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Friday, May 25, 2007

Ask TSCD #1

I have decided that I will start answering interesting reader questions on my blog. Of course, I will not answer questions on this blog about personal or confidential medical issues. However, quite a few of you have emailed me some interesting queries about being a doctor which I have often thought would make very good blog posts. I have also received questions about the weird and bizarre, from people who are perhaps trying to settle a bet or an argument.

So here's the deal. You can email me your weird questions to ickle_doc (at) yahoo (dot) com or leave them as comments on this post. Every Friday (or when I receive enough questions), I'll pick the one from the pool that I find most fascinating, and I will write a post about it on this blog. How does that sound?

Since it was Woof! that inspired me to start the "Ask TSCD" segments, I will start with his question first.

Woof! asks:
"When the umbilical cord of a delivered baby is snipped, does it hurt for the mother or the baby? If not, why?"

The cutting of the umbilical cord is painless for both the mother and the baby.

The umbilical cord is made out of blood vessels - two arteries and one vein - embedded in a jelly. The cord is not covered by skin, but a thin and slippery layer which is a continuation of the membrane that coats a newborn baby. This membrane, unlike human skin, does not have any nerve endings. Similarly, the jelly (called Wharton's Jelly) also does not contain any nerves. So, when the cord is severed, it does not cause pain.

Actually, the entire birthing process is pretty awful. Everyone knows that a woman in labour is in great pain. Women are in so much pain during childbirth, that some of them become delirious and start to hallucinate. During one of the births I observed, the poor mother was in so much pain that she started to see cartoon characters from The Beano running around her bed and across the ceiling.

What shocked me most of all was that when an episiotomy - a particularly brutal-looking procedure wherein the birth attendant takes a huge pair of scissors and snips a great big cut in the area where a woman is usually the most sensitive - is performed, most women barely notice anything. Granted, some local anaesthetic is introduced into the area first, but usually people feel some pain from the initial injection. The fact of the matter is that labour contractions are so horrific that being jabbed and sliced open with sharp implements is virtually imperceptible.

The other fact that people forget to consider, is that the infant is also undergoing great pain during birth.

First of all, the baby's head is getting moulded into a conical shape in order to fit into the birth canal. This means that the unfused skull plates of the baby's head will begin to overlap each other. I cannot see how this can possibly be a pleasant experience.

Additionally, with every contraction of the muscles of the womb, the blood supply to the placenta gets cut off so that the placenta later on detaches from the womb and is expelled from the womb. The placenta is that interface between mother and child which allows for delivery of nutrients and oxygen to the infant. This means that during contractions, the infant's supply of oxygen is cut off for up to 90 seconds. Try holding your breath for that length of time - you'll find it hard to last even one minute.

I think it is a blessing that babies are not able to form memories of the birthing process. It's too traumatic.


Blogger Ms-Ellisa said...

OH my god!... :-)
Labor seems really scary to me and all I can think of is how my mother always says that all the pain stops when the mother sees her baby. It's sweet and it's the only tiny ray of light of hope in the process :-)

6:50 pm  
Blogger Woof! said...

Thanks doc! That was really enlightening... and thanks for indulging me...

7:48 pm  
Blogger angry doc said...

Just a note of caution: while the process of vaginal delivery looks traumatic on the baby, babies born vaginally have a lower rate of lung disorder than babies delievered via caesarean section. It is believed that the compression during the passage through the birth canal has something to do with it.

9:13 pm  
Blogger tscd said...

angry doc: absolutely, the contractions force the fluid out of the infant's lungs and the deprivation of oxygen delivery kickstarts the final stage of rapid lung maturation - but it still isn't fun.

9:43 pm  
Blogger aliendoc said...

LOL! I think you just scared off a bunch of ladies from childbirth, TSCD!

I've been at both the giving & receiving end of childbirth...let's just say epidural anesthesia is one of mankind's greatest inventions! But end of the day, it's all worth it :D

Sometimes, childbirth is traumatic not so much for the mother, but for Dad. I blogged about it here.

10:25 pm  
Anonymous imp said...

arrrrrrrrgh!!!!! *clutches tummy to stop breakfast frm chucking*

11:17 am  
Blogger ampulets said...


(only because we've decided no kids)

1:28 am  
Blogger tscd said...

imp and ampulets: The birthing process is not actually gross - but it is very emotional. Mothers rely on alot of their inner strength and resolve - especially nowadays when they know they can just put an end to the madness and opt for an emergency C-section. I have also noticed that if the mother has alot of social support and is feeling secure, she doesn't appear to have as much difficulty with the process.

8:13 pm  

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