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Saturday
Jun192010

Those Darned Shoelaces

Did you know the tip of the shoelace is called an aglet? That shoelaces, while used for thousands and thousands of years, were patented in 1790 by Harvey Kennedy? While we all can appreciate a great shoelace… different colors, styles and lacing techniques… what does this have to do with birth? 

We cringe hearing stories about precipitous births outside the hospital, tales of passers-by offering their shoelaces to tie off the umbilical cord. Yet, those stories abound.

Judy Tsu Gives Birth on Expressway: Tracy helped Judy give birth in the front seat of the car. He said he remembered a story from ABC7 News This Morning about a woman who gave birth on the side of the road and her husband used his shoelaces to tie off the umbilical cord. Tracy did it, too, and he said it worked like a charm.

Orlando Woman Gives Birth in CarThe car door was open at the time and a man nearby heard the commotion and came over to help. He even offered his shoelace to tie off the umbilical cord. Then, Kimberly said, he led them to the hospital a few miles away.

Baby Born in Car Was in Bigger Rush Than Traffic: One passer-by -- "the shoelace guy" -- offered help.

"There was a guy who stopped who wanted to know if he could help," Pat Rullo said. "I was looking for a string or something to tie off the [umbilical] cord. The next thing I knew, there was a shoelace in my lap, and I never saw him again."

Baby Born in Back Seat of Chevy: The 911 operator on the other end of the line coached Jake through the post-labor procedure, instructing him to use a shoe string to tie the baby's umbilical cord.

The Sammers saved the shoelace for the baby's scrapbook, they said.

Dad Delivers Baby in Back Seat of Car: Dad wrapped up the baby in a blanket he had in the car, tied off the umbilical cord with a shoelace and called 911. 

Even in the Journal of Midwifery & Women’s Health, the “white shoelaces (to tie the umbilical cord)” is recommended. 

Where did this strange ritual begin? And didn’t anyone think, “Egads, how gross is that?” From 911 operators (“The dispatcher tells Martinez through the interpreter to find a string or shoelace and tie off the umbilical cord.”) to EMTs (“A shoelace commandeered from a passenger was used to tie off the umbilical cord.”), the shoelace myth comes to life. 

But, what lives on those shoelaces –and what if they had been stepped on before? 

            -E. Coli -“The common occurrence (96%) of coliform and E. coli bacteria on the outside of the shoes indicates frequent contact with fecal material, which most likely originates from floors in public restrooms or contact with animal fecal material outdoors."

      -Klebsiella pneumonia – “Klebsiella bacteremia and sepsis produce clinical manifestations similar to those caused by other gram-negative enteric organisms. Morbidity and mortality rates are comparable to those for other gram-negative organisms that cause sepsis and septic shock. In neonatal units, outbreaks caused by ESBL-producing strains present a more serious problem and may be associated with increased mortality.

            -Serratia ficaria –which causes infections in wounds 

Are we gagging yet? 

And people are tying these cesspools of infective agents around the pure and perfect umbilical cord? We have got to find another solution! 

Should we sell umbilical clamps at the corner store? Could we teach people how to use sterile rubber bands? Could we make Lotus Birth the new must-have in fashion birthing accessories? 

However we do it, I would love to see the demonization of the shoelace. 

I’m asking all childbirth educators, doulas, midwives, nurses, doctors and media folks to tell people not to use a shoelace, but to leave the cord attached to the placenta! If the mom and baby are going to the hospital (a tad unnecessary at that point, but that’s my opinion), they can sterile-y cut the cord. If you’re at home, using something sterile is really important. Otherwise, leaving the baby attached to the placenta via the cord is a great way to preserve, not only the sanctity of birth, but also the cleanliness. 

And don’t they say that cleanliness is next to Godliness? And who is closer to “God” than a new baby.

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Reader Comments (19)

Wouldn't it make more sense to bring the baby and the placenta to a hospital just to get everything checked out and properly tied off? I mean, lotus births are a bit of a push, but... Leaving the cord attached for even a few hours after birth doesn't sound like all that bad of a thing to do, no?

If I have a precip birth, I'm not letting anyone near me with a shoelace. :p

On a slightly related note- if the cord is cut after it stops pulsing, does it even need a clamp? Just curious. :)

June 19, 2010 | Unregistered CommenterSara

I ALWAYS wondered what the hell...just leave the baby attached! Why is this obsessed myth still such a big one? As you pointed out with Lotus Birth, etc, the baby can stay attached to the placenta for DAYS and be not only "fine", but many believe very much better off. And certainly better off than with some nasty used shoelace on a fresh unnecessary wound!

I am willing to bet that there are still a great mnay folks, victims of television births and the prevalence of just omitting the Third Stage of labor from all birth stories whatsoever, that they really think that there is a baby who comes out of mommy and it is attached to a string and when we cut that string the baby is now officially "born" (and ready to be whisked away/examined etc)...add that to the idea of the OMG IT WAS BORN IN THE CAR ITS LUCKY THEY SURVIVED hysteria and I am sure that baby will be whisked away asap?!

I love you and this is another great one! Sharing on Facebook!
Joy

June 19, 2010 | Unregistered CommenterHousefairy

I love, love, love that you wrote about this topic! I've always wondered where the shoelace cord clamping came from too. I find it BIZARRE that in 2010 this is what emergency medical personnel instruct people to do. Thanks so much for touching on this topic!

June 19, 2010 | Unregistered CommenterJen C.

It wasn't until I became a doula and childbirth educator that I realized how useless (and potentially harmful) it is to clamp and cut the cord immediately after birth. How silly to be in such a hurry to sever the bond between mother and baby! It is just a small example of how much of what we accept as "routine" during birth are designed to get the baby away from mom and into the capable hands of care providers...

June 19, 2010 | Unregistered CommenterVanessa

I have an honest question. I'm taking A&P right now. The Physician teaching the class said that doctors used to milk the placenta before cutting it, getting as much blood into the baby as possible. I get there's a mechanical difference between this and Lotus, but he said too much blood from the placenta getting into the baby can cause jaundice. I wonder if there's any correlation between Lotus babies and Jaundice? I don't even know how you would figure this out since most birthing data is collected in hospital and it doesn't seem like Lotus would be smiled on in that setting.
I like the idea of the non-violent birth, and plan to keep any future children firmly tethered at least until the cord stops pulsing, but three days seems a tad much. As I always say: Do what works for you and your family. It's the only parenting advice that gets listened to, anyway. ;)

June 19, 2010 | Unregistered CommenterBecky

Also- TETANUS!!

:P

June 19, 2010 | Unregistered CommenterKatie

As an interested reader and not a part of the medical profession, I have wondered the same thing many times when reading or hearing about these stories. I'm guessing the general public is under the impression that some sort of horrible catastrophe awaits them should they not IMMEDIATELY tie off the cord. It's an odd mindset for sure. Should I give birth in the car, I'm not going to use a filthy shoelace for sure.

June 19, 2010 | Unregistered CommenterTJ

I saw an episode of "I didn't know I was pregnant" where a girl had a baby in a bathroom at work at the 991 operator was directing her co-worker. In the re-inactment, I remember hearing the actress playing the co-worker say something like "We need to cut the cord so the baby can breath.e" I was shocked to be hearing such blatant misinformation about cord cutting.

June 20, 2010 | Unregistered CommenterBirth Unplugged

Hah! I thought this post was going to be about how tough it is to tie the shoelaces at the end of pregnancy - not use them to tie off the cord. That's the most disgusting thing! Brains need to be dusted off, I mean really who would suggest that?! Tea tree dental tape, does the trick every time...

June 20, 2010 | Unregistered CommenterShannon

Quite apart from anything else- perpetuating the myth that the cord even needs cutting (immediately or otherwise) results in worse things than shoelaces being used to tie it off. Here in Australia a short while ago a teenager had a precipitous birth at home and cut the cord herself (not knowing she should clamp it) and tragically lost the baby. So terrible! If only people knew that it needn't be immediately done!

June 21, 2010 | Unregistered CommenterLauren

Speaking of tetanus, did you ever hear about the situation on the very small Scottish island of St Kilda? In the late 19th century, they had a horrendous infant mortality rate there, to the point that a woman would have her husband build a casket when she found out she was pregnant. Turn out that the midwives were smearing a paste made of all kinds of natural matter on the newborns' umbilical cord stumps, and they ended up getting infected with tetanus.

Just keep your hands off the cord, people!

June 21, 2010 | Unregistered CommenterVW

@Becky - Milking the placenta (which I used to see a lot in the olden days) *is* very different than a Lotus birth... or a regular/normal birth where the cord stops pulsating on its own.

When a baby is born, the mechanism for the baby's own breathing kicks in and, seemingly, when they no longer need mom's oxygen, the cord gradually closes the vessels, or rather, constricts them.

(Mind you, I am NOT an A&P teacher! So the technical aspects are better left to research. This is the lay [har] midwife's explanation.)

While the vessels *are* constricted, they are still open enough that if the cord was cut, blood would ooze out each end. If the placenta is still attached, it can be a hemorrhage site for the mom.

It IS a hemorrhage site for the baby!!!!

It takes *days* for the baby's cord to "dry up"... shrivel enough for the vessels to close completely. When the cord stump falls off, that is the completion of the need of the 2 arteries and 1 vein; the lifeline to the mother for all those months.

Now, when a cord is milked, the provider typically takes some gauze and, while the placenta is still attached to the mom, s/he holds the cord, squeezes it at the introitus and then pulls the blood down into the baby. Because the cord is pulsating, they do this a couple three four times, pulling more and more into the baby.

I did see more jaundiced babies in Germany (where I saw milking the cord), but that can be attributed to the lack of sun (Vitamin D?!) - there are more jaundiced babies in the winter months. I don't see many jaundiced babies at all here in San Diego unless they are blood incompatibility babies.

Hypothetically, though, pulling more blood, hence red blood cells, into the baby than 1) s/he needs or 2) can process *would* cause polycythemia, I believe, before the jaundice, which comes on polycythemia's footsteps. (Macrosmic and premature babies are wont to get polycythemia.)

However, when the cord is left to her own devices, the exact right amount the baby needs, I believe, is what goes in. I believe this is something so individual that trying to measure it would be impossible.

Does this help?

June 21, 2010 | Registered CommenterNavelgazing Midwife

@Sara - Oh! I answered some of that above.

But, the maternal side does NOT need clamping IF the placenta has already been born.

The baby's side always needs to be clamped.

June 21, 2010 | Registered CommenterNavelgazing Midwife

Goodness. The public needs to be educated. Articles like this one: http://www.kens5.com/news/East-Texas-dad-uses-scissors-and-hammock-to-help-keep-baby-alive-96766524.html
are surely perpetuating the problem.
I remember as a teenager my mother, preparing for her home birth, did buy and sterilize (NEW!) shoe laces. I'm sure there were other things that could have been used, but she didn't have access to clamps or other such supplies and shoelaces were easy to find.

June 21, 2010 | Unregistered CommenterCilla

a mother cannot hemorrhage through a cut (and unclamped) umbilical cord because the blood flowing through it is the BABY's.

June 23, 2010 | Unregistered Commenterabundant b'earth

*squinting* You're making me think hard, trying to understand that mechanism. Isn't it interesting how ingrained what we learned is in there?

Hrm.

June 23, 2010 | Registered CommenterNavelgazing Midwife

Back in the 70's we were told to use clean baby shoelaces, straight from the package. And we did.
However when I helped my friend have a baby, she supplied me with a (clean,new) athletic shoelace. It was too wide. She asked me to check the baby, and blood was leaking out -in pulses-from the cord. I sent someone to her bathroom for dental floss, which did the trick. That really soured me on shoelaces.
Susan Peterson

August 11, 2010 | Unregistered CommenterSusan Peterson

Great public service announcement. You would think it would be common sense, but that could be said about so many things regarding birth.

February 19, 2011 | Unregistered CommenterWell Rounded Birth Prep

On the other hand, why not keep STERILIZED shoelaces in a first aid kit? We know they work, and that their tag-alongs are the problem, so having clean ones would solve the problem, yes? I can guess the responses to my idea, but we're never going to get rid of the germs, or the shoelace mythos, so why not work with it?

March 14, 2011 | Unregistered CommenterMothersforge

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