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Delayed cord clamping

Finally the wider world of maternity care is starting to see the benefits of delayed cord clamping!!  It's not just the midwives who are doing it anymore. Delayed cord clamping is defined differently by different people.  For some, it is waiting 60 seconds after the birth to clamp and cut the cord.  For others, it is 2-5 minutes.  For others, it is up to 10 minutes.  In my practice, this process generally takes over 30 minutes but often 45 minutes or more.  Sometimes the cord is not cut until after the placenta is delivered!  This sounds unreasonable to many people who have birthed in the hospital as the time between the birth of the baby and the birth of the placenta is so rushed and seems so dangerous. In fact, delayed cord clamping is a mutually protective process that is physiologically sound and highly effective.  It provides life support to the baby who must transition to breathing air and it protects the mother from excessive bleeding.




For the baby, it has many benefits:

The baby to receives oxygen continuously via the placenta and cord, even if the baby is not yet breathing well.

The baby receives his full blood volume and avoids hypovolemia.  Approximately 75-100 mL of the baby's blood is up in the placenta at the time he is born; this is equivalent to 1000-1500 mL in an adult!  In other words, if you lose this percentage of blood, you may need a blood transfusion!  Unfortunately, babies often "require" IV fluids or even a transfusion because they are so low in blood volume...this is directly caused by the rush to clamp and cut the cord.

The excess acid that can develop in the baby's blood during the birth process is buffered by the mother's system, which is much more developed and has greater reservoirs of buffering agents than the newborn.  Leaving the cord intact therefore negates the need to get blood gases on the baby.

The baby receives all his own stem cells which prevent later disease and shape his daily health.

The baby is able to transition gently after birth.


For the mother, it has many benefits too:

Excessive bleeding, or postpartum hemorrhage, is prevented in several ways.  This requires a bit of an explanation.  Once the baby is out of the uterus, it is large and flaccid for several minutes and the placenta remains attached normally.  Soon, the placenta begins painlessly contracting down to less than half its previous size.  Then, it begins the painful cramps that squeeze the uterus even smaller, causing the detachment of the placenta from the wall.  When this process is undisturbed, the placenta comes off in one piece, with minimal bleeding.

It is much less painful because the placenta is not being forcefully pulled off the uterine wall and the uterine massage that most women swear is more painful than the birth is unnecessary

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