Healthy Births for Healthy Babies: Delayed Cord Clamping

During pregnancy, labour, and birth there are many choices to make which can affect the health of ourselves and our babies. You might feel that all the ‘big decisions’ to make are over once your baby is born. But, research shows that there are many important choices to consider in the 3rd stage of labour, which have an impact on your baby’s health.

In a recent article by 42 weeks, we talked about the Mysterious Placenta and the third stage of Labour. Today, 42 weeks looks at Delayed Cord Clamping.

What is Delayed Cord Clamping?

Labour is broken down into 3 stages:

The First Stage is when your body is having contractions which open (dilation) your cervix. Your cervix needs to open to 10cm in order for your baby to be born.

The Second Stage is when your cervix is dilated to 10cm and you push your baby out to be born.

The Third Stage begins right after your baby is born and ends with the birth of your placenta.

In pregnancy, your baby shares a blood supply with the placenta which is separate to yours. The placenta provides oxygen and nutrition your baby. The blood supply circulates between the placenta and your baby through the umbilical cord. After the birth of your baby, before the placenta is birthed, your baby is still attached to you by the umbilical cord. When your baby is born, the cord still contains a blood supply from the placenta. The cord will look healthy and bluish in colour and may ‘pulsate’. Once the blood supply leaves the cord, it turns white in colour.

cord-engorged-clamped
The umbilical cord with blood supply and after the blood supply has ceased. (Google Image: Kate Emerson, Birth Without Clamps)

Following the birth of your baby, your health care professional will clamp the umbilical cord in two places – at your baby’s tummy and further down the cord – and cut the cord to separate your baby from the placenta. Sometimes, the cord is clamped immediately following the birth of your baby. In Delayed Cord Clamping, the cord is left unclamped for a short duration (1 – 3+ minutes) to allow your baby to receive the blood supply from the cord. Research has shown this increased blood supply has many benefits for babies.

As with all birth choices, tests, procedures, and treatments, your care team should go through all the benefits (the advantages of delayed vs immediate cord clamping), the risks (the disadvantages of delayed vs immediate cord clamping), implications (associated risks) and possible future consequences, in order for you to make an informed decision. Labour is not necessarily the best time to hear this information for the first time, so it is recommended you discuss the 3rd stage of labour and cord clamping options with your care team at your ante-natal appointments. A birth plan can be an excellent way to initiate this discussion. You can read more about birth plans and preferences here AND here.

The following are some of the benefits (advantages) and risks (disadvantages) of delayed cord clamping for you and your baby.

What are the Benefits of Delayed Cord Clamping?

* in pre-term babies, delaying cord clamping by 30-120 seconds reduced the need for blood transfusions
* in pre-term babies, delaying cord clamping reduced instances of intraventricular haemorrhage (bleeding in brain)
* babies with delayed cord clamping had healthier blood and iron levels as newborns
* babies with delayed cord clamping had healthier blood and iron levels at 3 and 6 months after the birth
* delayed clamping does not increase risks for mothers

What are the Risks of Delayed Cord Clamping?

* delayed cord clamping was associated with an increased risk of requiring treatment for jaundice

“The benefits of delayed cord clamping need to be weighed against the small additional risk of jaundice in newborns. Later cord clamping to increase iron stores might be particularly beneficial in settings where severe anaemia is common” Cochrane Database of Systematic Reviews.

Research has shown that there was no difference in results between immediate cord clamping and delayed cord clamping in death or a mother’s risk of haemorrhaging (severe bleeding after birth sometimes referred to as PPH).

What women say about delayed cord clamping

“I always requested delayed cord clamping and a natural 3rd stage but it never ended happening that way, something always got in the way despite no complications for me or the baby”

And:

“I was able to negotiate delayed cord clamping until the cord finished pulsating in surgery for a planned caesarean. It was wonderful to maintain some control in birth choices which would benefit my baby”

And:

“I had a homebirth and the midwife was very supportive of delayed cord clamping, it was very important to me and it was normal practice for her anyhow. I gave birth to our baby and remained in the pool while the cord finished pulsating. Over an hour later, we clamped the cord and I gave birth to the placenta.”

Like many birth choices, policy and practice can vary in each unit and even between individual health care providers. If you are interested in Delayed Cord Clamping, it’s important to initiate discussion with your care team early in pregnancy to ensure you are informed of your choices and options and involved in you and your baby’s care plan.

Research and Related Reading:

Delayed Cord Clamping After Birth Better For Baby’s Health

Delayed Cord Clamping in Very Preterm Infants Reduces the Incidence of Intraventricular Hemorrhage and Late-Onset Sepsis: A Randomized, Controlled Trial

Hospitals warned to delay cutting umbilical cords after birth

The Placenta: essential resuscitation equipment

WHO Early versus delayed umbilical cord clamping in preterm infants

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