Delayed Umbilical Cord Clamping and Cutting

When you are preparing for labor and delivery, you will likely have a long list of things you want listed in your birth plan. From the use of pain medications to breastfeeding right after birth, you probably have your entire labor and delivery planned. There is one consideration of delivery that is sometimes overlooked: when to clamp and cut the umbilical cord.

Traditionally, the umbilical cord is cut immediately after delivery and just before the baby is placed on your chest. Recently, however, it has become more and more common for practitioners, especially midwives, to place the baby on the mother's chest, deliver the placenta and then clamp and cut the umbilical cord. The decision you and your practitioner make depends upon a variety of factors. Those factors may slightly alter the benefits or risks.

Benefits of Delaying for Full Term Infants

By waiting as little as one to three minutes after the baby is born to clamp and cut the cord, the baby is less likely to develop anemia because iron stores remain elevated for approximately six months. The risk that the infant will need a blood transfusion is decreased, and the chance of bleeding on the brain is also decreased.

Benefits of Delaying for Pre-Term Infants

Pre-term infants have a unique set of medical needs that can affect the benefits of delayed cord clamping. Some of the potential benefits include a more stabilized blood pressure, decreased risk of lung infections, and a decrease in the number of days a ventilator is needed to support the baby. The pre-term baby may also need fewer blood transfusions and is less likely to suffer from death of bowel tissues.

Risks of Delaying for All Infants

Whether the baby is full term or pre-term, there is a risk that delayed cord clamping can delay resuscitation measures for the baby. This can lead to death and/or brain damage, among other conditions. There is also an increased risk of increased bilirubin, which causes jaundice. The risk of stroke and blood clots is also slightly increased.

Effects on the Mother

There aren't any added benefits for the mother when cord clamping and cutting is delayed. However, the mother may benefit emotionally from being able to hold her baby immediately after birth without having to wait for the cord to be clamped and cut. The only risk to the mother occurs when the mother has a bleeding disorder or when she has lost a significant amount of blood during delivery. In this case, there is a risk that the mother will lose too much blood if cord clamping and cutting is delayed, which may necessitate the need for a transfusion.

Conclusion

The decision to delay cord clamping and cutting is one that must be made depending upon the circumstances of your pregnancy, labor and delivery. Your infant's health must also be considered. Work with your doctor to make the decision that is in the best interest of you and your child.

Sources:
http://news.ucdavis.edu/search/news_detail.lasso?id=7729
http://www.sciencedaily.com/releases/2007/08/070816193328.htm
http://www.empoweredchildbirth.com/articles/birth/noclamp.html