On 2016 Jul 21, Judy Slome Cohain commented:

The term, avulsion means ‘forcibly detached from its normal point of insertion by either trauma or surgery’. It is unusual nowadays to have a medical term that by definition blames the practitioner for the problem. Probably this term is going to be replaced with cord snapping asap. But whatever the terminology, Yes, cord snapping or avulsion is caused by force. The cord only snaps if you pull too hard on it. If the cord is only 10 -14 cm, it is hard not to pull on it, so even if you dont intend to pull hard, if the cord is very short, you will have a cord snap if you do enough births. If you pay attention and have your clamp readily accessible (which is what you are being paid for) you clamp it right away and lose very little blood. To be perfectly clear, cord snapping after the baby is born is never a problem except when the practitioner is not acting expediently as they should be or if there is no birth attendant present or if the water is so murky that one cannot see what is going on or if the woman is in the middle of a large pool and inaccessible.

It was not pointed out that after coming out of the uterus, cords keep pulsing nicely in hot water. This is a great advantage when delivering breech babies because the cord keeps pulsing, even after half the baby is out, if it is under hot water, the fetus continues to be well supplied with oxygen. However, since hot water causes cords to keep pulsing, even the ones that snapped, perhaps that is why there are more cases described of babies who delivered into water, who had a snapped cord, who also lost significant amount of blood. But maybe it is not waterbirth, but pool birth. In most pool births, the midwife is not in the pool with the woman, so would not be able to expediently clamp the cord if it snaps. This is not true for bathtub births. This is another reason to recommend bathtub over pools. In a bathtub waterbirth, if the cord snaps, the midwife can easily clamp it. The other advantages of bathtubs over pools are: it is possible to get rid of the feces by draining the bathtub, it is much easier to keep hot, it is easier to get the woman out in the event of shoulder dystocia, and it enables the husband more time to bond with the baby instead of having to empty the pool.

On 2016 Jul 21, Judy Slome Cohain commented:

The term, avulsion means ‘forcibly detached from its normal point of insertion by either trauma or surgery’. It is unusual nowadays to have a medical term that by definition blames the practitioner for the problem. Probably this term is going to be replaced with cord snapping asap. But whatever the terminology, Yes, cord snapping or avulsion is caused by force. The cord only snaps if you pull too hard on it. If the cord is only 10 -14 cm, it is hard not to pull on it, so even if you dont intend to pull hard, if the cord is very short, you will have a cord snap if you do enough births. If you pay attention and have your clamp readily accessible (which is what you are being paid for) you clamp it right away and lose very little blood. To be perfectly clear, cord snapping after the baby is born is never a problem except when the practitioner is not acting expediently as they should be or if there is no birth attendant present or if the water is so murky that one cannot see what is going on or if the woman is in the middle of a large pool and inaccessible.

It was not pointed out that after coming out of the uterus, cords keep pulsing nicely in hot water. This is a great advantage when delivering breech babies because the cord keeps pulsing, even after half the baby is out, if it is under hot water, the fetus continues to be well supplied with oxygen. However, since hot water causes cords to keep pulsing, even the ones that snapped, perhaps that is why there are more cases described of babies who delivered into water, who had a snapped cord, who also lost significant amount of blood. But maybe it is not waterbirth, but pool birth. In most pool births, the midwife is not in the pool with the woman, so would not be able to expediently clamp the cord if it snaps. This is not true for bathtub births. This is another reason to recommend bathtub over pools. In a bathtub waterbirth, if the cord snaps, the midwife can easily clamp it. The other advantages of bathtubs over pools are: it is possible to get rid of the feces by draining the bathtub, it is much easier to keep hot, it is easier to get the woman out in the event of shoulder dystocia, and it enables the husband more time to bond with the baby instead of having to empty the pool.