. Women will need opportunity to debrief their birth with their care provider after unplanned caesarean. And as care providers we have a duty to help women understand and integrate their birth experiences. Unfortunately most women don’t have continuity of midwifery care, but all midwives and doulas can help a woman after unplanned caesarean birth. We can do this by listening, by witnessing their story without interrupting, then by answering their questions. We can believe them and validate their experiences, letting them know they made the best choices possible (being a professional means putting aside our personal opinions). We can congratulate them on their intuition, bravery, endurance etc, for giving it everything they had and then some, because of course every woman does. Don’t forget to mention her beauty and dignity in birthing, her graceful acceptance of the inevitable, and big up her support team too.

That woman is a birth warrior, she has done battle with nature and her worst fears, she has bravely laid her body down on the theatre table and has said “cut me open for the sake of my child’ risking her own life to save her unborn baby. She then returns from her battle triumphantly holding her reward, her baby, and should be welcomed home as a returning Hero. How can this warrior’s birth ever be seen as less than?

Conclusion

As a midwife I’ve had the pleasure to see empowering and ecstatic, planned and unplanned caesareans. I have personally had a vbac so also know the joy of vaginal birthing too. All births are great opportunities for us to grow and become more than we ever thought possible. This is a process of growth not lessening, so let’s treat it as such, and celebrate all birthing women as the birthing Goddesses they are.

Birth keeper or Baby catcher?

I felt compelled to comment on a great blog my the brilliant Rebecca Wright today. It can be seen here entitled “Are you a birthkeeper? Then don’t catch babies.” She was commenting upon the language used by birth workers in a facebook post which said “because maternity care providers are not serving mothers’ needs, more doulas and non-medically trained supporters being called on to catch babies.” She made great comment about mothers being the ones who should catch their own babies and why.

I’d like to elaborate further on my comments here, as this is an interesting subject, and I didn’t want to fill Rebecca’s site with my ramblings.

I was privvy to a conversation last year about the midwife’s role, brought about by the looming end to legal independent midwifery care. One party said when Independent midwifery becomes illegal we will be doing what doulas do anyway. The other camp were vehermently defending the title of midwife and not wanting to be compared to the service a doula provides. The arguement got heated (as is the way with passionate women!), and it was mentioned that women dissatisfied with their maternity care were indeed employing doulas to attend their births. Further heated discussion about the legality of this followed.

This got me thinking about what Independent or Authentic midwives do at a birth. I’ve been very honest over the past few years, telling my clients that I won’t actually be delivering their baby, they will. In fact most of my time (between the nurturing/ loving type of things) is taken up writing notes and drinking tea. I need women to realise that its not like on telly where the doctor heroically swoops in at the last moment to pull the baby out. It is the woman’s body, love, sweat and pure determination which get the baby born.

Several years ago I noticed that some women reach down to receive their own babies at the point of birth, but some are ashamed to touch themselves “down there,” especially if they are being watched! As a student midwife I recall watching my mentor move a woman’s hand away so she herself could ‘do’ the “delivery”. I’ve never been very directive myself, and have learnt the most by observing what women do naturally. Some women need to be informed that catching their own baby is possible as the power has so often been taken away from them. Professionals sometimes forget that they are there to serve the needs of the mother and baby – and not tell her what to do! (another post brewing on the balance of power). I remember telling a friend pregnant with her second child that I thought she could catch her own baby, for a number of reasons. I had seen many women slow down the birth of their baby if it was coming quickly and others who protect their own body in this way, giving tissues time to stretch (after practicing 11+ years I have never seen anything worse than a second degree tear). My friend did catch her own baby and tells all her friends that they can too!

empowered birthI’ve been mulling over what it means to be a midwife, what Independent midwives can call themselves, and how they can still serve women after October this year. I’ve also been thinking about what difference there would be between what a doula or I could legally do at a birth. There is potential for several posts on this, so I’ll try to stick to the current theme.

As a midwife I know it is the woman’s baby and not mine. I’m sure he prefers his mothers touch to mine, and encourage women to receive their own babies. I’ve shied away from unessesary internal examinations, and refrain from telling women how, or when to push, because I have attended many births where the mother does something totally unexpected and it turns out brilliantly. I remember being present at a birth centre birth where I was the second midwife. The woman was in advanced labour and spontaneously pushing with her first baby . We were prevented from being nosey, birth coach midwives, as visibility in the room was poor. The lights were dimmed and the water was a little cloudy, so our torch light couldn’t penetrate the water. Despite our efforts with torch and mirrror we could see nothing. I was concerned that I wouldnt be able to help her prevent a tear if I couldnt see when to tell her to pant, or give smaller pushes. As she pushed she spontaneously reached down and told us that she could feel the baby advancing, and before long told us baby was emerging. She lifted the baby triumphantly to the surface knowing she had done it all herself! We examined her perineum a while later and she had no tears. I told myself that women can obvoiusly prevent tears better than I can with all my experience.

I cannot bear midwives or doulas who brag about their ‘catches’ or how many deliveries they’ve done. I’ve no idea how many births I’ve attended (although it must be several hundred by now), and feel that keeping numbers makes it into some unsavoury sort of competition (like notches on a bedpost), rather than a unique event in someone’s life! Its a shame this bad habit starts in midwifery training where students have to get 40 deliveries to qualify as a midwife. Its not about numbers, its about people. I fail to see what student midwives learn when they are shoved into rooms to deliver a baby at the last minute, without knowing the woman, just to get their numbers. It can’t be nice for the mother either.

Being an authentic midwife means having the wisdom to not do everything you’ve been taught to do. The past 10 years of practice have been about unlearning the medical model, and learning from women. I like to think of it as a reverse Ina May Gaskin midwifery journey. A journey back to basic loving care, and being a birth keeper for the women and babies I serve.

Last word from Rebecca Wright: “Not all doulas or midwives are birthkeepers, of course, but the essence to me of this concept is exactly what you express here: service to mothers and to birth. Birthkeeping (and authentic midwifery) to me is about holding mothers and babies at the centre of their own experience, bringing with us whatever skills or talents we possess that are needed in that space, but always with humility and discernment.”

Thank you Rebecca for fueling my fire. xx

 

The Joy of birth

Has anyone ever told you that birth can be pleasurable or even pain free? It may be a very strange concept to women bombarded with stories of painful or traumatic birth. As an Independent midwife I rarely see women needing pharmacological pain relief, the main reasons being that they feel safe, loved and respected. They know and trust their midwife and know the sensations of labour are not to be feared. When a woman feels safe and supported throughout childbirth her biological functions can work as they were designed to. Her body produces complex coctails of hormones, endorphins and oxytocin to bring forth her baby in joy and triumph.

The strong sensations of childbirth are actually signs that our body is working well. The discomfort alerts us to the start of labour so we can move to a place of safety and gather our birth supporters around us. As the baby moves through our body it instructs us how, and when to move, to paricipate in the intimate dance of birth. As sensations change they let us know that we are making progress, and to assume a birthing position. The sensations of the expulsive stage enable us to work with our body and baby to give birth. These signals are more likely to be perceived as painful if the birthing woman is unsupported, scared, disturbed, or interferred with. Most women with good support manage labour with self-help techniques, love and their own determination.

I am of course referring to healthy women, experiencing full-term spontaneous labour, with a baby in the optimum position. If a labour is induced or augmented with artificial drugs, if a baby is in a really unusual position, or if an instrumental or surgical birth is necessary, then pain can be more difficult to manage.

The secret to an enjoyable birth experience is preparation, good labour support, and Oxytocin. Oxytocin has been called the love hormone as it is produced when we fall in love, or make love. It is very important in childbirth as it makes the uterus contract, enhances maternal behaviour and enables the letdown reflex in breastfeeding. Oxytocin is a very shy hormone though. It is hard to produce oxytocin in stressful situations.

The same environment which is conducive to making love is also advantageous in childbirth. Can you imagine having to make love in hospital, with bright lights, little or no privacy, unfamiliar staff wanting to watch, examine, time and chart every move? It would be very hard to mainain that loving feeling, let alone reach orgasm.

Oxytocin production is enhanced in an environment of trust, privacy, love, tenderness, darkness and emotional and physical comfort. As normal labour progresses it is normal for a woman to become more inwardly focussed, and less inclined to commumicate. The thinking parts of her brain need to not be stimulated as she enters a different state, sometimes referred to as being in “labourland.” If a woman is disturbed during active labour the flow of oxytocin can be interrupted.

According to wikipedia “The word oxytocin was derived from Greek  oxys, and tokos, meaning “quick birth,” so you can see its advantages!

Of course, if medical management is really necessary it is still possible to give birth in joy. Loving support, being in charge of the decision making process and sending love to your baby throughout, can make all the difference.

See the films below to see how joyful birth can be.

 

French woman enjoying giving birth – one of the best films of enjoyable birth I’ve ever seen.

Ecstatic birth –  shows the heights of pleasure some women can experience in labour.

Elephant birth – rather dramatic but worth watching just to see the power of birth and maternal instinct. Continue reading The Joy of birth

Copyright and the sharing of information

After an awkward issue arose between some midwifery colleagues over use of each other’s materials without consent I was prompted to write this page.

I believe all information is knowledge, knowledge is power and therefore should be shared to empower women. All information contained in this blog is my original work, from knowledge amassed throughout my midwifery career. I have worked very hard and am proud of the work I have done, so have marked photos, artwork and text as copyright Birth Joy Ltd(c). When I have used someone else’s material I will credit them in the text. I respectfully request that you do likewise. Please pass on information from my website but please remember to quote the origins of your information out of respect.

Photos are copyright to the photographer. I am very lucky that when I’ve taken birth photos, some women have given me permission to use these for teaching purposes, others have let me use their photos on my website. Some have allowed me to share with other midwives and one allowed publication in a midwifery text book. Many women have not, and I respect their right to do so.

For more information on copyright see this useful website.

“Am I allowed?”

A woman this week asked me one of the things that make me want to get on my soapbox about assertiveness and women’s rights.  What she said was “are you allowed to give birth to a breech baby?” My response, as ever, to this type of question is “it you who allows or disallows your care providers to do anything to you or your baby. Nothing can be done to you or your baby at home or in a hospital setting, without your consent. You are a mentally competent adult making rational decisions about your care, and you, more than anyone, has the best interests of your baby at the foremost in your mind”.

The Nursing and Midwifery Council (NMC), that govern all practicing midwives, provide information to midwives and nurses on the issue of consent:

“Legally, a competent adult can either give or refuse consent to treatment, even if that refusal may result in harm or death to him or herself. Nurses and midwives must respect their refusal just as much as they would their consent”.

The problem may lie with the allocation of power and responsibility in maternity care. Midwives and doctors are in a uniquely privileged position to be able to serve women at such a vulnerable time in their lives. We train long and hard to amass knowledge to help those we care for, but we should not use this to control or coerce women into what we think they should do. We are after all “Professional Servants” (Mary Cronk). We are there to serve the families we care for, but it is also our professional duty to inform them of any risks associated with their choices. The Nursing and Midwifery council (which regulates all midwives and nurses) has rules and codes of conduct advising us how to support our clients such as:

1. You must treat people as individuals and respect their dignity

2. You must not discriminate in any way against those in your care

3. You must treat people kindly and considerately

4. You must act as an advocate for those in your care, helping them to access relevant health and social care, information and support

5. You must respect people’s right to confidentiality.

6. You must ensure people are informed about how and why information is shared by those who will be providing their care.

7. You must disclose information if you believe someone may be at risk of harm, in line with the law of the country in which you are practising.

8. You must listen to the people in your care and respond to their concerns and preferences.

9. You must support people in caring for themselves to improve and maintain their health

10. You must recognise and respect the contribution that people make to their own care and wellbeing.

11. You must make arrangements to meet people’s language and communication needs.

12. You must share with people, in a way they can understand, the information they want or need to know about their health.

Point number 2 was obviously not read or understood by midwives who attended a woman’s home birth. The woman was from a particular religious group and her partner was from a different ethnic group. The woman phoned me as a result of midwife harassment in her current pregnancy, and in telling me her previous birth experiences said the midwives at one of her previous births had made racist remarks! I was livid and asked if she had complained – no she hadn’t! this is so wrong on so many levels I don’t know where to start! Harassing heavily pregnant women, and going against their wishes in labour is not acceptable but racism from a so called professional is a disciplinary offence. I gave the woman information and advice to make written complaints about current and previous problems, and gave her AIMS contact details.

Another part of our rules concerns consent:

13. You must ensure that you gain consent before you begin any treatment or care.

14. You must respect and support people’s rights to accept or decline treatment and care.

15. You must uphold people’s rights to be fully involved in decisions about their care. 

16. You must be aware of the legislation regarding mental capacity, ensuring that people who lack capacity remain at the centre of decision making and are fully safeguarded.

17. You must be able to demonstrate that you have acted in someone’s best interests if you have provided care in an emergency.

Whether your care provider will like or dislike your choices should be no concern of yours. I personally don’t like junk food, but understand that some people know the risks of consuming it, and still chose to do so. I may offer education about the risks, but wouldn’t dream of telling people not to do it just because I don’t like it myself. This applies to many areas of midwifery care, for example if you are told you are not allowed to give birth at home it would be good to ask if there are specific risks you need to be aware of, before thanking your health professional for their opinion, informing them that you will consider what they’ve said very carefully and let them know you will let them know your decision in due course (Taken from Mary Cronk’s assertiveness phrases). Consider how your care provider would actually be able to force you to do anything against your will (sadly, women have informed me of social services being used as a threat in some circumstances!).

REMEMBER: You do not have to ask permission to do anything which concerns your own body or your baby. Politely question your caregivers, do your own research then take responsibility for your choices! Your body, your baby, your choice!

See also:

Mary Cronk’s assertiveness comments on Angela Horn’s great homebirth website

AIMS the Association for the Improvement in Marternity Services has a great website and provides telephone support for anyone having trouble finding good maternity care. Please consider becoming a member or making a donation to their good work. x

All rights reserved. Copyright Birth Joy 2011 (C)


Breech Birth

Breech birthBreech birth is a very complex subject which needs in depth discussion with your care provider. I am lucky to have worked with one of the UK’s most experienced breech birth midwives, Mary Cronk, learning what I can about these unusual, but not abnormal  presentations. I have attended several breech births and taught alongside Mary Cronk, and Shawn Walker. I am happy to provide information and birth support for those carrying a breech presenting baby.

The Breech Birth Network run study days for health professionals and others wishing to learn more about spontaneous breech birth. This is a different set of skills to those needed to “Deliver” a breech baby which is a hands-on medical technique. Spontaneous breech birth is a hands off birth which can be facilitated by experienced midwives. The Royal College of Midwives consider this a normal type of birth.

Although breech is a normal presentation it carries additional risks compared with a head down birth. Breech babies are often born swiftly and spontaneously, but sometimes manouvers or surgery are needed to ensure baby is born safely. For this reason I recommend hospital birth with experienced care providers for breech presenting babies.

There are many things you can do to encourage a breech baby to turn see the brilliant spinning babies  website or the very funny pregnant chicken blog. The majority of babies who present as breech in pregnancy will turn head down by 36/37 weeks. If baby has not turned by 36/37 weeks of pregnancy you may be offered an External Cephalic Version (ECV) in hospital.

This ECV video  shows the technique used. The success rates (aprox 50%) vary with practitioner, whether it is your first baby, type of breech, how much fluid, size of baby etc. There is a small risk (1 in 200) of the baby becoming distressed during the procedure and needing immediate delivery by caesarean. More information is available here.

Breech babies can of course be born vaginally, but some doctors recommend caesarean surgery to deliver breech babies. Those doctors are probably basing their recommendation on the flawed Hannah trial (also called the Term Breech Trial or TBT) results. The TBT study seemed to indicate that babies born vaginally had worse outcomes than those born by caesarean, but when the outcomes were looked at 2 years later there were no differences in outcomes for the babies, but there are differences for the mother recovering from abdominal surgery. There have been many studies since, such as the PREMODA study (reported on at the 2012 breech birth conference) which show no differences in outcomes for breech babies born vaginally or by caesarean section. It is very important that you have a skilled midwife or doctor caring for you whichever type of birth you have.

The information and criteria which doctors use to determine who is a good candidate for sucessful vaginal birth can be found here. Please bear in mind that this green top guideline was published in 2006 and there has been lots of research done since then! I attended the International Breech Birth Conference in Washington DC in November 2012 and am eagerly awaiting the data soon to be published by Dr Frank Louven and his team in Frankfurt. See more information from the conference in Dr Rixa Freeze’s fantastic blog here.

See beautiful breech birth videos here:

A first baby born Frank Breech at home. Attended by a gentle doctor, this is a good illustration of spontaneous breech birth. The doctor does use a manouvre to help the baby’s head be born, and the baby doesn’t breathe immediately (this is fairly typical of breech born babies). You will notice how the doctor wisely does not cut the umbilical cord and how baby just requires stimulation to start breathing within a minute. Click here

A wonderful video of breech birth at home in water. It is the woman’s 4th baby and I can’t help wondering if baby would have got herself out sooner if the mother was in the supine position so buoyancy would have lifted baby’s body? The reverse of dry land breech birth, when the mother is on all fours and the baby descends aided by gravity. Anyway it’s a beautiful birth and a lesson to midwives that babies play an active part in the birth process.  You tube beautiful breech waterbirth

Another you tube film of planned breech birth at home clearly illustrating baby lifting her legs to flex her head (necessary for birth of the aftercoming head). It also shows how quickly breech babies can be born (this is the woman’s third baby), the midwife makes a very good catch of this little one! click on link Breech homebirth

There is also a lovely DVD you can buy which tells one woman’s story of deciding which birth was right for her and her baby. its called A Breech in The System. See the trailer here  and order your copy here

Of course I’m not saying all babies can, or should be born vaginally, but many can, and women should be given balanced information so they can make informed decisions about their care.

Da a Luz

Vanessa Brooks at Buddafields 2011

Just returned from a wonderful week in Spain. I met the wonderful Vanessa Brooks for the first time this year, and offered to share my experiences of breech births with her in Spain.

Unfortunately I was only able to spend 24hrs at the Midwives Rock workshop, as my family had accompanied me and were eager to do other holiday activities.
I taught at Da a Luz for 5 hours on the Saturday. I shared my experiences and knowledge that breech birth is unusual but not abnormal, and breech babies can be born vaginally as well as by caesarean. Although Breech birth is a variation of the normal I also taught that breech birth carries some additional risks for the baby however he is born, so careful monitoring of the progress of labour and baby’s well-being is essential.
It was a real pleasure to work with Vanessa and to meet Adela Stockton and all the other wonderful birth workers.
I look forward to teaching with Vanessa again in June 2012 in Brighton UK.

Had a wonderfully nourishing time with Vanessa and other like-minded birth workers in the summer of 2012! We talked about birth of the placenta, control of bleeding, orgasmic birth and so much more. Then it was my turn to contribute alongside Marta Orbis and Vanessa Brooks teaching about breech births and difficult births. Can’t wait to work with Vanessa again next year. xxx

 


Delayed cord clamping is a much kinder transition for the newborn baby

Cutting the baby’s umbilical cord is a ritual repeated unthinkingly by many doctors and midwives every day. Please educate yourself about the potential harm that could be caused for the baby by doing this.

In the 1980’s I was taught to feel for the umbilical cord around the baby’s neck, once the head was born, and to cut it if it was tight to facilitate delivery. I realise there were so many things wrong with this practice now. What if we cut a cord and then have a shoulder dystocia? We have effectively cut the baby’s lifeline. I don’t think many practitioners do this now. I certainly do not feel for nuchal cords as babies can be born, even when the cord is tight. The somersault manouver  can be used to keep baby close to the mother whilst the cord is untangled.

The brilliant midwife thinking blog highlights the dangers of premature cord clamping if a baby needs help to start breathing. Basically when the baby is born a significant amount of his blood is still in the placenta. After birth that blood is needed to perfuse the baby’s respiritory system, enabling him to transition to breathing air for the first time. If a baby is slow to breathe but has a good heatbeat he is still receiving oxygenated blood through his cord if it remains intact.

Some women like to keep the cord intact in the form of a lotus birth. Aida’s birth and lotus birth was filmed, and illustrates how not cutting the baby’s cord helps when her baby needs help to start breathing.

Here is a 7 minute film with good, common sense advice about not cutting baby’s cord immediately after birth. This film has brief images of a woman’s breast and nipple as she is with her newborn baby as his cord is cut and as he crawls to the breast to self-attachment. This process, called Self-Attachment and/or Breast Crawl is becoming known now as a very critical part of human development that has been disrupted by modern, medicalized birth. Click to view: We can be much kinder

Penny Simkin gives a visual aid teaching session on the subject of how much of baby’s blood is still in the placenta if we cut the cord too soon after birth. here

Robim Lim explains the importance of not clamping or cutting a newborn’s umbilical cord here:
https://www.youtube.com/watch?v=SwvRUrn0p90&feature=player_embedded