Bedside resuscitation of newborns with an intact umbilical cord: Experiences of midwives from British Columbia |
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| Affiliation: | 1. Midwifery Program, Faculty of Medicine, Suite 320 - 5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3;2. School of Population & Public Health and Division of Midwifery, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3;1. Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, University Park, AHC5-477, Miami FL 33199, USA;2. Public Health Research Institute of India, 89/B, 2nd Cross, 2nd Main, Yadavgiri, Mysore 570020, India;3. Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA;1. Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Centre, P.O.B. 169, Hadera 38100, Israel;1. Department of Obstetrics, University Medical Center Utrecht, 3584 EA Utrecht, Netherlands;2. Department of Neonatology, University Medical Center Utrecht, Netherlands;3. Netherlands Perinatal Registry, Utrecht, Netherlands;4. Department of Pathology, University Medical Center Utrecht, Netherlands;5. Department of Obstetrics and Gynaecology, Diakonessenhospital, Utrecht, Netherlands;6. Department of Obstetrics and Gynaecology, Zuwe Hofpoort Hospital, Woerden, Netherlands;7. Department of Pediatrics, St Antonius Hospital, Nieuwegein, Netherlands;8. Department of Obstetrics and Gynaecology, Admiraal de Ruyter Hospital, Goes, Netherlands;9. Department of Obstetrics and Gynaecology, Meander Medical Center, Amersfoort, Netherlands;1. Dalhousie University School of Nursing, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 4R2;2. Centre for Pediatric Pain Research, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8;3. Caritas Coach, Watson Caring Science Institute (WCSI), 4450 Araphoe Avenue, Ste 100 Boulder, CO 80303, USA;4. Women and Newborn Program, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8 |
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| Abstract: | ![]()
Contextlevel 1 evidence supports the practice of delayed cord clamping, and many doctors and midwives consider it routine care when delivering vigorous, term neonates. However, scarce research exists regarding the risks or benefits of delayed cord clamping for infants needing resuscitation with positive pressure ventilation. Nonetheless, some midwives in British Columbia already practice intact cord resuscitation (ICR) at planned home births and in the hospital in order to facilitate delayed cord clamping for infants who need resuscitation.Methodswe distributed an online survey to all registered midwives in British Columbia through the Midwives Association of BC between October 22nd and November 13th, 2014. This survey examined how midwives balance a commitment to delayed cord clamping with the need for resuscitation in home and hospital settings.Findingsa total of 82 midwives responded to the survey (response rate=35%). Many have practiced ICR (56, 69%). However, the majority (42, 78%) of respondents had only performed this type of resuscitation at planned home births and not in the hospital setting. In both settings, midwives found the ergonomics of resuscitation with an intact cord challenging, but cited a smoother physiologic transition for neonates as their primary reasons for this practice, despite the obstacles. Midwives reported a greater ability to use their delivery equipment to provide stable thermoregulation at the bedside at planned home births during a resuscitation compared with the set up of hospital delivery rooms.Conclusionalthough the majority of participants practice ICR at planned home births, very few use this practice in the hospital setting. In the home, ergonomics is the primary obstacle for easily practicing ICR; hospital culture, protocols and lack of training are additional barriers to this practice in the hospital setting. Ergonomics and lack of appropriate set up in the delivery room were also primary obstacles. Midwives expressed a desire to find ways to incorporate ICR into the hospital setting. |
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| Keywords: | Delayed cord clamping ICR Survey Midwives Bedside resuscitation Intact umbilical cord resuscitation |
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