All About Delayed Cord Clamping

Ever heard the phrase ‘wait for white’?
That term is all about delayed cord clamping (DCC), which you may have heard of since it’s becoming much more widely done. But just in case you haven’t, it’s the act of waiting to clamp and cut the umbilical cord after baby is born. (White being the colour the cord is after it’s drained of blood.)
The umbilical cord is the life line that connects the baby to the placenta (the wonderful organ that we grow in our uteri, which provides oxygen & nutrients to baby, while removing waste products from their blood).

After baby is born, it takes up to a half hour for the placenta to be born (the third stage of labour).
It used to be common practice to cut the umbilical cord pretty much immediately after baby was born, believing that delaying the clamping or cutting of the cord would cause newborn jaundice (which is when baby appears yellow due to excess of bilirubin that their liver can’t properly filter out).


That was, until research studies started to question this practice.

Look at that beauty of a cord! Photo by  Esther Edith

Look at that beauty of a cord! Photo by Esther Edith

Studies have shown that delayed cord clamping showed no increase in bilirubin levels.
In fact, there are actually very many benefits that come with DCC!
(Most of the resources I used I will either link to in this post, or they are from the amazing, comprehensive book ‘The Birth Partner’ by Penny Simkin.)

Benefits of DCC

-Because the size of the placenta diminishes as the blood drains from placenta to baby, delivery of placenta occurs sooner.

-Baby continues to receive oxygen until the umbilical cord stops pulsating, which is especially helpful in babies who are slow to start breathing.

-The increased volume of blood circulating to baby’s lungs speeds up optimal respiration.

-Iron stores increase by as much as 45%, and anemia is less likely to occur in baby for as long as 6 months.

-Very premature babies are less likely to need blood transfusions, and have reduced incidence of intraventricular haemorrhage (bleeding in the brain) and late-onset sepsis (infection in the blood).

The blood in the placenta totals approximately 150 ml, which is about 1/3 of baby’s total blood volume. Until the cord is clamped, or it stops pulsating on it’s own, this blood is transferred to baby. This raises baby’s red blood cell count by about 60%, while staying in the normal physiological range without any harmful effects.

The best way to make sure baby has the most blood is to place baby on mother’s belly right after birth and wait for cord to stop pulsating (this is also a great time for them to try the breast crawl!).

When to cut the cord?

The World Health Organization (WHO) recommends waiting 1-3 minutes after birth to cut the umbilical cord. Anything less than 1 minute is less than ideal. It is equally important for cesarean births to delay cutting the cord.

The umbilical cord stops pulsating around 5 minutes, so it’s not like you have to wait a crazy long time with your baby still being attached. (Unless however you are doing a ‘lotus birth’, in which you leave baby connected to the umbilical cord & placenta until it falls away naturally a few days later.)

Exceptions

Like with most things in life, there are a few exceptions to the rule.

In the case of DCC, the only time it is not recommended, and instead immediate cord clamping should occur, is when baby is very ill & requires immediate medical attention, and when the cord is wrapped too tightly around baby preventing delivery.
(Also, if you are planning on storing baby’s cord blood for banking.)

Just in those few instances is DCC not a viable option. Even in mothers who are HIV+, DCC is recommended. The benefits of delaying the cutting of the cord outweigh any theoretical risk. HIV+ women should already be receiving antiretroviral (ARV) drugs to prevent transmission of HIV+ blood to baby.

There is also no statistical evidence to suggest that DCC increases postpartum haemorrhage.

Lovely image by  Monet Nicole

Lovely image by Monet Nicole

What it comes down to is that delayed cord clamping is a safe and beneficial act the majority of the time.

Most care providers will probably follow the WHO’s guidelines, and wait 1-3 minutes to clamp your baby’s cord, but like I always say, knowledge is power & YOU are in charge of your birth.
Write it in your birth plan that you wish to delay your baby’s cord clamping, and tell your health care provider! Make sure that they know and understand your wishes. Also, having a doula on your side helps too ;)

Did you delay your baby’s cord clamping? Let me know in the comments below!