Oteda, Jan kyle S.

BSN 2-1 Assignment

Review of Related literature

1. Early Cord clamping and cutting

According to Stoltzfus (2008), One of the major interventions known to prevent iron
deficiency anemia during the first six months of life is delayed umbilical cord clamping at birth.
Waiting approximately three minutes to clamp the umbilical cord following the birth of the baby
allows placental transfusion (blood transfer from the placenta to the infant) to run to completion.
Delayed cord clamping in preterm infants had no effect on initial body temperature but these
infants had higher mean systolic and diastolic blood pressures, higher 1-minute Apgar scores, and
required less delivery room resuscitation as stated by Kaempf et al. (2012).

According to Armstrong L, Stenson BJ (2007), immediate clamping has been the standard of
care in several Swedish obstetric units. Two main advantages of ECC have been proposed: a
reduction of maternal postpartum haemorrhage (PPH) as part of AMTSL, and facilitation of blood
gas sampling from the umbilical cord. According to Yao AC, Lind J, Vuorenkoski V (2004),
Delayed cord clumping may have adverse neonatal effects with increased risk of respiratory
symptoms, polycythaemia, hyperbilirubinaemia and need of phototherapy. Unclamping the
previously clamped and separated umbilical cord, and allowing the blood from the placenta to
drain freely into an appropriate container, has been shown to shorten third stage labour and
decrease the incidence of retained placenta. This drainage corresponds to the transfusion occurring
from the placenta to the infant during DCC. The practice of early cord clamping was widely
introduced in the 1960s as part of active management of the third stage of labor. Early cord
clamping was also advocated in response to concerns that a placental transfusion of blood to the
newborn, which occurs when the cord is not immediately clamped, would result in neonatal
respiratory distress, polycythemia, and jaundice from circulatory overload as stated by Rabe H,
Reynolds G, Diaz-Rosello J. (2008).

2. Fundal pressure to facilitate Childbirth

According to Merhi ZO, Awonuga AO (2005), fundal pressure during the active phase of
the second stage of labor is a controversial maneuver and is defined as manual pressure on the
fundus of the uterus towards the birth canal. It is used to expedite birth of the baby and assist
in vaginal birth either as routine practice or because of complications (fetal distress, failure to
progress, mother exhaustion) and/or medical conditions whereby prolonged pushing is
contraindicated, for example, maternal heart disease. According to an article published in the
American Family Physician, shoulder dystocia can happen without warning, and ranks among
the most frightening emergencies that can occur during delivery. When shoulder dystocia
 occurs, the infant’s shoulder is impacting against the mother’s pubic bone, causing the child to
be stuck inside the birth canal. The doctor or midwife has little time to deliver the baby to
prevent serious birth injuries, particularly to the child’s brachial plexus – the nerves that travel
from the spinal cord at the neck and supply the shoulder, arm, and hand. Fundal pressure should
be absolutely avoided with shoulder dystocia. It is unlikely to help free the infant and could
cause injury to the baby and the mother. When fundal pressure is applied while shoulder
dystocia is occurring, it can cause the baby’s shoulder to further impact the pubic bone, which
can cause additional stretching and further damage to the nerves.

Caldeyro, Barcia, et al (1979),found that a woman’s pushing effort “spontaneously lasted

5 to 6 seconds” and that the fetus tolerated this well, however, when directed to push for longer
periods of 10 to 15 seconds, there was a compounding negative effect on the fetus

3. Beliefs and Practices of Traditional midwives

According to the World Health Organization (1992), As the Philippine government and
private birthing institutions are gradually implementing said protocol, pregnant women in the
marginalized communities still entrust their birthing care to traditional birth attendants (TBAs). A
TBA, as defined by the WHO, is a person who provides obstetric care services using acquired
knowledge from other TBAs or through experience. Even nowadays, especially in developing
countries, many community women still prefer the services of TBAs because they are always
available as they live in the same community, sharing the same culture and beliefs, and mostly
they are cheaper options compared to trained or professional health service providers, as stated by
Saravanan S, Turrell G, Johnson H, and Fraser J. (2010).

According to Verderese M. (1975), it may be said that the traditional system of midwifery
care includes steps that are recognized in modern midwifery. practices. Many of the
recommendations of the Traditional Birth Attendant on the care of the woman and child during the
maternity cycle make sense by modern standards. Differences between the two systems lie in the
fact that most of the traditional birth practices are interwoven with traditional ideas and prejudices,
which permits sometimes the cropping up of certain elements of the local culture which manifestly
are harmful. Differences are also found in the lack of hygienic precautionary measures in the care
of women during childbirth and of the newly-born child

4. Ritual Male Circumcision in the Philippines

According to the World Health Organization (2008), An estimated one in three males
worldwide are circumcised, with almost universal coverage in some settings and very low
prevalence in others. As with any surgical procedure, circumcision can result in complications.
The most common early (intra-operative) complications tend to be minor and treatable: pain,
bleeding, swelling or inadequate skin removal. However, serious complications can occur during
the procedure, including death from excess bleeding and amputation of the glans penis if the glans
is not shielded during the procedure. Late (post-operative) complications include pain, wound
infection, the formation of a skin-bridge between the penile shaft and the glans, infection, urinary
retention, meatal ulcer, meatal stenosis, fistulas, loss of penile sensitivity, sexual dysfunction and
edema of the glans penis.

In the traditional method of Circumcision, a boy will go to a local circumciser who first
distracts the boy by having him chew guava leaves. Then the circumciser performs the procedure
with a traditional knife. The knife is made out of a curved piece of wood, which is anchored to the
ground. A quick blow is made with the wood, slicing the upper foreskin. The boy then washes off
in the cold waters of a nearby river and applies the guava leaves as a poultice to the wound. This
method, while referred to as circumcision, is actually a dorsal slit. This type of circumcision is a
single incision along the upper length of the foreskin that exposes the glans without removing any
tissue, as stated by Joson R. (2004).

Reference:

Stoltzfus RJ. (2008). Journal of Nutrition. Retrieved from

http://digitool.library.mcgill.ca/webclient/StreamGate?folder_id=0&dvs=1575111939533~35

Kaempf et al. (2012). Delayed umbilical cord clamping in premature neonates. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/22825092

Armstrong L, Stenson BJ (2007). Use of umbilical cord blood gas analysis in the assessment of the
newborn. Rertrieved from https://www.ncbi.nlm.nih.gov/pubmed/17951550

Yao AC, Lind J, Vuorenkoski V (2004). Expiratory grunting in the late clamped normal neonate.
Retrieved from http://breastcrawl.org/pdf/Delayed%20clamping%20of%20cord%2006.pdf

Rabe H, Reynolds G, Diaz-Rosello J. (2008). Effect of timing of umbilical cord clamping and other
strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Retrieved
from https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003248.pub3/information

Merhi ZO, Awonuga AO (2005). The role of uterine fundal pressure in the management of the second
stage of labor: a reappraisal. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16121114

Caldeyro, Barcia, et al (1979). The Influence of Maternal Bearing‐down Efforts during Second Stage
on Fetal Well‐being. Retrieved from
https://www.researchgate.net/publication/229651804_The_Influence_of_Maternal_Bearing-
down_Efforts_during_Second_Stage_on_Fetal_Well-being

World Health Organization (1992). Profile and birthing practices of Maranao traditional birth
attendants. Retrieved from https://www.dovepress.com/profile-and-birthing-practices-of-maranao-
traditional-birth-attendants-peer-reviewed-fulltext-article-IJWH

Saravanan S, Turrell G, Johnson H, and Fraser J. (2010). Birthing practices of traditional birth
attendants in south Asia in the context of training programmes. Retrieved from
https://eprints.qut.edu.au/35766/2/35766.pdf
 Verderese M. (1975). The traditional birth attendant in maternal and child health and family planning:
A guide to her training and utilization. Retrieved from https://www.semanticscholar.org/paper/The-
traditional-birth-attendant-in-maternal-and-and-Verderese-
Turnbull/01d5f3afe4a2a013dad252081d14ab5f5ee2ff62

Joson, R. (2004). Patient care. Should I have my son circumcised this summer? Pinoy MD, the
Website for Filipino Doctors. Retrieved from http://www.pinoy.md/
modules/news/article.php?storyid579.

World Health Organization (2008). Male circumcision: global trends and determinants of prevalence,
safety and acceptability. Retrieved from https://bmcurol.biomedcentral.com/articles/10.1186/1471-2490-
10-2