One thing pregnant women have in common is that they want only the best for their baby. This is why they spend so much time researching every option they have during pregnancy and the delivery process. All sides are carefully weighed in order to make the best possible decision.
If expecting, then you know the latest buzz topic is delayed cord clamping. Everyone wants to know what it is, the pros and cons, and whether or not they should participate. Like anything else, there are people supporting both sides.
What is it? Americord defines delayed cord clamping as the practice of waiting to clamp and cut a newborn baby's umbilical cord until after the placenta is delivered. Instead of cutting the cord after birth, you ask your doctor to wait until your baby has received additional blood from the placenta.
That's all fine and dandy, but now I need to know why someone would consider doing it. Is this something I should be thinking about doing for my baby?
There is a lot of research being done on delayed cord clamping right now. Studies are looking at the benefits for the child, the mother, and even on long term effects. Some of these studies are working do provide validation for or against the various concerns and red flags that have been put up. As a pregnant woman, you need to take a look at it all before making a decision.
So let's dive into the details and see what each side has to say.
14 Pro: Extra Blood From The Placenta
The function of the umbilical cord is to provide your baby with nutrients and blood from the placenta. In a typical birth, the cord is clamped within minutes of a baby being born. Clamping the cord stops the blood flow between the baby and the placenta. It essentially allows the baby to begin supporting itself completely. One of the reasons experts are telling Mom's to consider delayed clamping is because halting that blood flow too early actually reduces the total supply of blood inside the baby's body.
By delaying the clamping of the cord, it can increase total blood supply by up to 33%. That means more red blood cells, antibodies, and nutrients. This can provide a lot of benefits to the baby as they transition from the womb to the outside world. As a Mom, that is huge! It helps to ensure you start your baby off on the right foot.
13 Con: Cord Blood Banking
There has long been a concern that a mother cannot choose to both delay clamping of the cord and collect cord blood for storage. Depending on the amount of time that passes prior to clamping, there may not be enough blood left following the placental transfusion. There is approximately 200 milliliters of blood in the placenta and umbilical cord at the time of birth. It's necessary to have a minimum of 50 milliliters of blood to bank cord blood. That blood is not collected until after the cord has been cut.
The various stem cells collected are able to develop into many different types of cells. This is important for treating diseases later in life. The cells can also treat the mother as they are a perfect genetic match. There is so much value in cord blood collection that mothers worry if a mistake is made, they may not have enough blood left to bank it.
12 Pro: Increases Iron Intake
With the increase in blood flow gained during delayed clamping of the umbilical cord, there is an increase in iron intake. Iron is an important nutrient for both pregnant mothers and their babies. It's found in both prenatal vitamins as well as formula. Iron is a natural mineral found in the blood and is necessary for proper, normal brain development and growth. It's also required in order for your body to make hemoglobin.
Hemoglobin is the protein in red blood cells that carries oxygen through your blood stream. When there are low levels of hemoglobin in the blood, a condition called iron deficiency anemia occurs. When this happens, your body produces smaller red blood cells, which in turn do not provide adequate oxygen levels to the rest of the body. Low levels of iron can delay a baby's ability to walk and talk. If not treated, it can cause longer term behavior and mental problems.
11 Con: Delay Of Skin-To-Skin
Every pregnant mother has read about the benefits of immediate skin-to-skin following birth. Stability for both the baby and mother is noted. The baby shows signs of steady respiration, temperature, and glucose levels. There is less stress and the baby will calm faster and be happier. The bonding process can begin, which will form the attachment between mother and baby. For those mothers that plan to breastfeed, studies have shown immediate skin-to-skin will help encourage a baby's natural instinct. It will also increase the mother's confidence helping them to breastfeed for a longer duration of time.
There is even evidence that these first moments of birth can form negative effects that the baby will remember and set the stage for their life. During delayed cord clamping, skin-to-skin is typically delayed to allow for the placental transfer to take place. A mother must weigh the pros and cons. This is an important part of the birthing plan to discuss with your doctor.
10 Pro: Improves Development
There are many studies being done to look not only at short term effects, but long term effects related to delayed clamping of the umbilical cord. A study by Swedish investigators found a measurable difference as they looked at long term effects. Their focus was specifically on 4-year old children. They published findings from their clinical trial in JAMA Pediatrics. What they found was an increase in fine motor skills and social skills when comparing those that delayed clamping and those that did not. This increase was noticed in the male participants.
Improved development can be attributed to the increase in iron mentioned earlier. That will help to ultimately boost brain development. Another area of concern that is being studied is related to autism. According to Autism Speaks, there have been questions as to whether or not premature cord clamping causes or contributes to autism. Either way, two things that point towards benefits of delaying clamping.
9 Con: Risk Of Postpartum Hemorrhage
There is a lot happening in the delivery room during the third stage of labor. A lot can go wrong and the doctor must be well equipped to manage this stage closely for the health of both mother and baby. Postpartum hemorrhage is the leading cause of maternal mortality in pregnancy. It essentially means too much blood is lost during the delivery process. While it's normal to lose blood during the delivery process, certain conditions and circumstances can increase the amount lost and be cause for concern.
Early clamping of the umbilical cord decreases this risk. The reason is that most of the blood loss occurs as the mother delivers the placenta and it breaks away from the uterus. Those open blood vessels will bleed. The timing of clamping the cord can impact the way the placenta breaks away from the uterus. Therefore, it can play a role in the amount of blood loss.
8 Pro: It's Fast And Easy
There is a lot of controversy over the exact amount of time that should pass prior to clamping the cord. You will want to discuss this with your doctor as it will depend on your health and the health of your baby. However, most research shows the sweet spot being between one and a half to three minutes. The process entails simply keeping the baby connected to the placenta, without clamping the cord, either until the pulsations in the cord cease or until the placenta is delivered.
This process where blood is transferred back to the baby is referred to as placental transfusion. It is a natural part of the birthing process. The blood inside the placenta is not a waste or "extra" blood. It is blood that belongs to the baby. This simple, quick process will allow the baby to collect what belongs to him/her. Once complete, the cord is clamped and cut. Same as with any other birth.
7 Con: Increases Risk For Jaundice
According to the American Pregnancy Association, there is an increase in jaundice among the babies that delayed umbilical cord clamping. Jaundice is the yellowing of the skin or whites' of the eyes that occurs within the first few days following birth. It's attributed to an increase in bilirubin levels in the body (a brownish yellowish substance found in bile that is produced as the liver is unable to fully break down red blood cells). This increase is due to the baby's liver not functioning efficiently enough.
While jaundice is considered common, it must be monitored very closely. Phototherapy treatment is sometimes necessary. It's administered by placing the baby inside a warmer with a special light to help break down the bilirubin in their blood. In more severe cases, a blood transfusion is required. Parents must weigh this concern and the health of the baby in order to determine what risk exists.
6 Pro: Mom And Baby Stay Connected
There is some research out there that suggests clamping the cord too soon can disrupt the natural birthing process. It stresses the importance of keeping the baby and the placenta connected for a longer period of time to allow for nature to complete the job of circulating blood to the newborn. The World Health Organization states the “optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased, and the cord is flat and pulseless (approximately 3 minutes or more after birth).”
This in turn keeps the baby connected to it's mother for a longer period of time. Allowing this unit to stay intact can reduce complications while the doctor delivers the placenta. Some say this enhances the bonding process, and provides more necessary support to the baby as it transitions out of the womb.
5 Con: Diabetes And Other Blood Conditions
There are certain conditions found in the blood that can be cause for concern when considering whether or not to delay clamping of the umbilical cord. One of these is polycythemia, which is a blood cancer. Another is hyperbilirubinemia, which is related to bilirubin in the blood and the poor breakdown of red blood cells. While these are going to be rare cases, they are mentioned frequently in the research. Not a lot of research has been done to rule out all of their negative effects.
Then a more common condition, one that impacts a much larger number of women, is gestational diabetes. Even diabetes in general. There are still a lot of unknowns at this time how delayed cord clamping impacts it. Many doctors recommend that women with gestational diabetes (or uncontrolled diabetes) opt out of delayed cord clamping entirely. These situations should be discussed in detail with your doctors.
4 Pro: Increases Oxygen To Organs
Prior to being born, the placenta and the baby share a circulating blood supply. This keeps their blood separate from the mother. While in the womb, the baby needs very little blood supply as life is sustained by the placenta. As the baby transitions, that all changes. Remember the increase in iron that was necessary for the hemoglobin production? Hemoglobin in our red blood cells carry oxygen in our blood stream out to the rest of our body. That oxygen feeds all of our organs.
As the baby is born they take their first breath, and they begin using their lungs. This extra boost of oxygen can be vital as they begin crying. The rest of their organs begin to function on their own and the required blood supply and oxygen need increases significantly. The more red blood cells carrying oxygen through the blood the better support the baby will have through that process.
3 Con: Past Practices
Many people are rooted in their history. They are most comfortable with things they know versus venturing out of their comfort zone. They believe that it has always been done this way so why change it? This may especially be the case if this pregnancy is not their first baby. There is a feeling that their other kids didn't have delayed cord clamping and they're just fine. Based on that, they don't see the need to make a different choice this time around.
Other people may just choose to disregard the research and let their doctor make the decisions. In this instance they trust their doctor to do what's right. They assume since their doctor does this for a living, they know what they are doing and have our best interests at heart. Regardless of what anyone else thinks, these are valid choices. It is entirely their decision.
2 Pro: Added Benefits Of Stem Cells
Stem cells are cells that have the ability to create other types of cells and repair the body. No other cell in the body has that ability. This is why they are being studied, though their use is still very controversial. They are used medically in cell based therapies to assist with treating certain diseases and boosting the immune system. Embryonic stem cells are readily available in the placenta blood.
This is why cord blood is collected and saved for future use. Delayed clamping of the umbilical cord allows for more of these cells to pass into the baby's blood supply at birth. The theory here is that if stem cells are good, more stem cells in the blood should be better. This is especially true for NICU babies, i.e. those born early or with health conditions. The thought is if delayed cord clamping can provide additional benefits to help, why not give the baby every resource available to it?
1 Con: Certain Doctors Don't Do It
Some doctors are old school. Even though the World Health Organization, the American Pregnancy Organization, and the Association of Obstetrics and Gynecology all talk about the benefits, there are still a large number of doctor's not doing it! If mothers are doing their own research and making decisions on the topic, that tells me it isn't common practice at all. As a birth plan is created, there are always topics that must be discussed with the entire team that is delivering the baby. This includes both ahead of time in the office and at the hospital the day of delivery.
Regardless of the research and wishes, there are times a doctor just may not agree with your request. This is a good reason to do your research early in your pregnancy. Have conversations early in the process. If you and your doctor do not see eye to eye on the things you are most passionate about, you will have time to find another doctor if necessary.