When should you cut the cord? After the birth of the placenta is a good time. Leaving the cord intact, even with its white, is an important way to support the baby’s vitality after birth and increase apgar scores. Gravity brings the baby to the anterior as the hips or chest come through the pelvic floor. A raised hospital bed, birth ball, or even her loving partner are not in front of her accidentally preventing her intuitive movements during the birth of the baby’s head. Hands-and-knees (or knee-elbow) lets the woman on a flat surface rock back and forth, rise up, and lower down as instincts instruct. Avoid gluteal lift unless indicated by adipose tissue obstructing a baby in a good, flexed head position in the outlet. The mother’s rocking down may help or maintain flexion. She’ll feel the baby and won’t sit on the baby too much. No wiping the mother’s bottom or pushing it up away from the mattress or floor to prevent her sitting on the baby. Hands-off the breech unless baby needs help due to condition or position. If the provider has limited skill in upright breech birth, it may be protective and easier to conduct maneuvers if the mother is on her hands and knees or in a knee-elbow position. That said, the knee-elbow position offers extreme improvement in the baby’s outcomes over the woman being on her back. ![]()
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