Polycythemia and the natural emergence of the placenta

I have only encountered it once in my career (over 1300 births plus lots of prenatal class parents, 35 years in the birth biz). The baby with polycythemia I worked with was very ill with it, she was hospitalized on Day 2 of life and had some blood removed which improved her condition right away. She remained in hospital for about 7 days. She had Down syndrome and polycythemia can be part of the presentation with Down. A very good friend who is also a doula has a daughter with Down Syndrome and her story is almost exactly the same as the baby girl in my practice i.e. polycythemia after a gentle homebirth which was treated well in hospital. Both these baby girls were discharged from hospital much faster than the medical professionals involved expected.

I am a believer in leaving the birth of the placenta for a full 30 minutes (or longer). If the placenta births before 30 minutes, it is rare, and it means that the mother pushed it out without any advice from me. In my work, the cord is clamped and cut only after the placenta is out. With the one exception of the girl with Down Syndrome, I do not see cases of polycythemia, jaundice or any of the other dire predictions that the medical profession warns about with leaving the cord to pulse until it stops naturally. Fear of polycythemia is no justification for continuing on with amputating the placenta prematurely. Waiting only two or three minutes to clamp the cord is still an assault on the baby.

Couple cutting cord after birth of placenta

Couple cutting cord after birth of placenta

Remember, scissors, hemostats and cord clamps have only been invented for a short time in human history. Before that, people waited till the placenta came out naturally before doing anything about the umbilical cord. When the baby is adjusting to life with the cord intact, the blood goes back and forth through the two arteries and one vein in the cord. . . it isn’t just going in to the baby from the placenta, it’s coming out, too, in correct balance for that baby’s anatomy. The placenta was trusted to sustain the well being of the baby in every way for nine months, I am certain that it’s okay to let it keep performing that function for another 30 minutes.

(This is a comment from Facebook that I made in response to a query about cord clamping. The women who birth at home are not induced, not medicated and receive no routine injection of pitocin after the birth. They are healthy women with full term babies, for the most part.) Gloria Lemay

3 thoughts on “Polycythemia and the natural emergence of the placenta

  1. Thank you for sharing your wonderful work. You described it clearly that blood flow from placenta to the baby after birth and also flow back to the placenta in correct balance when umbilical cord is left intact without immediate cord clamping. I had a recent case when working as a birth doula with an active management doctor, he was so worried about delay cord clamping caused the blood to flow back to the placenta, therefore, he clamped the cord quickly after pushing the blood from part of the umbilical cord to the baby upon requested by the mom. Active third stage of labour was performed of course. It was supposed to be a calm water birth turned out to be quite a chaos. Definitely no waiting for birth of the placenta before cord clamping except accidental home birth here in Singapore. I do hope more OB gynaes can be more open minded in regards to delay cord clamping until the birth of the placenta.

  2. I’m wondering if you happen to know the treatment protocol for polycythemia in a newborn? My mother in law has this disease, and I know from her situation how rare it is, but it is especially rare for anyone under age 50. Praying for peace and comfort for this family. I can’t imagine managing this disease with a tiny precious one.

    • Leigh, the treatment protocol was to remove some of the baby’s blood. No other treatment was given to the baby girl I attended and she was home quickly and needed no further treatment. Gloria

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