Tuesday, April 07, 2009

Robin Lim on cord & placental abnormalities

I received this email forwarded from Robin Lim, a midwife working in a birth center in Indonesia. I never met Robin personally, but she used to work in Iowa as a CPM before returning to Indonesia and trained many of the midwives I knew there. She has seen a dramatic increase recently in cord and placental problems: short cords, velamentous insertions, abnormal placentas, etc. Her email below describes some of the abnormalities she's encountered recently, and she wonders if the Indonesian diet, which is heavy in GMO soy, is somehow connected to this phenomenon. I had a velamentous insertion with Zari, so I'm naturally a bit curious about this. If you are a birth attendant, have you encountered a rise in the frequency of these cord/placental abnormalities?

Dear sister midwives... (and docs) please excuse this group email to friends...

I am writing from Indonesia, the country who got GMO soy first... to share what I am seeing, and ask if you too are seeing the same, and begin a dialog....

In 2008 Bumi Sehat Bali received 573 babies. We saw an increase in retained placentas (we often see hemorrhage). Also I am seeing an increase in velamentous cord insertion. One would expect given the rate of malnourishment here - that the birthing women would use every bit of Qi to push out their babies (and we go so gently) - leaving little or not much Qi for releasing the placenta and involution. However, in 2008 and so far in 2009 we have seen many too many "sticky" placentas, two even had to be transported (we do manual removal on site when absolutely necessary) - but 2 really had to go in, one for a hysterectomy, in another. Dr. Weda Gama nearly took her into surgery... but was able to remove the placenta (over 1 liter blood loss!).

In the last 6 weeks of 2008 I had to go after 4 placentas!!! It was not pretty, and I do not take it lightly (usually never more than 1 per year). Also most shocking is the empirical experience (I have no research to prove it) of seeing an increase of velamentous umbilical cord insertion and short cords.

Two weeks ago we had Padma, a vegetarian for 15 + years... third baby died the week before birth - from what was diagnosed as a cord accident. This 4th baby was born healthy... but the cord was flat and 4 to 5 cm wide (looked like a tape worm) and had five skinny vulnerable vessels arriving each separately to the placenta!!! The placenta was not [like] the lovely placentas I know and love (I am doing a book on placentas - so I am having a love affair with them). There was no Wharton's jelly to speak of, and I am seeing a decrease in Wharton's jelly among all our babies.

Last week a young mom lost her baby in labor... suddenly FHT went from 150 to zero exactly 15 minutes between listening times... there was no dipping or drop in heart tones, but we were concerned as they had gone up to 160 and once above... but easily stabilized with position change
of mother. We had no time to transport before infant demise. Five hours later a lovely baby girl was born dead. There was no hope. This mom is very poor, husband no job. The cord was less than 30 cm long and had been pulled too hard as it was wrapped tightly around her foot.

Yesterday evening we had a 2nd time mom come in, very poor and malnourished. On arrival FHT were above 160, she was 9 cm, but nothing we did to try to stabilize baby worked... and when we got up to 188 and climbing (that is with O2 support! and hands and knees) we transported... stat cesarean, baby was very weak low apgars... but she has come around and
my staff midwife has gotten her out of hospital nursery and onto breast. This baby would not have survived our normal hands-off gentle birth. Saved by O2, a doppler and cesarean - is this the kind of drama the placentas want now????

Cords are shorter. We don't cut them for a minimum of 3 hours at Bumi Sehat and many families choose lotus birth... so we hang out with the cords a long time. Last week our midwife Ayu had to cut a cord after birth of head, as the body would not follow, it was that short a nuchal cord... she had never had to do this before in her life as a midwife!

These are just a few stories... but we are seeing many less dramatic examples of shorter cords, velamentous cord insertion, diminished Wharton's jelly, and strange looking placentas.

This morning Dita having her second baby was stuck at 9 cm (with crazy transient but strong intermittent urge to push) from 7 pm to next morning at 8:30 she finally got complete. After hands and knees with butt up, moxa Kidney 1 and pulsatilla to dis-engage baby from pelvis and then elephant walking stairs to bring him down right.... we had had strange bleeding in first stage, but baby remained strong and stable, mom also was quite well through the long labor - but I was spooked to speed this up in any way... just wanted the cord to stretch gently. 20 minutes before the birth FHT were suddenly absent. Hands and knees, O2 and slowly slowly, he
came back. Now Dita was really urging to get her baby out. He was most stable when she squatted, but this was not our preferred gentle birth... Dita did it (we had not time to transport - I actually considered episiotomy - imagine, and had ready a quiwi to vacuum him out!!!) her
son was born by her own power and all of our prayers to Allah. Allhumdullilah!! our 3.6 kilo Baby boy's cord was short, just about 40 cm. velamentous insertion... AGAIN. Yet another.

Last week we had a five babies in a 12 hour night... two had velamentous cord insertions! It's just not average anymore. In five days time I saw one fatal cord accident, another cord problem leading to stat cesarean birth, and today another incident of deep fetal distress due to cord problems. BTW - none of these three were nuchal cords, just short and velamentous.

What are you midwives seeing? Please send this round to your friends... I am curious. The study I read concerning M16 genetically modified corn showed that when fed to pregnant mice, ALL THE OFFSPRING, in one generation, had alterations of ALL the cells in ALL their organs!!! Can you see why I am worried about our precious placentas? I did not make this connection, until I began to see an increase in abnormalities and pathology due to placenta and cord troubles. The fact that so many Indonesian women depend upon genetically modified soy products (tempe and tofu) for their day to day protein - and the early introduction of GMO soy here - well it got me wondering??

Dr, Hariyasa... Are you seeing an increase in this kind of cord and placenta problem at R.S. Sangla and Harapan Bunda? Some midwives at R.S. Ari Canti say they are seeing more problems. Dr. John... are you seeing more problems like this in Maui? Iowa? England? Australia? East Coast? I HOPE this is not a trend or a pattern. We really don't want GMO foods, or anything, i.e. environmental pollutants etc., to make changes in placentas. It would be shattering.

As I see it we have three combined potential ways in which the placentas are being affected in Indonesia: Malnutrition, Pollution (including Roundup) and GMO soy. We can also add to that economic and emotional stress, which taxes pregnant women's vitamin and mineral stores. Add to that increased cortisol, which Dr. Odent has proven impairs brain development in fetus. I hope I am wrong - that the placentas and umbilical cords are fine and that this is all coincidence. Please give me your input and any similar findings you are seeing.

p.s. yesterday we received a lovely baby girl, the birth was gentle and beautiful, mom did not even have a tear. However, the cord was quite long, but had a 2 cm hematoma very close to the baby; this is yet another rare abnormality.

Om Shanti, Ibu Robin Lim


  1. Wow! That is a disturbing email. I don't know much about genetically modified foods, but it stands to reason that when you mess with nature, nature fights back. I'll be interested to hear what other midwives think about this and what they are experiencing.

  2. Actually soy (in large quantities) is potentially concerning whether it's genetically modified or not.

  3. Correlation does not causation make. Remember the rate of pirates on the high seas has decreased at the same time global warming has increased. I dont think the global warming is killing off the pirates. Who knows what is causing these placenta issues. It could be a number of things together.

  4. Eeeek! This is very disturbing! I wouldn't doubt at all that there might be a link.

  5. interesting....

    In class, we were always told velamentous insertion was unusual. And they seemed to be present in every other placenta from a birth I attended as a student.

  6. pinky--
    Definitely you have to be able to separate the two. I don't think Robin is asserting there is a definite causality--more wondering about this as a *possible* explanation for what she's been seeing lately. In order to figure out correlation & cause, you have to start by asking questions! (many of which will turn out to go nowhere, of course).

  7. I'm not ruling out genetically modified foods, but the one other thing all these women have in common that changed fairly recently is the tsunami. Could something influenced by/from that be causing these problems?

    I tend to be cautious about messing with mother nature, and I'm certainly not crazy about GMO foods, but it's important not to jump to conclusions.

    However, there is NOTHING wrong with asking questions, making observations, and considering hypotheses. I'd just say that readers should be careful about drawing any real conclusions yet, as I'm sure Robin is being careful about doing.

    This is just one possibility among many.

  8. A couple my midwife friends here had made mention not that long ago that she was seeing an uptick in placental abnormalities here in Ohio. One of our midwives in the south part of the state is looking into environmental causes in her area. I suspect a similar effect up in our area. Both are industrial areas of the state.

  9. Agh. I'm already soy paranoid and this does not help. I'm really uncomfortable with the phytoestrogens in soy. This is terrible to hear. Hope you hear more about this from other midwives so you can pass news on to Robin.

    BTW I keep checking your blog and thinking ! maybe Rixa had her baby! (I know it's too soon... but it's close! Last time Zari surprised me!)

  10. I'm not a birth attendant (just a birth junkie) but this is SOOO interesting to me. My 7th baby, born in Sept '08, had a short cord (35cm). None of my previous 6 babies had cord or placenta abnormalities (as far as I know.) One thing I did differently with this pregnancy was to add tofu to my diet so as to get more plant protein. When I first read your post, I was convinced there was a correlation, but this morning I read the label on the tofu I buy and it says "non-GMO soy." So who knows? It could be so many things causing these abnormalities, (soy in general, environmental toxins, etc,) but I would have to say that I'm definitely hearing of more and more of them. (Several recent mentions of short cords on Hypnobabies yahoo group and my neighbor had placenta accreta in May '08. I live in Utah.) I'm really interested to learn more about what's causing this sad phenomenon.

  11. I'm going to Bumi Sehat in September, and wow...this email really gives me pause. I know I will see so much more outside our norm, but this is very concerning.

  12. Rixa- I was just at a lecture series where I learned that IVF parents have a much higher rate of vasa previa, presumably due to the artificial hormone profile at the onset of pregnancy. Interesting, no?
    Sarah Macrorie, DEM

  13. It could be something else in the environment, a singular event. A toxin prevalent in their area, could be household or agriculturally based, or something in the water, or all of the above. All of these happening at the same time could indicate they were all exposed to the same thing at the same time of their pregnancy. Sort of like higher number of people getting cancer in a geographic area, from a site not cleaned up, etc.


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