I’m sorry you’re getting downvotes. I’m betting the bulk are because you’re in c/askscience saying you don’t have any evidence to support your question, but that’s kinda the whole reason to ask a question. You weren’t speculating in a top level comment so I think it’s rude to be downvoting. As far as I can tell you’re asking genuine questions which is kinda the whole point of this community. Fuck the haters, ask questions when you’re curious!
It’s awesome that you’re already setting some stuff up. Feel free to DM me if you’ve got any questions!
I’m putting in my rank list for EM right now. Some people certainly have some…peculiar…ideas about health and healthcare.
But most animals don’t leave it intact. They chew through it shortly after birth. You can’t really have a tissue that is sturdy enough to survive tension during fetal development and vaginal delivery that then instantly falls apart, so it has to be manually severed after delivery. The vast majority of mammals don’t let it stay attached for long at all, because their offspring are pretty mobile immediately after birth. From my reading of some of the random websites that recommend this, apparently it was based on the observations of a single species of higher ape (a chimp I think) that doesn’t sever the umbilical cord quickly. But when we have been severing cords as a species for generations and the vast majority of other mammals sever the cord with their teeth, I think the evolutionary biology evidence points towards severing the cord quickly.
Now evolutionary biology isn’t a solid basis for medical practice, but we don’t really have much scientific data at all to base this on at this point. There have been reports of increased rates of serious infections from the practice, which has face validity with the fact that you’re leaving a devascularized piece of tissue attached to the vascular system of neonate with an immature immune system. Outside of infection, there has been some case reports of polycythemia (excessively high red blood cell count) and jaundice in these infants. This makes sense physiologically. While attached to the placenta there is a greater intravascular volume available to the infant, which is the entire basis behind delayed cord cutting. It stands to reason that continuing to allow that extra blood volume to enter the infant would result in polycythemia and jaundice.
I’m not intimately familiar with the foundational literature by which the standard DCC cutoffs of 1 minutes or cessation of umbilical pulsatility were founded upon. There could be a very real argument for saying, should the time be 2 minutes? 5 minutes instead of 1? Or should we at least study it if it hasn’t been already?
In summary, we have a piece of dead/dying tissue attached to a physiologically stressed neonate with an immature immune system. Leaving it attached for days is in contradiction to the vast majority of other mammalian labor behaviors, is inconsistent with the majority of human’s labor history, and has a clear pathological mechanism by which the commonly reported complications can be easily explained. Without some legitimate evidence to actually support benefits or disprove the risks, I think this practice should be discouraged by healthcare professionals.
Well they don’t eat it to get it off of the baby. While I’m not a vet or a zoologist, my understanding is they eat it for the nutrients as well as to help remove the scent, and newborn animals are easy prey and targeted by predators.
Doesn’t actually belong to the baby, it’s a hybrid organ that contains DNA and tissue that comes from both the mother and the fetus.
I personally wouldn’t recommend it, I’ve seen babies die miserable deaths of sepsis and it’s heartbreaking. But I’m not going into pediatrics or OBGYN so thankfully this isn’t gonna be a discussion I have to have.
To somewhat play devil’s advocate, what’s wrong with a minute? What benefit are you expecting from leaving it on longer?
The long and the short is Delayed Cord Clamping is really the only thing we have data for, and that’s what we should do without evidence something else is better.
This is an alternative birth method called “lotus birth” or more formally “umbilical non-severance” in which babies are left tethered to the delivered placenta until their cord desiccates and detaches from their body on its own, usually in 3-10 days, while applying salt to the placenta to increase the speed at which it dries. It will eventually fall off, however, after its delivery the placenta is no longer being supplied with the oxygenated blood it needs to survive, and becomes necrotic (dead). This can act as an easy entry point for infectious organisms to enter the neonate, and can result in life-threatening infections. Neither the American College of Obstetrics or the American Academy of Pediatrics have explicit guidance statements as to whether this should be recommended against. AAP has published that there have been multiple case reports of severe infections with various bacteria secondary to this practice.
This should not be confused/conflated with Delayed Cord Clamping, which is waiting 30-60 seconds after the baby’s delivery for some of the residual fetal blood in the placenta to be delivered to the baby’s circulation to prevent anemia. This has good evidence for benefit to the baby, is recommended by ACOG, and is basically standard of care in the US.
Source: ACOG and AAP publications, also I’m a 4th year medical student that has completed OBGYN rotations
Oh, absolutely, there was going to have to be a discussion well before I would be willing to do that. I’d never take unilateral control of a player’s character like that
My table tends to not metagame at all, even in situations I really wish they would. I think of all the answers I’ve gotten, this is the most reasonable and actionable answer. Just remind the player more often. I’m gonna have to come up with a good way to not sound like a condescending asshole because this is the only player I’m going to have to do it to. It just sucks cause it’s one more thing I’ve gotta do while running combat. But that’s life I guess
That’s a really cool narrative way to go about fixing this, though it does feel kinda rail-roady. I’ll give it some thought.
I go back and forth on this. I feel like I’m enabling these choices by pulling punches. But it feels excessively anti-fun to just kill them and be like “sorry lol be better”. I don’t think I have the heart to just murder characters all the time.
It’s not quite 3 years. I’ve been DMing for about 3. This player has been playing on-and-off for about 1.5. I have complicated the rules a touch because in the last 8mo or so I’ve switched to PF2e. I mean this problem in specific isn’t that system specific, so I don’t think that really excuses it.
But all-in-all you’re right. The most effective answer is find another group that is more invested in the game. I’m moving across the country in a few months, so I guess I should just ride the issue out a little longer and then move on, which is a huge bummer. I guess in the meantime I’ll try and remind them more regularly and once again have the conversation about “Why?”
Thank you
I don’t try and TPK my players, quite the opposite. I’m actively downgrading encounters and making mechanically disadvantageous choices to avoid them. The only thing I’m not doing is fudging rolls.
I am reaching out to the community to help me try and better understand how I can resolve this problem at my table, and everyone else in this thread seems to agree that this player’s choices are, at a surface level at least, baffling. I recognize it is probably reflective of some underlying assumptions that I have tried multiple times to elucidate so I can better understand the situation. But for some reason, you are the only person I have encountered who has become hostile and accusatory towards me. I don’t know if you’ve been butt-hurt by some DM in your past or if your games live by the rule of cool. Regardless, you’re being disrespectful and I don’t appreciate that. I won’t be engaging with you anymore.
That’s why I came to the community. I feel like I’m a reasonable and half-way experienced DM at this point. The player is aware cantrips are unlimited use. The player is a very intelligent individual. I’ve had the conversations about spell use. At its core, I genuinely think the player is attracted to the “cool factor” and “aesthetic” of playing a caster but doesn’t actually want to engage with any of the mechanics. I can remind the player about spells and that reminder will last for a combat, sometimes less. I feel like I’ve done everything I know to do aside from straight banning the player from playing full casters or queuing them to cast spells every-other turn, I’m at a loss.
This is a great thought, I’ll definitely give it some thought
They generally pick combat focused spells, minimal utility cantrips/leveled spells. But then don’t use them. When they have utility cantrips, they rarely use them outside of combat (like won’t cast detect magic to look for things, won’t use prestidigitation for intimidation, etc).
I haven’t explicitly stated “your poor choices are killing your friends” but after the last TPK, they were sad and I apologized for killing them, but then immediately went into a discussion of “you know you were fully rested for this, why didn’t you use any of your more powerful spells?”
Unfortunately none of my players are exceptionally well versed in the rules of the system/their characters. They know the basics well enough. Unfortunately they (and I) have very demanding professional lives and reading a rule book is too low on their priority list to ever make it to the top.
I totally agree that the individual would be better suited to an eldritch knight, Paladin, arcane trickster rouge, etc. We’ve had that discussion twice, and it seems to go over well and they agree, until the next session comes up and they have made another caster character.
Not OP but loss of the Pi results in loss of network connectivity. A headache if you’re home and never doing anything time-critical on the network. A disaster if you or anyone else is dependent on the network for anything time-sensitive (virtual doctors appointment, work call, etc), or you’re away from home and unable to directly VPN to your router to reconfigure DNS settings.