When to cut?

Going into the delivery room, you might have decided who was going to cut the umbilical cord. Will the doc do it, or is it something Daddy wants to do?

We often think about who is going to cut the cord, but give little regard to when the best time is to do it. Many people would say “immediately” is the obvious answer. But some people never cut the cord, leaving newborn and placenta attached for the first few days of life.

On this one, I’m most comfortable somewhere in between. I vote for delayed cord clamping (waiting a few minutes until the cord has stopped pulsing before clamping it), but I have no plans to practice Placentophagy (eating the placenta for its nutritional value).

For the most part, a hospital wants to get a woman in and out as soon as possible. Not necessarily because the place is run by a bunch of jerks, but because there is only enough space. Most of the time, the preference will be to clamp the umbilical cord within a few seconds of birth.

But this might not be to baby’s advantage. More and more people are asking for delayed cord clamping, realizing the many benefits that come along with it.

Delaying the cord clamping can allow up to 50% of the baby’s blood volume to flow back into her little body, while early cord clamping results in fewer red blood cells and can cause postpartum haemorrhage, retained placenta and respiratory distress for the baby. Delayed cord clamping may help prevent anaemia later in life.

The Society of Obstetricians and Gynaecologists of Canada says, “Waiting at least two minutes after the baby is born before cutting the umbilical cord may help your baby get more blood supply. This may be most helpful for premature babies. If your partner wishes to cut the cord, this can also be arranged.”

Cord Blood Donation

I was surprised to see how quick the hospital was to push for cord blood donation. It was the first thing we were told about when we went in for an appointment a few weeks pregnant.

There are two public and 10 private Health Canada-registered cord blood banks in Alberta and Quebec.

When we went to visit our hospital to check out where we would be having the baby, a big part of the presentation was spent waxing lyrical about donations. There has been a lot of controversy surrounding cord blood donations, not necessarily because of the early clamping that’s necessary to keep the blood, but because people aren’t so sure of the point of public cord blood banking.

Donating to a public bank makes a lot of sense, I think (it’s public donations that the hospital was all-for). Private donations on the other hand are mind-boggling. The chances your child will ever use his own cord blood are so slim.

And if he has certain illnesses like Leukemia (one of the most common diseases that cord-blood stem cells are used to treat) his own blood likely can’t correct the defect. Treatment would likely end up being taken from a public bank anyway.

Some people take comfort in keeping the blood in case a sibling is ill one day, but private storage of your child’s blood into teenagerdom costs thousands of dollars.

After watching the Hema-Quebec supported video at the hospital it was time for my partner and I to have a long talk about what we wanted to do. He was very touched by the video, feeling that if he had the chance to save another child’s life, he would like to take it.

Maybe I’m heartless, but my vote was for allowing our baby to keep her own blood. We sought out the advice of our doula, who never offers her opinions unless I drag them out of her.

“So,” I asked, “Hypothetically speaking, what would you do?”

She said that if she spent the entire pregnancy taking such good care of herself and the baby by making the right food choices, exercising regularly, and taking prenatal vitamins etc., why deny that baby this last bit of nutrients?

After a little more discussion we decided: Baby, you can keep your blood.

Congratulations! You’re pregnant! First thing’s first: would you consider an abortion?

If your pregnancy was planned or the surprise was a happy surprise, it may seem like a silly question. But more and more new parents are being presented with this option when they are asked if they want to have prenatal screening tests like Amniocentesis or Chorionic Villus Sampling. Based on the results of those tests, terminating the pregnancy can become something that people consider.

To be clear, this is not an argument against abortion rights: women’s sovereignty over their bodies is not in question. What I do question is making invasive procedures routine, especially when the results they produce are not definitive. And the tests also pose difficult moral questions: if the potential for abnormality is present, is that a reason to terminate a pregnancy? People obviously make their own choices for their own reasons, and I can’t stand in judgment of that. What I can tell you is why I decided that these tests were not for me.

Am I being dramatic by calling these tests invasive? Not at all. For an Amnio, done around week 15, a large needle is inserted into the amniotic sac after it passes though the woman’s abdomen and uterus. About 20 mls of fluid is extracted and tested for various disease markers and other potential abnormalities. Can this cause harm to the fetus? You bet. Can it cause a miscarriage? Yes, ma’am.

A test used mainly to screen for Down syndrome (as well as Edwards syndrome, Turner syndrome and neural tube defects like spina bifida) Amnio is standard for women over 35, as the chances of giving birth to a baby with a chromosomal abnormality greatly increase with age.

According to the The Society of Obstetricians and Gynaecologists of Canada, at the age of 27, my chances of giving birth to a baby with Down syndrome are approximately 1 in 1,111. A woman aged 42 has a 1-in-64 chance.

Author and midwife Ina May Gaskin says in her Guide to Childbirth, the reason 35 was chosen as the recommended age is  “…at this age the likelihood of having a baby with a chromosome condition is about the same or greater than the risk the test will injure the fetus or cause a miscarriage.”

Depending on whether you choose to pay for it privately ($375–$900 at one Montreal clinic) or get the free test at the hospital, you will wait between 48 hours and five weeks for results. Probably a very nerve-wrecking wait.

After a CVS, done earlier in pregnancy than Amnio (in the first trimester), you may discover that your baby could be born with Down syndrome. Either you consider this is a reason to terminate the pregnancy, or you spend a very anxious few months wondering and worrying about your baby’s health. Though maybe for some, being armed with this knowledge would be a way to mentally prepare and plan for a baby who was not born “perfect.”

At our first visit with my OBGYN, we were presented with a pamphlet for a private clinic which offers prenatal screening tests. We didn’t open the pamphlet.

I was surprised when a few friends and some family members seemed to think it was careless of us not to do go in for screening. If the test is available, why on Earth would we choose not to take it? Did we need to borrow some money?

Amnio was the first of a long list of medical interventions we would choose to bypass. Just because certain technology is available doesn’t mean we need to make use of it. I am at such a low risk for delivering a baby with a chromosomal abnormality that we felt the risks outweighed the benefits. Secondly, after a very brief discussion with my partner, we knew we would carry this baby to term and love her regardless.

We decided we would enjoy this pregnancy, assume the best, and hope she is born healthy and happy. Just like our parents did.

Jenn Hardy

If you’ve picked up the latest issue of This Magazine, you might have noticed Jenn Hardy’s article on Canada’s midwife shortage. (Jenn is a former This intern and now a Montreal-based freelance writer. She has written for us recently on sustainable agriculture, Montreal musician Vanessa Rodrigues, and investigated the environmental claims of the DivaCup.)

You might have noticed that we added a little note to Jenn’s story about the fact that she is, in fact, pregnant right now, and due to deliver in just about a month. She’s been chronicling the experience so far, plus her efforts to make hers a “natural” pregnancy to the greatest degree possible, from her eating choices to finding environmentally friendly baby products. You can follow her entire blog at MamaNaturale.ca, but she’ll also add a few thoughts here on the This blog over the coming weeks.

For now, we’ll simply point out a few of the notable posts from Mama Naturale, to get you started. Make sure to follow us on Facebook or Twitter, or directly through our RSS feed, so you’ll never miss new articles and blog posts. You can also follow @Mama_Naturale on Twitter for the latest.

Catch up with Mama Naturale in 5 easy posts

• Peeing on a stick
• Looking into a water birth
• Hearing the heartbeat
• Hand-Me-Down Hardy’s guide to reducing, reusing, and recycling baby gear
• Quebec’s acute midwife shortage

A little while ago we alerted you to the fact that This contributor Jenn Hardy was nominated for the inaugural Professional Writers Association of Canada Writing Awards. Well, the awards were given out last Friday, and Jenn won! Please join us in congratulating her on the article and the award.

We take great pride in being a magazine that supports, publishes, and advocates for young or emerging writers, so it’s really gratifying to see other organizations recognizing the writing our contributors work so hard on. Jenn continues writing for us, most recently in the May-June issue, a short profile of Montreal band Po’ Girl.

Congratulations to This Magazine contributor (and former intern!) Jenn Hardy for her nomination in the inaugural Professional Writers Association of Canada Writing Awards. Jenn’s cover story on permaculture, “Cleanup in Aisle One,” in the July-August 2009 issue of This was a reader favourite from last year, so it’s great to see it getting some more recognition now from her professional writer peers.

This is the first year that PWAC is running awards of this kind, and it’s another much-needed opportunity to recognize and thank the talented, hard-working (and usually underpaid) freelance writers who make magazines like This possible. We were thrilled to be able to publish Jenn’s article and we’ve got our fingers crossed for next Friday, when PWAC will announce the winners at the Writers’ Industry Awards Luncheon. Friday’s also the day of the National Magazine Awards, where we have three nominations. Big day!

Vespa Nation

La dolce Vespa, icon of chic Euro-style and Mod subculture, has motored back to Canada after an 18-year absence. The federal government banned the stylish scooter in 1986 because Piaggio, its Italian manufacturer, failed to meet toughening emission regulations. Its reappearance this past May was due to the diligent pestering of Piaggio by Morey Chaplick, president of the Toronto-based Canadian Scooter Corp.

Chaplick persuaded the innovators of Italian transport that there is a market for Vespas in Canada—our burgeoning urban areas are already home to thousands of devotees of vintage Vespas. And the machines themselves have come a long way. The new line includes a much more environmentally sound four-stroke-engine model, and even the two-stroke-engine model now complies with California emission standards, the toughest in North America.

Piaggio began manufacturing Vespas in 1946 to provide sturdy, inexpensive mobility to Italians on war-ravaged roads in a post-WWII economy. The Vespa has remained popular in Europe due to soaring gas prices, narrow streets and traffic congestion that have made the freedom of the compact, wasp-like scooter a common alternative on arrondissements, stradas and caminos. The Vespa ET4 costs around $5,400 and carries a 150cc four-stoke engine, while the ET2 costs closer to $4,000 and has a 50cc two-stroke engine.

Gridlock: The nimble Vespa measures a slight 1.7 metres in length and a little over half a metre in width. The average city parking space, measuring six metres in length and 2.7 metres in width, can accommodate about 10 Vespas. And you could fit 86 Vespas into the 25 parking spaces that line the length of the average city block on each side.

Fuel Efficiency: If Vespas made up 15 percent of vehicles on Canadian roads, and they were driven 15 kilometres a day, drivers would save more than 91 million litres of gas each month. The average four-door passenger vehicle uses anywhere from 7.89 litres per 100 kilometres to 17.20 litres per kilometre, while the Vespa ET2 uses 3.6 and the Vespa ET4 uses 5.6.

Pocket Change: With today’s gas prices hovering around 90 cents a litre, it costs about $8 to fill the nine-litre Vespa tank. Driving 15 kilometres a day at 90 cents a litre would cost 62 cents a day. If you were willing to bundle up and ride your Vespa nine months out of the year (taking a break for only the three worst winter months), you’d spend a total of $156.24 on gas. Insurance: For the average cost of insuring one car for a year you could insure six Vespas. In major urban areas, insurance rates range from $1,400 to $2,800 per year for a car. Vespas, considered less hazardous on the roads, can be insured for a mere $300 to $400 a year. By Jackie Wallace

Unread Menace
Though some call us a Communist publication, apparently This Magazine is not Communist enough for the Chinese government, according to a 2002 study by a pair of Harvard Law School researchers. Try to look up www.thismagazine.ca in China, and all you’ll see is an error page. Jonathan Zittrain and Benjamin Edelman tested 200,000 websites and found that 50,000 offering information about politics, education, health and entertainment—as well as some 3,000 sites from Taiwan—were inaccessible on proxy servers in China because of longstanding policies of the ruling Communist Party. For a complete list of blocked sites, check out cyber.law.harvard.edu/filtering/china/ By Jenn Hardy

Split On Svend-Gate
When Svend Robinson revealed in April that he had pocketed a pricey antique diamond ring, conservatives were gleeful with schadenfreude, and progressives scratched their heads and wondered what had possessed their fallen hero. Even the experts seem divided about Svend-gate, with opinions almost as polar as Stephen Harper’s and Jack Layton’s.

“There are a lot of different ways to snap, and shoplifting is quite a common one in my experience,” explains therapist and recovered shoplifter Terry Shulman, who runs www.shopliftersanonymous.com. It’s not just a way to get free stuff. Those who shoplift for psychological reasons, he points out, often discard the stolen items soon after the deed is done. “With politicians, it’s hard to say whether it’s pure ego, or if they feel over-extended,” Shulman says. “Politicians are for helping people, that’s their job. That’s really an awesome responsibility, and their own needs may become sublimated.” He explains that many people, including him, have shoplifted as a way to compensate for feeling that they have sacrificed or over-extended themselves.

Toronto psychiatrist Dr. Mark Berber rejects this theory as applied to politicians. “Politicians are very well-supported—they have large staffs and lots of holidays,” he says. “I think sometimes celebrities and politicians may think that at some level they are above the law.” Shulman and Berber also have differing perspectives on Robinson’s case in particular. “When he said ‘I’ve failed,’ that tells me that he was putting a lot of pressure on himself to have this perfect image,” Shulman says. Berber takes a less sympathetic view, emphasizing the importance of knowing the sequence of events in Robinson’s case. “It’s been reported that he was looking at rings beforehand, and if that’s the case this becomes more complex, more pre-meditated,” he says.

Shulman sees the antique ring in question as symbolic. He says the ring represents commitment issues, and antiques represent a longing for times of old. Berber laughs when asked if he reads anything into the ring. “Let’s not get into Freudian issues now.” By Annette Bourdeau

Martin Bucks Wheat Agreement
The potential conflicts of interest involving Paul Martin’s ties to Canada Steamship Lines (CSL) are unlikely to go away soon. Martin owned the private company throughout his tenure as finance minister, keeping it in a blind trust while nonetheless getting briefed on the company’s affairs. During the debate over the Kyoto Protocol to address global climate change, many speculated that Martin’s ties to CSL, which is a major shipper of coal, was the root cause of his wavering support for the agreement.

CSL’s grain shipping business may also be a factor in Canada’s failure to ratify the Cartagena Protocol on Biosafety. The protocol, finalized at a 2000 conference in Montreal, aims to protect against the risks posed by importing genetically engineered (GE) organisms. Once released into the environment, GE organisms can become a permanent fixture, contaminating domestic plant species. Canada signed the Biosafety Protocol in 2001, and the agreement came into force last September. Ninety countries, including Mexico, Japan and all members of the European Union, have ratified it. Even China has stated that it will ratify in the near future. Yet Canada is still dithering.

The biotech industry, worried about provisions in the accord requiring imports of GE products to be labelled as such, has aggressively lobbied against ratification. Pro
-biotech bureaucrats have put forward an ever-changing list of reasons for Canada’s failure to sign on. The latest justification, according to top officials on the file from various departments, is the effects the agreement will have on the grain shipping industry. And one of Canada’s top grain shippers is CSL.

In a September 2003, memo obtained under access to information, Stephen Yarrow, a director at the Canada Food Inspection Agency, stated that bureaucrats are still examining the pros and cons of ratification. “Specifically, this analysis is focussing on the potential impacts on the Canadian grain handling and shipping industries.” At parliamentary hearings this past March, lead bureaucrats from Agriculture Canada and Environment Canada confirmed that shipping industry concerns are the “principle point” hampering Canada’s ratification.

There is no direct evidence that Martin intervened to discourage Canada’s ratification of the protocol. However, his ties to CSL are widely known within government, and many bureaucrats, who already have a cozy relationship with biotech companies that are against the agreement, may be raising the shipping concern as a way of cowing others within government who support ratification.

As a result, so long as shipping concerns remain the primary justification for failing to ratify the Biosafety Protocol, Martin’s ties to that industry may cause some to question why Canada is opting out of a widely supported international agreement. Ottawa Report: By Aaron Freeman