Optimal Cord Clamping

Babies cords are usually clamped shortly after the baby is born. For the past 50 years doctors and midwives have mostly routinely clamped and cut the cord immediately with no evidence that timing of that clamp and cut has any significant impact.

However, evidence now shows that there are benefits in delaying cord clamping:

Cords cut before 60 seconds after delivery are classed as early cord clamping, but in a perfect world, a cord should not be cut until it has stopped pulsating – i.e. all the blood flow from the placenta to your new baby has completed it’s journey.

If the cord attached to your baby is left for as long as possible, not only will your baby receive extra blood, but it can increase birth weight, can boost your baby’s blood volume by up to a third and can increase your baby’s iron reserves for up to 6 months. Research shows that placental transfusion is mostly complete by 3 minutes.

Iron deficiency anaemia, the most severe form of iron deficiency, affects around a quarter of pre-school children globally and 3-7% of the population in Europe. This deficiency can go on to affect a child’s brain development.

The solution is to keep the baby attached for as long as possible to make sure he or she has a good amount of iron stored up for the future.

If you allow nature to take the intended course and delay the clamping and cutting of the cord, you and your baby are still attached, therefore no one can take your baby away from you. All a midwife needs to do can be done with your baby in your arms, with their skin against yours. That is a moment no one in the world can ever take away from you. And it’s doing good stuff at the same time!

Is it right for you and your baby?

There may be a reason why delayed cord clamping may NOT be an option for you and your baby. The World Health Organisation tells us that early cord clamping i.e. before the magical 60 seconds, is not recommended UNLESS resuscitation is needed. Sometimes newborns don’t like being forced out of their cosy environment into a bright new world and they might need a little helping hand to come round and breathe on their own. If this is the case, then it is best to get them started and cut the cord unless there is a mini resuscitaire available, which enables resuscitation with the cord intact.

Can it be done after a Caesarean Section?

There is nothing said professionally that delayed cord clamping cannot happen after a Caesarean in theatre. Increasing numbers of hospitals have guidelines in place to permit delayed cord clamping following caesarean section. Having a Caesarean does not write off your opportunities to have delayed clamping and furthermore skin to skin contact should be every woman’s right to make their birthing experience the best it can be.

In a normal delivery, once your baby has been delivered, you will then embark on the third stage of labour – either physiologically i.e. waiting for the placenta to come out naturally with no help (which can usually take up to 60 minutes before intervention is required) or, an active third stage (when your midwife will give you a little helping hand and an injection to help the placenta be delivered). Whichever one you choose, or end up having, delayed cord clamping can still be offered.

Remember, Weight can Wait! Although one of the first things new parents want to know is what the baby weighs, think of the advantages of waiting just a little bit longer for that information.

YOUR Birth Preference

You have the opportunity to make your wishes heard about how you want your birth to go and it’s called a birth plan/ birth preference. Here are a few ideas you might like to consider or discuss with your midwife:

  • I would like delayed cord clamping, if possible
  • I would like immediate skin to skin contact with my baby
  • I want [name]to cut the cord
  • I would like a physiological third stage if possible
  • Weight can wait!
  • I would like an UNDISTURBED 60 minutes with my baby after birth during the third stage of labour

Special Thanks

Our sincerest appreciation to Hannah Godwin and Amanda Burleigh for writing this article.

Please visit the Blood to Baby campaign for further information.

References

  • Bender, S (1976). Obstetrics for Student Midwives. William Heinemann Medical Books.
  • Campbell, D (2013). Hospitals warned to delay cutting umbilical cords after birth. The Guardian.
  • Fraser, D. M. & Cooper, M. A. (Eds.) (2009). Myles Textbook for Midwives: 15th Ed. London: Elsevier.
  • Mehigan, S. (2014). Can I ask for a delay to my baby’s cord being clamped?
  • Roberts, M. (2011). Delay cord clamping for baby health, say experts. BBC News.
  • WHO (World Health Organisation) (2012). Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants.