You know the birth scene in nearly any movie or show that has a birth in it? The one where they’re screaming “PUSH!,” the mom is screaming, and then the baby pops out screaming and is quickly wrapped and handed to the mother to hold? Have you ever wondered where the umbilical cord went in all the chaos? I know that film is not a realistic representation of what happens during birth, but sometimes the umbilical cord is cut so fast that you may not even know it was there… you know, if you didn’t have to birth the placenta and mind the remaining cord attached to baby. My point is, sometimes the cord is cut extremely fast, and I want to share with you some information about leaving it well enough alone for a little bit.
I am a huge proponent for delayed cord clamping, until it stops pulsing. Why? Here are some of the benefits:
- Increased levels of iron
- Lower risk of anaemia
- Fewer transfusions, and
- Fewer incidences of intraventricular haemorrhage.
According to the WHO (World Health Organization), care providers should leave the cord pulsing for at least one minute after the birth of the baby, unless the baby must be moved to be resuscitated. In a birth where the baby is slow to come (but does not necessarily need resuscitation), the cord should remain attached until the baby is stimulated enough and breathing is established. WHO also states that this delayed cord clamping includes babies born via cesarean section and babies with HIV positive mothers. The recommendations came from WHO in 2012, and yet the ACOG just came out with the recommendation in 2016.
The ACOG (American College of Obstetricians and Gynaecologists) came out with a statement in December 2016 recommending delayed cord clamping. Now, they only say 30-60 seconds, which is a little less than what the WHO recommends, but it is still a huge leap from when they used to recommend immediate clamping.
In preterm infants, delayed umbilical cord clamping is associated with significant neonatal benefits, including improved transitional circulation, better establishment of red blood cell volume and decreased need for blood transfusion. It also lowers the incidence of brain hemorrhage and an intestinal disease called necrotizing enterocolitis. For term infants, it increases hemoglobin levels at birth and improves iron stores for several months, which helps prevent iron deficiency during the first year of life. Iron deficiency has been linked to impaired cognitive, motor and behavioral development. ~ACOG
Another thing that the WHO and ACOG make clear is that delayed cord clamping does not increase the incidence of maternal hemorrhaging and it should not interfere with active management of the third stage (delivering the placenta). As a doula, I support your decision for active management or natural release, but it is good to know that your decision regarding cord clamping will not affect your decision regarding active management. But that is for another blog post. Another thing you should know is that your decision to delay cord clamping may make it ineligible for cord blood banking. The benefits to the newborn baby outweigh the benefits that may or may not come later in life, but that is a personal decision to make, and I’m happy to walk you through it.
** all the photos in this blog post were taken by Monet Nicole, an incredibly talented birth photographer in Denver. If you have not seen her work, I highly encourage you to look her up on Instagram @monetnicolebirths and Facebook. Or click any one of the pictures to be taken to her website. Warning, your uterus will twitch if you’re not pregnant already.