Delayed Cord Clamping - what is it? And why would I want it?

There's a lot of talk these days about a procedure called Delayed Cord Clamping. It's something that is becoming more common amongst some hospitals, but we still have a long way to go before it becomes recognized as a regular part of standard practice in most women's births.

Transient

So here's the low down on delayed cord clamping, and why you might want to include it in your Birth Plan. When your baby is safely born, he or she is still attached to the placenta by the umbilical cord. Historically, the cord has been cut by the doctor or OB rather quickly, or sometimes cut by the father in the first few minutes of life. However, research and peer-reviewed studies have proven that by waiting to cut the cord by even a few minutes, you can create a healthier outcome for your baby.

Delayed cord clamping is the decision to leave the umbilical cord attached to your newborn baby for a length of time, either a certain number of minutes, or until the cord stops pulsating.  Benefits include lower the incidence of anemia in your newborn, and the ability for your baby to receive more blood from the placenta, which continues to filter through the umbilical for a short time after birth. One study noted that babies whose cords remained uncut for more than five minutes had a higher rate of jaundice, a relatively harmless condition in which your baby's excess bilirubin levels turn his or her skin a yellowish colour. However, some of the benefits of allowing the blood to pass for a few extra minutes may include better oxygenation of blood supply, and better functioning of the lungs, which only begin working after birth.

There are some cases when, even if requested, delayed cord clamping will not happen. If your amniotic fluid contains meconium (your baby's first poo), it's likely that the cord will be cut immediately and the baby passed to a paediatric team, just in case the baby has aspirated any of this substance. Likewise, I've seen a baby's cord cut shortly after being born when the doctors were concerned about a low Apgar scale. You'll also likely find that if your baby's cord is wrapped tightly around his or her neck, the doctor or midwife may cut it during the birthing process.

The last thing to say is that you cannot have both delayed cord clamping and cord blood storage. In my opinion, the immediate (and free) benefits of delayed cord clamping would seem to outweigh the hypothetical benefit of cord blood storage. However, if you feel strongly about the latter, there is no reason to change your plan.

Overall, recommendations by the WHO and other medical bodies have found good reason to delay cutting your baby's cord for the first few minutes of life. If you choose to include this in your Birth Plan, having a doula can definitely help achieve this goal: the rush and excitement of your baby being born is not a time for remembering your Birth Plan, in my experience. It is, however, my job, if that's part of your plan, and I can say from experience that it's something that can easily be overlooked in the emotional first minutes after the birth, when it's not part of the standard of care.

Ultimately, you and your partner should be the ones deciding when you'd like your baby's cord to be cut. Delaying the cutting may be part of your plan, and may have longterm benefits when done correctly.

Stayed tuned for a post about Lotus Birth, a form of delayed cord clamping that is also gaining in popularity.