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  • Paula Schnebelt

What is delayed cord clamping?


What is delayed cord clamping, and why is it something to consider? Delayed cord clamping is a birth practice where the umbilical cord is not clamped or cut until after the pulsations have stopped, or up until after the placenta is delivered (OnetoOneMidwives). By delaying the clamping process, we allow a healthy blood volume to go to the baby, which includes a full count of red blood cells, stem cells, and immune cells. Research has shown that when we delay cord clamping, the neonate will receive up to 30% more of the fetal-placental blood volume than it would have with immediate cord clamping., which makes sense as the cord and placenta contain about one third of the baby’s blood at the time of birth. Allowing this placental transfusion ensures safe oxygen levels and blood volume in the baby.

Studies have shown that some of the risks associated with immediate cord clamping include:

+ Lower iron stores in the infant for up to six months after birth (which can potentially lead to neurodevelopmental delay)

+ Increased risk of postpartum hemorrhage and retained placenta in the mother

On the other hand, some benefits associated with this practice of delayed cord clamping are as follows:

+ Increased hemoglobin levels and improved iron stores at birth (which can affect development), + Benefits to preterm infants such as improved transitional circulation, better establishment of red blood cell volume, decreased need to blood transfusion, and lower incidence of necrotizing enterocolitis and intraventricular hemorrhage

(ACOG)


The American College of Obstetricians and Gynecologists recommends a delay in umbilical cord clamping in both term and preterm infants for at least 30-60 seconds after births. However, it is becoming more common for women to request delaying cord clamping for even longer periods of time, or until the placenta is birthed physiologically/naturally; this is especially common in home birth settings due to the more holistic nature of the midwife’s training and model of care, which places great emphasis on not disrupting the normal and physiological birth process. Additionally, Swedish researches have associated delayed cord clamping in neonates with higher social and fine-motor skills in preschool boys (AutismSpeaks). In previous research, the investigators had linked early cord clamping (within 10 seconds of delivery) to iron deficiency in infants, which has long been associated with poor behavioral, motor and intellectual development in children.

So…why did we begin the practice of cord clamping in the first place? Well, the practice became common more than a century ago with the belief that it would reduce the risk of maternal bleeding and, more recently, that it would prevent infant jaundice, although now, studies have shown that neither is true (AutismSpeaks). Nevertheless, lack of knowledge, the strong influence of tradition and the modern practice of umbilical cord blood banking keep the practice popular in today’s society (Downey & Bewley). It is also a likely possibility that the continued practice of immediate cord clamping, particularly in hospital settings, is due to the fact that most medical professionals practice based on a medical model of care that is physician-controlled and, due to hospitals being a business, wants to get mothers in and out as quickly as possible. Why wait if you don’t have to? The only thing we can do, however, is continue to educate others on the benefits of delayed cord clamping and hopefully, with continued research and word-of-mouth, immediate cord clamping will cease to exist.


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