What is it and why you would want to do it.

You may be asking yourself, why in the world would I care about delayed cord clamping? Maybe this is your first pregnancy and you aren’t even sure what I am talking about. In this post we will talk about what cord clamping is, what the research says about the timing of said clamping, and how to discuss this topic with your providers before and during labor.

Cutting the Cord

Just in case you are absolutely green to this whole pregnancy, labor, and birth thing, your baby has something called an umbilical cord. It is attached to the babies umbilicus (belly button) on one end and attached to the placenta on the other end. This is your babies life line for his/her duration in utero. Most of the time, this cord contains three vessels. Two arteries which are responsible for carrying de-oxygenated blood away from the baby to the placenta, and one vein responsible for carrying oxygen rich blood to your baby from the placenta. Sometime after delivery, this cord is cut and the baby is responsible for circulating its own oxygenated and de-oxygentaed blood. Traditionally the cutting of the cord took place quickly after birth, but there is mounting evidence to confirm that delaying this procedure is beneficial to babies, and not at all harmful to mothers.

Benefits of Delayed Clamping

One of the benefits of delaying the clamping and cutting of the cord is an increase in the babies blood volume. The increase can help prevent low hemoglobin by transferring more iron to the baby. This increase can also help improve blood flow to the babies brain and gut.

Delaying the clamping of the cord can improve maternal infant bonding and promote skin-to-skin contact after birth, which has a lengthy list of benefits in its own right. (See my post here on the Golden Hour)

In babies born premature, the risk of brain bleeding and sepsis can be reduced by delaying the clamping and cutting of the cord. There is also a decreased need to treat low blood pressure and low blood volume with intravenous fluids or blood transfusions. Delaying has also been shown to reduce the risk of Nectrotizing Entercolitis (NEC), which is an intestinal disease caused by bacteria that attack the babies intestines leading to possible serious infection or death.

The best news is that there appears to be no risks associated to delaying cord clamping in otherwise healthy babies that are vigorous at birth!

How Long Should You Delay?

Now that you know there is no reason to hasten cord clamping and cutting in vigorous babies, you may be asking: how long should we wait? Are we talking a couple of minutes, or am I going to have to attend Kindergarten again? Unfortunately, there is no solid agreed upon length of time that gives babies optimal benefit, but the consensus among the American Academy of Pediatrics (AAP), American Heart Association (AHA), and the American College of Obstetricians and Gynecologists (ACOG) is to wait 30 to 60 seconds. This topic has literally been debated among healthcare professionals for hundreds of years. There was even a publication about this topic in 1801 that recommended delaying cord clamping! Many sources recommend waiting until the cord has stopped pulsating. The decision on how long to delay, should be one you discuss and decide on with your provider(s).

Why Isn’t Delayed Clamping Just Standard?

With all the outlined benefits, you may be wondering why everyone isn’t delaying cord clamping for vigorous, healthy newborns. What you should know, is that this may be the standard of care for your provider(s). If so, count yourself blessed, because the provider(s) you have chosen are well informed and up to date on the latest evidenced based care practices surrounding cord clamping. However, there are still many provider(s) and facilities where this is not standard practice for every birth. There could be multiple reasons for this. The fact is, they may not be aware of the benefits and recommendations. There are also many perceived risks of delayed cord clamping that are not supported by research, which may be keeping a provider or facility from adopting this plan of care. Lastly, maybe they don’t know that you are a well informed mama who wants to give your baby the very best start! So, how do you tell them?

How to Talk to Your Provider about Delayed Cord Clamping

I would recommend you start this conversation with your provider between your 24th and 28th weeks (6-7 months) of pregnancy. You could start the conversation be asking “How do you feel about delayed cord clamping?”. If they say “This is best practice, and I support it”, then your work here is done! Of course you will still want to add this to your birth plan and discuss it with your partner, labor nurse, doula, and any other support persons you plan to have with you during labor and birth. This just ensures everyone is on the same page. But, what if your provider is reluctant or just not sure? Well, then you have a little more work to do. Tell your provider why you want to delay the clamping and cutting of the umbilical cord. Let them know about the many benefits discussed in this post, and make sure they understand how important it is to you. If needed, you can point them to the following resources: ACOG.org and AAP.org. These are both well respected membership organizations in the Women’s and Children’s medical community. Both organizations have position statements on delayed cord clamping.

What is the Bottom Line?

Delayed cord clamping causes no harm in healthy, vigorous term and pre-term babies, and has many potential health benefits. There are also, no increased risks to mama! The bottom line is that delayed cord clamping and cutting is the recommended standard of care! If delaying this procedure is important to you, talk to your provider today and advocate for the care you and your baby deserve!