Delayed Cord Clamping
The umbilical cord is the lifeline that connects your developing baby to your placenta. Normal umbilical cords have 2 arteries and 1 vein which help your unborn child oxygenate their blood, provide nutrients and process waste in the womb. A cord can grow to be 60 cm long, which gives your baby plenty of room to flip and move while being safely attached to the placenta. Wharton’s Jelly is a gelatinous substance which protects the vein and arteries from being kinked inside the umbilical cord. It’s the same kind of gelatinous tissue found in the eyeball.
I mention the anatomy of the cord because SO MANY moms worry about cord entanglement. If you’re visibly pregnant in this world, chances are someone has told you their horror story of a baby with a “cord wrapped around the neck.” While cord accidents happen (rarely but sadly), the majority of births result in resilient, safe babies. Your team of midwives/ doctors and nurses are monitoring your baby closely to ensure this safe passage. Cords around the neck, called nuchal cords may occur in up to 30% of births. Wharton’s jelly ensures your cord is thick and healthy, protecting the vessels and ensuring adequate oxygenation to your baby in delivery. Imagine a garden hose. Empty of water it is easily kinked. Full of water (or Wharton’s Jelly), it is difficult to kink.
Keep in mind that your provider really wants to honor your birth plan, but sometimes birth doesn’t go according to plan. The safety of your baby is paramount to all else, and if your little bambino is struggling with their first moments on earth, we may clamp and cut the cord immediately which will release your baby to the skilled hands of the neonatal team. Sometimes, a baby is tangled in the cord so tightly, that we need to (double) clamp and cut which will untangle your babe and ensure safe passage. Again, an uncommon scenario – but nonetheless a reason why your provider may not honor your request. Now that’s out of the way, let’s get back to normal….
Delayed cord clamping is a birth practice where the umbilical cord cutting is delayed until after the vessels within the cord stop pulsating. When your baby is born, about a third of their blood is left behind in the placenta. The idea of delayed cord clamping is to transfer that amount of blood back to its rightful owner, your babe.
In delayed cord clamping, babies are handed right to their mothers because they are physically tethered to the placenta which is still inside the mother. For women who want to be skin to skin with their babies, this practice ensures it will be physically impossible for your baby to be whisked away to do measurements or non-emergent practices. The cord usually allows enough room for your baby to be plopped right on your abdomen for their first hello, but not quite long enough for your baby to be at the breast.
While you’re blissed out and spending the first moments with your baby, the cord is thick and pulsating, transferring blood to your newborn. The bulk of your blood transfer “back to its rightful owner” takes about 3 minutes. The average blood volume of a 6 ½ lb baby is about 300 mls. After 3 minutes of cord pulsation, your baby gets an extra 100 ml of blood volume. Your midwife or doctor will feel when the cord has stopped pulsating and has gone limp. This tells us that the transfer has been made and we can clamp and cut.
Benefits of delayed cord clamping / increased blood volume in your newborn are: less chance of anemia in infancy, higher birthweight, longer time spent skin to skin, and faster oxygenation of the newborn at birth. Babies born prematurely can also benefit from delayed cord clamping, though this piece tackles the healthy newborn at term. If your baby’s cord was cut early, studies show no significant differences between rates of postpartum hemorrhage (excessive bleeding after baby is born) between the delayed cord clamping groups and early cord clamping groups.
While there are many advantages to delayed cord clamping, doing so can increase your baby’s risk of jaundice. Jaundice, or yellowing of the skin is a common health condition for newborns. Jaundice can occur when red blood cell’s waste products are not excreted properly (through meconium poops). So, if your baby received extra red blood cells through delayed cord clamping and your baby can’t empty those waste products adequately, your baby may require phototherapy – meaning a prolonged hospital stay. The risk of jaundice is small and benefits of delayed cord clamping may outweigh the risks.
As a midwife, I review a lot of birth plans. Delayed cord clamping is a very common request and is standard at my practice. However, this may not be true in your office and needs to be discussed with your caregiver.
Building your preferences as a new parent is best tackled with 2 parts research and 1 part intuition. There are risks and benefits with all things—even walking across the street. If you’re overwhelmed, take a deep breath, find your village and know in the end, you’ll make the choice that’s right for you and your baby.
- Cord-blood banking
- “Effect of timing of umbilical cord clamping of term infants on mother and baby outcomes“
Emily Darnall, CNM | Natural Beginning
Emily has served women and babies since 2003. She spent most of her nursing career as a neonatal intensive care RN, then transitioned to labor and delivery nursing. Emily discovered her passion for maternal health while caring for babies in need abroad in Romania and Mozambique. Through the pregnancy and birth of her first daughter, she realized her life’s purpose to serve women as a midwife. She is passionate about promoting midwifery to the women of Austin, while providing more choices for women in pregnancy and birth. Emily believes there is no greater example of the mind-body connection than birth and remains in awe of the transformation of women as they navigate their journey to motherhood.
Emily joined our practice in October of 2015 as the Administrative Director of Natural Beginning Birth Center, and also sees patients every Friday. If you are laboring during the day, you will most likely find Emily at your side providing continuous labor support. She is looking forward to transitioning to a full scope midwifery role in 2016. Emily earned her Masters degree in Nursing Administration at the University of Texas at Austin and more recently completed a Masters program in Nurse Midwifery through Frontier Nursing University.