Brain Damage By Asphyxia

The following excerpts are from an article titled Brain Damage by Asphyxia at Birth by William F. Windle (Scientific American, Volume 221, Number 4, October 1969).

The practices outlined in this article are still routine in many hospitals today. If you plan on having your baby in the hospital, you should do some research on why it is potentially dangerous and harmful to have the umbilical cord cut within seconds of your babyís birth. I always cringe when I see the cord cut immediately after birth.

Unassisted birthers wait for nature to take its course. Itís not uncommon for the placenta to detach twenty minutes, forty-five minutes, an hour or even a few hours after the baby is born. Many women cut the cord after the placentaís out, while others opt for a ďlotus birth.Ē

Brain Damage by Asphyxia at Birth

In both monkey and human infants handicaps that arise from such asphyxia seem to disappear with time. Experiments with monkeys, however, demonstrate that asphyxia permanently damages the brain.

by William F. Windle

(The following are excerpts):

Most monkey births occur at night, as in the case with human beings. Labor is short: an hour or less. The female squats and drops the infant on the ground. During delivery most of the blood in the placenta passes to the infant and, as the uterus continues to contract after birth, the placenta is expelled. Thereupon the female severs the umbilical cord with her teeth and, like most other mammals, eats much of the placenta. Human infants are born much the same way in many parts of the world. The woman delivers, often unassisted, in the squatting position, and the infant, being below her, recovers most of the blood from the vessels of the placenta and the umbilical cord. I would not recommend that women revert to primitive ways, certainly not to chewing the umbilical cord to sever it (a practice that is still encountered in some places). Nevertheless, in any delivery it is important to keep the umbilical cord intact until the placenta has been delivered. To clamp the cord immediately is equivalent to subjecting the infant to a massive hemorrhage, because almost a fourth of the fetal blood is in the placental circuit at birth. Depriving the infant of that much blood can be a factor in exacerbating an incipient hypoxemia and can thus contribute to the danger of asphyxial brain damage.

In advanced countries, of course, the supine position of delivery is used to enable the attending physician or midwife to observe the birth conveniently and to assist if necessary. The squatting position, in addition to allowing the infant to receive the placental blood from above, has other advantages over the supine position. It avoids compression of the blood vessels supplying the placenta, which occurs in the supine patient when the gravid uterus tilts back against the pelvis. Delivery while the woman is lying on her side, however, can also avoid such compression and prevent the infantís oxygen supply from being sharply reduced.

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Monkeys asphyxiated at birth whose brains were affected in this pattern displayed abnormal neurological signs after resuscitation. They had trouble righting themselves and for a time could not move about easily. Their limb movements were uncoordinated. All of them had trouble feeding because they could not suck. These abnormalities eventually disappeared, often within a few days and at most within a few weeks. The electroencephalogram of the monkeys, when it was affected at all by such asphyxia, quickly became normal.

These monkeys may be comparable to human infants who encounter some degree of asphyxia at birth, have low Apgar scores (an index of the newborn infantís general condition) but recover without apparent neurological deficit. It is generally believed that such infants are normal. If one could inspect their brains as we examined the brains of our monkeys, one would probably find the same kind of lesions. It is no longer acceptable to assume that the human fetus or newborn infant is so resistant to oxygen deficiency that it will escape harm from a short exposure to asphyxia neonatorum. If the infantís brain can be compared to the monkeyís, asphyxia of such duration that resuscitation was required will certainly have damaged it. The damage, although it is minimal, will be permanent even when it is clinically noticeable for only a short time or when it produces no symptoms at all. What effect such minimal brain damage will have as the child matures is not known.

Human infants may be more susceptible to traumatic birth injury and brain hemorrhage than monkeys because of their larger heads. The use of drugs to strengthen uterine contractions and hasten delivery can cause bleeding from the vessels of the brain. Oxytocin administered to a gravid monkey to induce labor was responsible for hemorrhages in such deep-seated fetal brain structures as the globus pallidus.

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The monkey experiments described in this article have taught us that birth asphyxia lasing long enough to make resuscitation necessary always damages the brain. This could be proved, however, only by histological examination. A great many human infants have to be resuscitated at birth. We assume that their brains too have been damaged. There is reason to believe that the number of human beings in the U.S. with minimal brain damage due to asphyxia at birth is much larger than has been thought. Need this continue to be so? Perhaps it is time to reexamine current practices of childbirth with a view to avoiding conditions that give rise to asphyxia and brain damage.