An 8-year-old Tampa girl helped deliver her baby brother on her home’s bathroom floor.
 
Her mother went into labor Monday morning and couldn’t make it to the hospital. 
 
Krystle Garcia, the mother, held healthy baby Joseph in her arms that evening.
 
"He has a big smile on his face,” she said. “I will never forget this day." 
 
Joseph James Snyder began arriving as Krystle went into the bathroom to get ready for work.
 
"I was in the bathroom and my water broke and I yelled for her... ‘Jazmine grab the cordless phone. Dial 911,’" she said.
 
Jazmine McEnaney called for help at 7:02 a.m. She told the 911 operator, "My mom is pregnant and her water just broke. She is in so much pain."
 
Krystle said she was frantic in that moment.
 
“Even if I called somebody, they are not going to come quick enough,” she said. “It happened so fast."
 
Her baby was two weeks early. All five pounds 10 ounces of little Joseph couldn't wait. 
 
The operator guided Jazmine in how to help deliver the child. Just 13 minutes after that 911 call started, and before paramedics could arrive, Joseph made his appearance. 
 
The 911 operator asked, "Is your mom pushing or straining yet?" 
 
"Um, mommy are you pushing or straining?" Jazmine asked.
 
From the background Krystle screamed, "Yes! Yes!"
 
Talking about what the 911 operator asked Jazmine to do, she told us, "It was like, kind of hard." 
 
Krystle held the phone as Jazmine worked to deliver Joseph. On the 911 call, Krystle told her, "Come here. Hold the baby's head please. Hold the baby's head please, Jazmine." 
 
"She definitely stayed calm when she needed to. I was hysterical," Krystle said. "She did a very good job. I am proud of her."
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Nearly every pregnancy-related television show and movie has that quintessential scene where the doctor turns to the newborn’s father and asks if he’d like to cut the cord. While it’s always a sweet moment, experts who understand the importance of delayed cord clamping watch these scenes and cringe – because the vast majority of the time, the cord is getting cut way, way too soon.

“At the moment a baby's born, 1/3 of their blood, the blood that's been going through them for all of pregnancy, is still outside their body. And what happened for all of human history is that after the baby is born, the cord would pump. It would pulse. It would push blood into the baby. They'd get 30% more blood. They get 60% more blood cells. They get iron to last them through their first year. They would get white blood cells to fight infection. They would get antibodies. They would get stem cells to help repair their body. But what happened in the 20th century is we got the idea to immediately put a clamp on the cord. To clamp it, cut it, and lock out the oxygen, lock out the iron, lock out all those wonderful things,” explains Dr. Alan Greene, a world-renowned pediatrician and author of Feeding Baby Greene. “If you wait just an extra 90 seconds or so, you get all the good stuff in your baby.”

Ninety seconds – a blink of an eye, a few key photo ops with you and your newborn babe doing skin-to-skin for the first time – seems like a ridiculous amount of time to argue over, but that’s just what’s happening in the majority of maternity wards. As Dr. Greene explains on Kids in the House, “It became medical tradition in the 20th century to clamp immediately and whisk the baby away to do medical care. But the medical literature is very clear: there is no medical benefit from immediate clamping.”

Despite these facts, most physicians continue to prematurely cut their patients’ umbilical cords.  “I'm taught as a physician, first do no harm. Sadly, the first thing doctors do is to lock out babies from their birth right, of all these iron and oxygen and white blood cells and everything,” says Dr. Greene.  “95% of babies around the world today are having the cord clamped immediately…there'll be a quarter of a million babies born today, most of them will have the cord clamped immediately.”

This is why Dr. Greene started an awareness campaign to alert expecting parents about the benefits of delayed cord clamping, called TICC-TOCC (Transitioning Immediate Cord Clamping to Optimal Cord Clamping). He offers the following tips for ensuring that your baby’s cord isn’t cut prematurely:

1. Put it in your birthplan. Since many doctors and midwives aren’t aware of the benefits of delayed cord clamping, you should discuss it beforehand, as well as writing a request in your birth plan (in case your regular care provider doesn’t end up delivering your baby)
2. Know that banking doesn’t have to mean premature clamping. You can still do delayed clamping if you want to bank your cord blood – there will be enough leftover for this process, even if you wait 90 seconds.
3. Don’t rule out delayed cord clamping if you’re having a c-section. C-section mamas can request delayed cord clamping – again, talk to your doctor beforehand to make your desires known.
4. Understand the logic. Delayed cord clamping isn’t a modern idea. Not only have humans done this throughout history, but all primates – indeed, all mammals – wait until the cord stops pulsing before severing it.
5. Learn and share. Share this information with your friends, and help spread the word about TICC-TOCC. Learn more by watching Dr. Greene’s videos on Kids in the House.

While this procedure has been around for several years in the UK, it has more recently happened at Trillium Hospital (Mississauga Site) and at Sunnybrook.

An innovative way of delivering babies by Caesarean section, emphasizing skin-to-skin contact and bonding between mother and baby, is being led in Canada by physicians at Sunnybrook Health Sciences Centre.

“We are using the technique of skin-to-skin Caesarean sections because the benefits of skin to skin contact between mother and baby immediately after birth are clear. This is done with babies born vaginally, and now we are bringing this practice to babies born by Caesarean section,” says Dr. Jon Barrett, Chief, Maternal-Fetal Medicine at Sunnybrook Health Sciences Centre and Director, Women & Babies Research Program at Sunnybrook Research Institute.

Babies born by Caesarean are typically given to their mothers three to five minutes after the birth, after being cleaned off and receiving routine care. In a skin-to-skin C-section, the baby is put directly on the mother’s upper abdomen, and the medical team pushes the baby underneath the drape separating the medical team from the mother’s upper body. The baby then settles directly on the mother’s bare chest.

“Skin-to-skin contact immediately after birth helps babies regulate their temperature and glucose levels. It promotes bonding, and babies often initiate breastfeeding on their own from that position as well,” says Dr. Barrett, who is also Associate Professor, Department of Obstetrics and Gynecology, University of Toronto. Depending on the circumstances, the baby stays on the mother’s chest from ten to twenty minutes following the birth.

Dr. Barrett emphasizes that skin-to-skin C-section is not possible in every birth. “It may not be indicated even in low-risk deliveries, and is not appropriate for emergency C-sections. The obstetrician needs to be experienced, and the procedure does require an extra member of the medical staff to be in the operating room,” he says.

Last month, Brandon Gill New gave birth via a medically necessary, skin-to-skin C-section, becoming just the second mother to deliver her baby using this technique at Sunnybrook. “It was a really amazing experience to be able to have a C-section and then have your baby come right on top of you, and transition into the world in such a peaceful way,” she says.

Dr. Barrett is now studying skin-to-skin C-sections, the first time this technique has been studied in Canada. “C-section rates are between 25 to 30% of all births. If we’re delivering one third of our babies by Caesarean, we should look at ways to see if we can mimic the normal birth process,” he says.

 For additional details, check out: http://sunnybrook.ca/media/item.asp?c=1&i=1125&f=caesarean-section-skin-contact

Although medical interventions during labor and childbirth are used with the intention of ensuring the safety of the mother and her baby, maternity care interventions may result in unintended effects.  This is because these interventions disrupt the normal physiology of pregnancy, labor, and birth. These effects are often attended to with further intervention, which may lead to even more problems and side effects. This chain of events is frequently referred to as the “cascade of intervention”.

Without an unequivocal answer as to whether medical interventions should be used routinely during (low-risk) pregnancies, instead it may be more effective to ask whether medical interventions are being used properly and in a way that provides the greatest benefit to mother and baby.

A significant factor in the rising rate of C-sections is that obstetricians have become afraid of being sued if something happens to the baby after a vaginal labor and delivery.  In an article in the journal of Obstetrics and Gynecology, the obstetricians’ college polled 5,644 of its members and found that 29% admitted to performing more Caesareans because they feared lawsuits.

How do women’s beliefs and attitudes about pregnancy relate to all of this?

Research demonstrates that women are not always happy with their birth experiences, and this may be influenced by fear and negative attitudes toward childbirth.

Researchers in one longitudinal cohort study with a sample of about 500 Swedish and Australian women aimed to develop profiles of women based on their attitudes towards birth and their levels of childbirth related fear.

They developed three clusters: the ‘Fearful’ cluster (high levels of fear and safety concerns), the ‘Self Determiners’ cluster (not afraid of childbirth and wanted control over experience), and the ‘Take it as it comes’ (not afraid of childbirth and no clear preferences for the birth) cluster.  Belonging to the ‘Fearful’ cluster had a negative impact on women’s emotional health during pregnancy and increased the woman’s likelihood of an operative birth and a negative birth experience. Women in the ‘Take it as it comes’ cluster were more susceptible to having an operative birth.  Finally, women in the ‘Self determiners’ cluster had the highest percentage of unassisted vaginal births.

It is possible then, that if doctors and midwives inform women and quell some of their fears about childbirth, they will be less likely to request, or end up requiring, certain kinds of medical interventions and also remember their labor and birth experience more positively.

Importantly, even if you plan to have a natural childbirth (intervention-free), the birthing process is as unpredictable as children (if you didn’t get the hint, this means they are highly unpredictable!).  Oftentimes interventions are medically necessary, particularly in high-risk pregnancies.  In these cases, they are very likely to be the “best” choice. It is, however, important to distinguish between medically necessary interventions and those that are used simply because the interventions are available.

- See more at: http://www.mindthesciencegap.org/2013/04/02/has-labor-become-a-cascade-of-interventions/#sthash.LKDLirk3.dpuf