Kirstie has questions about cord clamping and pregnancy examinations

4d ultrasound scan

Here, our resident midwife Sarah Denning answers Kirtsie’s concerns about examinations, cord clamping and breach birth.

Sarah Denning is a midwife at The Birth Team

I’m scared of having vaginal examinations. How many can I refuse and which are completely essential?

Many women find vaginal examinations stressful and uncomfortable; it should not be done unless it is essential. You should always be informed why an examination is recommended and asked for your permission; sometimes a student midwife may ask if he/she can examine you too. You can refuse them all if you want to; it is only with your informed consent that any can be done. It’s your body and you have the right to say no. Vaginal examinations are an important part of care in labour though, giving your midwife or doctor information about how well your labour is going, so speak to your midwife about techniques that could help you to cope.

I’ve read about delayed cord clamping. Is this beneficial to my baby and are there any reasons when it’s not possible to do this?

Delayed cord clamping is helpful to the baby, as the cord continues to pump blood for a few minutes after the baby is born; waiting until pulsation stops means that your baby can receive an extra few millilitres of blood. If all is well, and you are skin-to-skin with your baby, there is no reason to cut the cord immediately. If your baby is distressed at birth, has a complication that needs immediate attention or if you do, it may not be possible to delay clamping the cord.

I’m worried my baby may be breech – she has been head-up at every scan. Can midwives ‘turn’ my baby and is it safe to deliver breech?

I wouldn’t be concerned – lots of babies lie in this position. If she’s breech at 34-36 weeks, your midwife can refer you to hospital for a turning procedure called ECV (external cephalic version). This is done by an experienced specialist doctor. Current guidelines say it’s safer for a breech baby to be delivered by Caesarean. Quite a few babies spontaneously turn at the last minute, so even if you have been booked for a Caesarean, the position will be checked by scan before you go to theatre and if baby has turned you can go home! Moxibustion (a traditional Chinese remedy), reflexology and acupuncture by experienced practitioners are all worth considering too if your baby is breech.

I don’t think I’d like to be induced. How long overdue is it safe for my baby to go?

The recommended time to go past your ‘due date’ is around 14 days, because there’s a tiny increase in the number of unexplained stillbirths after 42 weeks; it’s thought the placenta becomes less efficient. In a normal, uncomplicated pregnancy, most hospitals will offer to induce you if nothing has happened by 10-12 days (it can take a while for the induction to work). While you don’t have to be induced, your healthcare providers would rather not induce you either; they will offer the safest care for you and your baby, based on evidence-based practice. If you choose not to be induced, the risks of waiting will be carefully explained to you, you will be referred to hospital for a discussion with an obstetrician and may be offered extra monitoring.

I have been thinking of having extra 3D scans. Is there any risk to my baby in having more scans that are usually given at routine appointments?

Whilst there is no direct evidence that 3D ultrasound has any risks attached, there is no evidence that it is completely safe either. Really, for the sake of a few weeks waiting to see your baby’s face, I would just be patient and not subject her to more scans than are necessary.

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