Delayed Cord Clamping
Delayed Cord Clamping:
Many people do not understand cord clamping. We are familiar with seeing the baby being born and the cord being cut straight away and handed to either mom or the nursing staff. Did you know though that cutting the cord immediately after birth is not as beneficial as delaying this procedure?
A friend of mine when expecting baby #4 brought this topic up for conversation with her Doctor. She was telling him about how she wanted to have delayed cord clamping for her new baby. Her doctor retorted saying that it is a dangerous procedure that causes the blood in the baby to drain back into the placenta and can be harmful to the baby.
When I heard this I thought, “You’re joking, right?” I wasn’t necessarily shocked by this information. I knew that he was wrong simply from doing my own research, but I was shocked because I didnt realize that mainstream Doctors really BELIEVED that! Unfortunately I have learned that many Doctors do believe that this is true and are telling their patients this same information.
There are many benefits for leaving the cord attached to baby, unclamped for many minutes after birth. One big one is that 1/3rd of a babys white blood cells are in the cord at the time of birth. When you cut the cord immediately after birth those white blood cells never make it into baby.
I read a study many years ago that talked about how the babies who had DCC (Delayed Cord Clamping) had blood vessels that were more round & fuller shaped. The babies who had ICC (Immediate Cord Clamping) had blood vessels that looked more like a deflated balloon or a raisin in texture and shape. This study claimed that when the cord is left attacked and unclamped on baby, a full amount of the babys blood enters into their own system and causes these vessels to open up fully.
There is also some information to suggest that when the baby enters into the birth canal and is born a release is able to happen from the placenta as there is reduced pressure on the plcetna and the blood can flow more freely into the baby. The blood in the cord was always MEANT for your baby.
In one of the studies listed below a clinical test was done on 2 test groups. In Group A the cord was clamped immediately. In Group B it was delayed. This test was done on premature babies; the conclusion of this test was that the babys in Group B (DCC) had less of a need for blood transfusions. The results of this study show that when you leave the cord unclamped and allow baby to get all of its blood, babies are healthier from the start. If this is true for preemies, its still true for full term babies as well.
In another study listed below, babies that are born to moms with low iron had a better start to life when delayed cord clamping was followed then those that had immediate cord clamping.
Even more info is out there, about the misconception that mothers with an Rh negative blood factor need immediate cord clamping for their health and their babies. Yet research suggests that it actually harms both mom and baby to cut the cord too soon.
Please take some time to look through all the articles & video at the end of this blog post. There is a lot of great information out there. Enjoy!
I wanted to post one tid-bit from a site I read about just some of the cons to baby alone with immediate cord clamping.
…
The Effects of Cord Clamping on the baby.
Before birth, a baby’s blood is distributed throughout his or her placenta
and body. The blood in the baby and in the placenta rightfully belongs to
the baby and should go with him or her at birth. Many health practitioners
mistakenly think that the baby’s body is already full of blood and that the
placental blood is excess. The placental blood, however, serves and
important purpose.
Prior to birth, the baby’s lung alveoli are fluid-filled, and as such they
keep the blood vessels of the lungs constricted, automatically impeding the
flow of blood to the lungs. When a baby is passing through the birth
canal, the pressure exerted all around his body forces the fluid up and out
of his lungs so that by the time he is born, the major portion of his lungs
is clear of fluid. At birth the blood vessels of the lungs fill with blood
and, within seconds, the baby starts to breathe. This increased need for
pulmonary blood flow to breathe, combined with the increased movement of
the baby’s arms and legs, provides ample use for the placental blood.
When the cord is clamped immediately, the baby attempts to breath right
away, without the aid of the oxygenated blood from the placenta. For
premature babies, this can be particularly consequential. Several American
reports suggest a tendency among hospital-born babies whose cords are
immediately clamped to have poor circulation and bluish limbs.
If a blood pressure gauge is placed on an unclamped umbilical cord, it
will pick up pressure rises as high as 60 mm Hg (millimeters of mercury)
with each uterine contraction. This indicates that these contractions are
intimately involved in the transfer of placental blood through the cord. A
striking pressure rise, which persists through the first few hours of life,
is also evident in the baby’s vena cava and right atrium of the heart. 6
All studies on this indicate a significantly higher systemic pressure in
infants who have been clamped late (90 percent in the first nine hours),
and conversely a significant drop in pressure in early clamped infants (70
percent of systemic by the second hour, and almost 50 percent of systemic
by the fourth hour).
Furthermore, three groups of researchers have independently reported that
early clamped infants have a much higher incidence of cardiac murmurs
during the first 14 days of life. 7 Granted, under certain circumstances,
a baby’s cord must be clamped immediately for instance, when it is wrapped
too tightly around the nick. However, under ordinary circumstances it
appears that an early clamped infant may not be operating at full potential.
-http://www.whale.to/a/butler7.html
This article is just one of MANY that talk about so many reasons why delayed cord clamping is better! Read through the links below and gain a wealth of knowledge on the subject!
Sources and Links for more Info:
We Can Be Much Kinder – Watch the top videos of the week here
http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/ –> a really good perspective from an OB who over time in their career changed their thinking from Pro Immediate Cord Clamping, to trying to change her entire practice to not EVER cut the cord immediately. Interesting.
http://www.indianpediatrics.net/feb2002/feb-130-135.htm –> This study shows how the test group for delayed cord clamping had better outcomes for babies born to mothers with low iron.
http://pediatrics.aappublications.org/cgi/content/abstract/117/4/1235 –> This study shows how delayed cord clamping improved the health of these premature baby boys in comparison to the test group that did immediate cord clamping.
http://www.springerlink.com/content/1e3rxxpbfn4e2va7/ –> Another study done with 2 test groups. This one showed results from delaying the cord clamping by 20+ seconds vs. 40+ seconds and even in just 20 seconds different the results showed dramatic healthier outcomes for the babies in the 40+ second test group.
http://www.gentlebirth.org/archives/lateClamping.html –> 5 Good Reasons to Delay Cord Clamping.
http://www.gentlebirth.org/archives/cordIssues.html –> This entire site is excellent! A good resource for learning about Rh- too. Great site!!!!
A Few More:
http://www.naturalchildbirth.org/natural/resources/labor/labor04.htm
http://ecochildsplay.com/2010/01/06/natural-childbirth-delayed-cord-clamping/
http://www.facebook.com/delayedcordclamping
http://www.gentlebirth.org/archives/cordIssues.html#Delayed
As always, Please let me a comment!!!! I love hearing what everyone thinks, or getting asked questions. 
~ Julie ~
| Print article | This entry was posted by Julie Wannamaker on January 25, 2010 at 12:00 am, and is filed under Baby, Labor/Delivery. Follow any responses to this post through RSS 2.0. You can leave a response or trackback from your own site. |
about 3 years ago
>> http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/ –> a really good perspective from an OB who over time in their career changed their thinking from Pro Immediate Cord Clamping, to trying to change her entire practice to not EVER cut the cord immediately. Interesting.
Thanks for the link, but I’m not a she!
I’m not sure immediate cord clamping has any harm to the mother as you mention, but otherwise I think most of what you say is quite accurate. I appreciate the scientific basis you use to describe the issue, as this is ultimately what is required to promote change. Based on current data there is little reason to immediately clamp a cord – really only if we are planning to store fetal cord blood for future use, in which case we need to get as much of that blood as possible.
The difficult thing for an OB to do is delay clamping after a very preterm delivery. We want that baby to get to the pediatricians as quickly as possible as it will need to be intubated to oxygenate, but most likely the baby can continue to oxygenate through the cord as long as the placenta is attached. The best of both worlds would be for the pediatricians to be able to work with the baby with the cord still intact, but this is logistically/physically very difficult.
Nicholas Fogelson, MD
Academic OB/GYN Blog
Thanks for the link!
about 3 years ago
Thank you for posting this and the link to share! I recently met with a midwife who told me of a doctor in town who recently gathered a substantial amount of convincing material as to why OB’s should do DCC in most (low risk) births & he presented this information to his colleagues, who in return basically said they didnt care and didnt have the time (bc Doctors are the only ones who can cut the cord in hospital protocol, I believe). His colleagues told him that he could do whatever he wanted to with his own patient, but that they were not going to make the switch. I find it sad that when there is convincing evidence to suggest that this is beneficial to the baby, that their time would be priority over their patients.
I appreciate your comment! Thank You. 
about 3 years ago
Hi there,
My husband and I recently delivered our baby girl. We had asked for delayed cord clamping in our birth plan. The doctor on call that day went through our birth plan with us and had no issues UNTIL I was pushing our daughter out. I was in the midst of intense pushing and she began to debate the DCC with my husband and I. I obviously ignored her because I was busy, and my husband was trying to assist me with my pushes. He argued with her the best he could, but in the end we just let her cut the cord immediately because she was being so rude about it! I regret this now, but am unsure what else we could have done in that situation. She was armed with loads of misinformation (this will cause your baby to be jaundiced, the blood will flow from your baby into the placenta) but how do you argue with a doctor and especially when you’re in the middle of trying to push out your child? We were completely appalled by her behavior. I really wish that this information was more widely known and accepted by the medical community.
about 2 years ago
Do you know any where can I find info on this: the blood in the baby to drain back into the placenta? My Doctor told me this too.
about 2 years ago
I can definitely get more info on that for you! Some doctors surprise me with their thinking that the blood drains back into the baby. Its just silly- Ill find out more.
about 2 years ago
Here is a link from a midwife & natural birth advocate about DCC: http://www.gentlebirth.org/archives/lateClamping.html.
More:
~Delayed Cord Clamping Should Be Standard Practice in Obstetrics: http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/
~Umbilical Cord Clamping Should Be Delayed, Says Expert: http://www.sciencedaily.com/releases/2007/08/070816193328.htm.
~Early or Late Cord Clamping? : http://www.naturalchildbirth.org/natural/resources/labor/labor04.htm
~Delayed Cord Clamping
Neonatal Transitional Physiology: A New Paradigm. Mercer JS and Skovgaard RL. J Perinat
Neonat Nurs (March 2002); 15:56-75. :: http://www.sgbirthservices.com/delayed.pdf
~Cord Blood – Why Delaying Cord Clamping Benefits Your Baby:: http://www.bellybelly.com.au/articles/birth/cord-clamping-delaying-cord-clamping
I hope that helps! Please let me know if you have any other questions!
~Julie
about 2 years ago
I have read all this articles, but I can’t find any that will explain if the babies blood can go back to placenta leaving the baby with less blood as doctors says. Does the blood after birth flow back and fwd or just fwd or it will flow back and fwd for a time and then it will stop the back flow and keep the fwd flow? Thanks
about 10 months ago
Thanks for all the info! Is there any sort of guidelines that say how long the cord clamping should be delayed?
about 10 months ago
What about the situation when there is mother-baby Rh incompatibility (the mother is Rh negative and the baby Rh positive)? I was told that, in this case, the cord has to be clamped as soon as possible, in order to minimize the blood transfer between the mother and the baby, which can lead to the mother’s immunization and problems in future pregnancies. Is this true? It seems quite logical, but I am looking for several opinions…. Thank you!
about 9 months ago
You will not know before blood work is done after birth if the mom & baby are incompatible. I can assure you though that leaving the umbilical cord intact would not interfere with this process at all. The umbilical cord has been supplying your baby with blood for the whole pregnancy & by leaving the cord intact you are simply allowing them to get more of the very same white blood cell rich blood they have been getting.
I am personally an RH- mother & so far 2 of my 3 children have my same blood type & 1 has a + blood type. I have delayed cord clamped for over an hour after birth each time (homebirth). There is no concern to your health most of the time unless you suffered an over traumatic or high-intervention birth.
about 9 months ago
As long as possible! In a homebirth we leave it on as long as the blood is still pumping from the placenta to the baby. But honestly if you’re provider is all for giving you 5 minutes- ask for 20, but take 5 minutes over 0 minutes because every bit of cord blood is beneficial for your baby!