What does the midwife think about cord blood collection and storage?

 Natalia Barska- midwife, graduate of the master’s program at the Faculty of Health Sciences, WUM. He is currently working at the St. John’s Specialized Hospital. St. Families in Warsaw As well as at Katarzyna Grzybowska’s birthing school “Birth House”. According to her, it is hugely important in obstetrics to provide the patient with comfort and respect, which she considers the absolute basis for a good start to motherhood. In her work with patients, she focuses on aspects of postpartum, a topic that today needs as much attention as childbirth itself. The spectrum of her interests also includes the topic of natural childbirth – water birth, or home birth. Privately, she designs shirts for childbirth, which is a big change from the hospital mode for her, you can find them on Instagram : shirts_en_tulle.

In your work, how often do you meet Parents who are determined to bank cord blood?

Certainly more often than when I started work, but it is still too rare in my opinion. This is mainly due to a lack of knowledge, as ladies often learn about the possibility of storing cord blood only upon admission or during a hospital stay. This is too late, because unfortunately not all hospitals in Poland have emergency kits that can then be used. Particularly during the ongoing pandemic, the situation is more difficult because, due to the limited presence of the partner at the delivery party, Parents cannot make this decision together. Recently, I met with a pregnant friend who is a doctor herself, and yet, she didn’t know much about cord blood banking and had a lot of questions about it. Fortunately, as a midwife, I was able to reliably introduce her to this information. Unfortunately, there is also a large group of women with whom gynecologists and midwives do not broach the subject, despite the current Organizational Standard of Perinatal Care.
^[i]
Due to the fact that parents-to-be are not educated about cord blood storage options, they often cannot make an informed decision. By attending birthing school classes, they receive basic information on the subject, but this knowledge, in my opinion, is insufficient.

So what concerns do Parents have about cord blood collection and storage?

Parents often ask about the diseases in which the stored stem cells can be used. The public has been led to believe that they are mainly for leukemia or lymphoma, while few know that they can be used, for example, in children with cerebral palsy. Parents-to-be are also surprised by the fact that this branch of medicine is developing rapidly all the time, that the list of possibilities in which stem cells can be used is lengthening, and that we are currently unable to predict what else scientists will discover.

Are Parents paying attention to the cost of cell storage?

For many couples, the value of the secured material is much higher than the price they have to pay for the collection and storage of cord blood. If Parents decide to use the service, and cannot afford such an expense for various reasons, they can spread it into installments and cover it with, for example, 3 or 4 months of the 500 plus benefit. A good idea, often practiced, is to have other family members cover part of the cost, among others. grandparents as a gift for the child. If you take into account, the possibilities of later eventual use and saving the health and even life of your own children is a very good investment in the future. It seems to me that there is a myth, saying that it is terribly expensive, that it is very rarely useful, and after digging deeper into the subject, it turns out that this is not true. This is because research is continuing all the time and newer and newer reports are coming to us. Doubts stem from the fact that the level of knowledge in society about cord blood banking is too low.

Does the collection of cord blood affect the faster unclotting of the baby? What does this procedure of collecting cord blood look like in practice?

This is a common question I hear from Parents. The answer to them is clear. It does not in any way accelerate the baby’s unwinding. The vessels are well enough filled and wide enough that there is no problem collecting enough cord blood. The important fact in this case is the sterility of this intake. There must be no blood contamination during the procedure, contaminating the sample. Parents also mistakenly believe that the procedure may be painful for the child or woman. This is untrue, the collection of cord blood is completely painless.

As for the whole procedure and the willingness to bank the blood, from the midwife’s side it looks like the Parents come to the hospital with the cord blood collection kit. The basic thing then is to draw blood from the mother-to-be. Then, after the baby is already born, when the umbilical cord stops pulsating, after about 1 minute, a sterile field is created and blood is drawn from the umbilical vein. As a midwife, I collect cord blood this way during natural childbirths. When it comes to cesarean sections, this is handled by neonatal nurses.

What if there is not enough cord blood?

The midwife is not able to determine from the amount of cord blood collected how many stem cells are in it It also happens that after collection it turns out that there are too few stem cells in the sample and it is not worth storing them. However, these are isolated cases. On the other hand, I had a patient in whom we collected very little cord blood, and after examination at the Bank, it turned out that it was heavily saturated with cells and there was enough for storage

Did you have a situation , that the child following the cord blood collection had consequences of the procedure?

No, I have not had such a situation in my work. No one has ever complained about any negative effects of cord blood donation in a child. Remember that the cord blood that is collected for the kit is blood that would otherwise be disposed of. The collection already takes place after the unbuttoning (cutting of the umbilical cord). The blood drawn would no longer return to the baby’s circulation, so the procedure should not have such consequences.

Do all midwives take an open approach to cord blood collection?

There are still many midwives working in Polish hospitals who do not feel the need to further their education and learn new things. It is very difficult to convince them of new knowledge. Due to the fact that they do not know the possibility of using or at all the procedure of collecting and storing cord blood, there are situations when they discourage Parents by reproducing untrue facts and myths about cord blood banking. Unfortunately, this is due to the fact that they treat something new and unfamiliar as bad and unnecessary. Although they often have access to the latest knowledge and scientific reports, they do not take advantage of this, and this is the case not only in the context of cord blood, but the entire work in the gynecology-obstetrics department.

Do you personally know anyone who has benefited from stored stem cells?

In the hospital where I previously worked, there was a situation where a patient, encouraged by my colleague (a midwife), decided to collect and store cord blood, and these stem cells came in handy for the older sibling of the child born. If I remember correctly, it was leukemia, and the child eventually recovered. In my opinion, such stories confirm that it is definitely worth the decision to store cord blood. Ideally, however, it should be fully informed, undertaken after consultation with a gynecologist or midwife. Wondering if it’s worth storing your child’s stem cells? https://www.pbkm.pl/komorki-macierzyste/dlaczego-warto

^[i]
[i] In accordance with the Organizational Standard of Perinatal Care effective 1.01.2019