Cord Clamping: The evidence & your options
I really want to delve into the WHOLE third stage of labour, but I feel like I need to separate it. So here we are looking at cord clamping first. It is really so vital to know this info - especially if you have a baby pre term (before 37 weeks) and even in a caesarian birth - there are more options than you think - and care providers are not always forthcoming with their “policies”.
There are three sets of timing that are used by care providers
Early Cord Clamping
Clamping within a minute of birth. This is pretty old school, and yet it is what we see in movies and probably imagine what happens in birth. When a cord is clamped within a minute of birth, you have the potential to leave up to half of the baby’s blood volume in the placenta. It’s well known and should be common practice to wait at least 1 minute before clamping and cutting the cord, even in an emergency. If the baby is attached to the pulsing placenta they are still getting oxygen from mum - so even in resuscitation situations, this is beneficial. Adding to that, a good care provider can provide resuscitation to babies wherever they are in the small chance that this is required.
Delayed Cord Clamping:
Clamping within 1-3 minutes of birth. This is what the World Health Organisation recommends in their guidelines - stating that it should be standard in all births, even caesarean birth and preterm birth. Some benefits include: 61% reduction in severe anaemia, 59% reduction in the rate of intraventricular haemorrhage in preterm infants, 62% reduction in the rate of necrotizing enterocolitis among preterm babies, 29% reduction in the rate of neonatal sepsis for preterm infants, 52% reduction in the rate of blood transfusions for low blood pressure among preterm babies.
Wow. Just wow! Something so simple as waiting a couple of minutes can have this amazing effect on a baby - care providers should be discussing this with women!
Optimal Cord Clamping:
Clamping and cutting the cord after the cord is white and clear of blood means that your baby has gotten all of the blood from the placenta. This means your baby will have all the benefits of delayed cord clamping, plus more. Babies that receive their full blood benefit also receive their full quota of stem cells, which are the building blocks for the future well-being of the infant. Cords can be clamped and cut after the placenta is delivered, or not at all. Some mothers like to have a Lotus Birth, where the placenta is birthed and kept until the cord naturally falls away from the baby. This can take up to 15 days to happen.
There is often no reason to cut the cord immediately even if you have a medically managed placenta delivery - though it is usually offered as a package. The discussion of cord clamping definitely needs to happen with your care provider during pregnancy, and make sure your birth partners know your choice as well. That way while you are busy bonding and getting to know your new baby, they can all advocate for your choices and know your reasons why. Stay tuned for the next blog: I’ll dive into your options for supporting physiology or medically managing the birth of your placenta.
Britt xx
Resources and further research:
The Midwives’ Cauldron Podcast S03 E05: Placentas & Cord Blood
https://midwifethinking.com/2016/04/13/the-placenta-essential-resuscitation-equipment/
My name is Brittney Blakeney and I am a Pregnancy, Childbirth and Postpartum Doula, with an emphasis on education and preparation for your birth experience as a woman and mother.
My job is to give you the most up to date research so that you can make decisions with confidence, and to give you the tools, techniques and encouragement to feel calm, safe and supported during your pregnancy, birth and postpartum journey. I aim to create villages around women to ensure they feel strong, supported and listened to as they transition to their new role.
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