Delayed Cord Clamping
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Wait, or Clamp? And Why?
I hadn’t heard of delayed cord clamping until a pregnant friend asked about my plans for clamping. Plans? I had no plans! In order to make an informed decision on the topic, however, I decided to dive in and figure out what the heck delayed umbilical cord clamping is and whether there are good reasons to clamp immediately or wait a few minutes.
As it turns out, the American Congress of Obstetricians and Gynecologists doesn’t seem to have a strong opinion on delayed cord clamping; it recognizes the general benefit for preterm infants but identifies both pros and cons for full-term infants. Not exactly the quick-and-easy decision recommendation I was hoping for.
After digging a little deeper, I read a few academic publications that reviewed the literature on the topic. One pretty solid review recommends delaying cord clamping for at least 2 minutes.
The purported benefits of delayed cord clamping, according to the review? Better iron levels, lower rates of anemia, and higher (healthy) red blood cell levels. Typical cons commonly associated with delayed clamping (such as higher rates of jaundice and polycythemia) were not significantly increased in cases of delayed clamping among high-quality studies. It is worth noting, however, that the studies included in this review didn’t offer enough information about the risk to the mother (like additional blood loss) from delayed clamping to allow them to make a conclusion about the maternal risk of clamping.
A larger and more recent review performed by the Cochrane Collaboration found similar benefits for infant iron levels but did detect a significant increase in the probability of jaundice. The Cochrane review also found that waiting 2–3 minutes to clamp the umbilical cord had no significant impact on the mother’s likelihood of excessive postpartum blood loss when compared to early clamping.
In general, scientific studies seem to support delayed cord clamping (at least 30 seconds after delivery) for preterm infants, who may be less likely to need transfusions when clamping is delayed.
Making Your Decision About Delayed Cord Clamping
Although this research doesn’t exactly settle the controversy, it does offer some useful information for expectant mothers. There is little indication that a small delay can cause any harm, and there is strong evidence supporting some potential benefits to a brief delay (at least 30 seconds, up to 3 minutes).
If you carry full-term, discuss clamping options with your midwife or obstetrician before delivery. Some practitioners routinely delay cord clamping, while others routinely cut the cord within 20 seconds of delivery. Consider filling out a written birth plan template to help organize your delivery decisions. Make your preferences clear, and make sure your doula, partner, or labor support person is aware of your choices.
Regardless of what you decide, you can rest easy with the knowledge that in most cases, your decision about cord clamping is unlikely to make a large impact on the health of your baby. If something happens during delivery that prevents your preference from being followed, don’t sweat it—healthy babies are possible (and common) with either method!