After your baby has been born the umbilical cord, which links your
placenta to the baby, continues to pulsate and transfer blood and oxygen
and stem cells to your baby until baby has transitioned to life outside
the uterus and becomes stable.
Cutting the cord immediately after the birth has been routine practice for 50-60 years but more recently research is showing that it is not good for the baby as it means the baby misses out on a large amount of blood (214g). This has led to more recent changes in guidelines and practice towards delaying clamping. Waiting until the cord has stopped pulsating and becomes white is becoming increasingly normal practice in births where there is no medical reason to speed things up.
Normally the doctor/midwife should be able to feel when this happens by just touching the cord. If there is a reason why time cannot be allowed for this, then the midwife or doctor waits 1-3 minutes following the birth of the baby before clamping and cutting the cord.
SOGC guidance recommends that cord clamping is delayed in all maternity units for at least 1 minutes in all babies unless the fetal heart is less than 60 bpm and not getting faster, at this point, for practical reasons, the baby may need to be taken away to get breathing support.
Delayed cord clamping allows the blood from the placenta to continue being transferred to the baby even after they are born. This means that the baby could receive up to 214g of cord blood, which is about 30% more blood than they would have without it.
The benefits of this include:
Babies who have immediate cord clamping (particularly boys) have also been shown to be more likely to:
In most situations DCC is extremely beneficial. However there are a few circumstances in which it may not be suitable, such as:
If the baby needs help with breathing (resuscitation) the cord may need to be clamped early if there are no facilities in the hospital to do this beside the mother, however it should be possible to delay cord clamping while the baby is assessed and the breathing support starts.
DCC is a natural and physiological process where the cord blood is transferred to the baby with no assistance from health professionals. ‘Milking’ the cord occurs when the midwife or doctor push the blood through the cord so it is transferred more quickly. It is a safe technique but it usually only happens if there is a need to speed this process up, most commonly if the baby needs help with their breathing.
Yes, you can add DCC to your birth plan, particularly if you know you are at risk of having a premature baby or if you are having a planned caesarean section. Although most units should be practising it, it is taking longer for it to become ingrained in usual practise and the more women who open up the conversation about it, the more usual it becomes.
Cord clamping and having a premature babyDCC has been shown to have lots of benefits for premature babies or babies of a low birth weight. These include:
If you know you are at risk of having a premature baby, you can put Delayed Cord Clamping on your birth plan and discuss it with your health care team.
DCC can still be practised if you have a caesarean section, whether it is planned or an emergency and is becoming very common practice at hospitals which recognise the benefits of delayed cord clamping. Do talk to the health professionals caring for you about this. Including it in your birth plan will give you an opportunity to talk about it.
Yes, even with the injection it usually takes at least 5-10 minutes before the placenta is delivered and during this time the cord can remain intact allowing for the transfer of the blood.
It is possible to help your baby with the cord remaining intact. In fact, it has been shown that babies have better outcomes if their cord is left than if it is clamped and cut quickly after the birth. Some hospitals have equipment to allow breathing support to happen without having to cut the cord.
Some small studies have shown that DCC can slightly increase the chance of baby have a higher level of jaundice but strong evidence shows that the benefits of DCC outweigh this.
Jaundice is very common in newborn babies and usually does not need treatment however a small amount of babies may need phototherapy to help them get rid of the jaundice (no matter when the cord was clamped).
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