Umbilical Cord Avulsion in Waterbirth

Abstract

Umbilical cord avulsion (or "cord snapping") is often cited as a risk associated with waterbirth. This article discusses a case study in which a cord avulsed during a waterbirth and uses it as a basis to explore the incidence, etiology, and associated risk factors of umbilical cord avulsion. The diagnosis, clinical presentation, and management of cord avulsion in waterbirth is presented along with a thorough review of the literature and relevant professional standards. This article offers recommendations for clinical practice to minimize the risk of a cord avulsion and highlights the need for additional research and provider education to ensure optimal care of women and newborns.

Maternal and Newborn Outcomes Following Waterbirth: The Midwives Alliance of North America Statistics Project, 2004 to 2009 Cohort

“…Waterbirth is highly controversial in the United States, [1][2][3][4][5][6][7][8] despite being an accepted practice in other high-resource nations. [9][10][11][12] Proponents of waterbirth cite anthropological evidence from Odent and Tjarkovsky regarding childbearing traditions that include immersion 13,14 ; the maternal benefits of laboring in water, such as pain relief and reduced stress on tissues secondary to buoyancy 15,16 ; the potential benefits to a neonate of being born into a warm, liquid environment similar to the amniotic fluid 17 ; and a series of studies, mostly small and observational, suggesting no adverse effects for either the laboring woman or the neonate.…”

“…Laboring in water is considered safe; the current question in the literature is whether waterbirth is safe. 3 Published reports of outcomes following waterbirth in the United States currently consist solely of case series 1,2,4,5,[21][22][23][24] rather than studies with robust designs and adequate power. However, there are several cohort studies from Europe describing waterbirth outcomes, [25][26][27][28][29][30][31][32][33][34][35] nicely summarized by Nutter et al in a recent review.…”

Parto acuático: complicaciones y beneficios más relevantes respecto al parto vaginal convencional. Revisión Integradora

“…La mayor parte de la literatura hallada es de tipo descriptiva, observacional. Entre los estudios revisados, el 33 % (n = 5) coinciden afirmando que el parto en el agua produce una reducción del dolor, aumentando la satisfacción de la mujer como consecuencia de aportarle mayor autonomía y movilidad durante todo el proceso de dilatación, siendo una consecuencia de ello la reducción de la tasa de epidural (Cortes et al, 2011;Davies et al, 2015;Maude & Foureur, 2007;Salazar-Herrera et al, 2016;Schafer, 2014) Davies et al, (2015) y Henderson et al (2014 afirman que este tipo de parto supone un descenso de la tasa de intervenciones respecto al parto vaginal convencional en consecuencia reduciéndose considerablemente el número de episiotomías, el tiempo de duración del parto se reduce considerablemente. En contraposición, otros autores como Bovbjerg, Cheyney & Everson (2016), lo correlacionan con una mayor tasa de desgarros, justificándolo por un acortamiento de la segunda fase de la dilatación y el menor tiempo de adaptación a la presión de los tejidos musculares perianales.…”

“…Esta importante revolución, fue liderada por el también obstetra francés Michel Odent, autor de la publicación « Nacimiento bajo el agua» (Odent, 1983). Desde entonces ha ido aumentando su aceptación y demanda en la mayoría de los países con ingresos altos (Henderson et al, 2014;Schafer, 2014). Bárbara Harper fundó la organización Waterbirth Internacional en Santa Bárbara, California (1988).…”

A Model Practice Template for Hydrotherapy in Labor and Birth

“…Failure to respond immediately with effective management could result in the need for a neonatal blood transfusion. 7,[14][15][16] B. Hyperthermia. Elevation of maternal core temperature can result in maternal hyperthermia, which can lead to fetal tachycardia.…”