The umbilical cord is an absolute ingenious piece of nature’s excellence and is responsible for passing nutrients and oxygenated blood to and from the placenta throughout your pregnancy. However, soon after your baby is born, the cord is clamped and cut. This is standard procedure but it’s worth knowing more about when the optimum time is for cord clamping as delayed clamping can have great benefits for your baby. In this article I’ll explain the difference between delayed and premature clamping and what they both mean for your baby.
What is clamping?
I’ve found that increasingly, women are interested to learn more about the benefits or circumstances of delayed cord clamping as it’s often a topic that’s not given much attention in birth preparation.
Put simply, delayed cord clamping is simply the act of not clamping the umbilical cord until at least one full minute after giving birth. After giving birth the umbilical cord will continue to pulsate with blood, giving your baby the last nutrients and oxygenated blood from the placenta.
Is the umbilical cord useful outside the womb?
Those first few moments in the outside world are unlike anything your baby has ever experienced – it’s the first time they’ve ever had to breathe on their own. Nature’s response is to give your baby a final surge of extra blood from the placenta so that their little heart can direct 50% of its’ output to the lungs (whereas in the womb the lungs only receive 8%). This extra push helps their lungs to adjust.
It’s a bit of science lesson here, I know – but basically, this extra surge of blood from the cord means that the lungs are better able to clear any fluid and help your baby to breathe more effectively from the get-go.
This, in turn, means that your baby can start to send oxygen around their body. These first few minutes outside the womb are crucial for establishing all these complicated processes for the first time – and delayed cord clamping helps support your baby in the process.
What are the benefits of delayed cord clamping?
There are some extraordinary benefits from delayed cord clamping. Allowing blood to continue to flow from the placenta to your baby directly after birth can increase your baby’s blood volume by up to 30 percent and can also enable your baby to benefit from higher levels of red blood cells for the first one or two days of their life. For preterm babies, this delayed cord clamping has been found to be particularly beneficial.
There is also evidence to suggest that babies who have delayed cord clamping have improved iron levels for the first six months, which can have a positive effect on their mental and physical development.
What is immediate cord clamping?
To be honest, I often think that delayed cord clamping should just be called cord clamping and that any clamping carried out before one-minute after childbirth should be called premature cord clamping.
Ideally, with delayed cord clamping, blood will continue to flow to and from the placenta to your baby for between one and three minutes. This is when the baby will get the most benefit.
However, in some circumstances, it is just not appropriate to have delayed cord clamping and it has to be cut immediately after delivery. This is usually when there has been a C-Section birth where a baby needs immediate assistance with their breathing. Theoretically, it is possible to resuscitate a baby with their placenta still attached via their cord, but the majority of practitioners prefer to work on a clean and spacious surface and hence the cord is often cut prematurely.
Does delayed cord clamping come with any risks?
There is some evidence to suggest that delayed cord clamping can slightly increase the risk of jaundice but most practitioners agree that the benefits far outweigh the risks.
If you receive syntocinon to help with the third stage of your labour (the delivery of your placenta) then it’s important that delayed cord clamping is capped at one to two minutes. This is to reduce the risk that any of the drug is accidentally passed onto your baby.
If you haven’t had any syntocinon, then there really is no maximum time that a cord can be kept unclamped for, but the chances are you’ll want it snipped fairly soon after the first few minutes so you and your partner can hold your baby more comfortably. Some midwives I know have reported feeling the cord pulse for up to seven minutes. It’s worth discussing your preferences for cord clamping with your doctor or midwife, well in advance. It’s also important to keep in mind that if delayed cord clamping does not take place then it is not going to put your baby in any danger to have the cord clamped immediately (or prematurely) after birth. Delayed cord clamping does have some health benefits for your baby but it is not essential for you to end up with a healthy baby.
Myths and legends
Like the placenta, the umbilical cord is a subject of great interest and has lots of cultural and scientific significance. Previously some sources have suggested milking the cord before it is clamped, but medically speaking this is really not necessary.
If you’ve been researching cord clamping then you may have even come across lotus births whereby the placenta and cord remain attached to the baby until they come away naturally. I’ve yet to be convinced of any medical benefits of this practice. In any case, it’s certainly not for the faint of heart!
Preparing for delayed cord clamping
Most midwives and doctors will clamp the cord between one and three minutes after birth and are very aware of the positive effects. Nonetheless, I’d definitely recommend you talk about delayed cord clamping with your midwife, birth partner, and doctors so that you can make the right choice for your and your baby. It’s not possible to do it in every circumstance, but immediate cord clamping does not put your baby at risk and is in most cases done to help support your baby in other ways.
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photo credit: Albany J. Alvarez