Delayed Cord Clamping
Lets chat delayed cord clamping! It is one of the birth preferences I love to talk clients through when it comes to making their birth plan as it has some incredible benefits to your baby and can be facilitated in a vaginal birth, induction and in a caesarean birth.
What is delayed cord clamping?
Delayed cord clamping is when you delay clamping the cord (which is attached to your baby and to the placenta) to allow for the blood in the placenta to transfer back to baby (placenta transfusion). Allowing the cord to completely turn white will allow the maximum amount of blood in the placenta to transfer to baby providing baby with their full blood volume and will circulate in the lungs supporting and aiding breathing. If you would like to watch a demonstration, Dr Rachel Reed has a great video that demonstrates this!
Delayed cord clamping has only been in place since 2015. Prior to 2015 the cord was clamped immediately once baby was born as it was believed the blood was escaping from the baby.!
What are the Benefits of Delayed Cord Clamping?
Firstly, the baby would benefit from all the blood which can be up to an additional 30% more blood which could provide your baby with:
Higher Iron levels which is essential for infant brain development
Increase baby’s weight which could be particular beneficial for pre-term babies
Receiving their full quota of stem cells which are building blocks for their future
Higher haemoglobin concentration (more oxygen in the blood)
Improved fine motor skills of children age 4.
There are also benefits for you, such as:
May help to minimise pain from sutures if required post birth
Reduction in estimated blood loss post birth
Reduced hospital stay
What are the risks of Delayed Cord Camping?
We've discussed the benefits , lets discuss the risk. Studies have shown that there may be a small increase in level of jaundice however the study also had some bias in the groups so they would need to be studied further.
How long does delayed cord clamping take?
WHO suggests 1 minute before clamping withm Most NHS trusts policies for delayed cord clamping is for 3-4 minutes however, it can often take much longer.
image from Wait4White
How long it will take, will depend on lots of different reasons, the babies breathing/crying, the size of the baby, length and position of the cord (if baby is higher up then the placenta, for example on the chest for skin to skin it can take a little longer as it is pumping upwards) and weight of the baby (around 90 ml per blood per KG for a baby at full term with a third of that blood remaining in the placenta for transfusion). Therefore waiting for white as opposed to time is more optimal as length of time will vary from baby to baby as above.
Can wait for white be facilitated in all births?
Absolutely, even in a caesarean birth waiting for the cord to be turn white can be facilitated. During a caesarean birth, the trust can easily facilitate the removal of the placenta and bringing baby towards you for skin to skin as soon as possible so that it allows time for the cord to turn white.
Immediate skin to skin can still take place however it will depend on the length of the cord and may have to wait for the placenta to be removed to bring baby up to you (to avoid any pulling of the cord). Sometimes in a gentle caesarean which is a longer process to allow are more gentle birth may result in the cord turning white before baby is brought to you after removal of the placenta. It may mean baby is resting on your legs whilst the placenta is removed.
There may be some situations that clamping of the cord may need to be done before the cord turns white if baby requires resuscitation or is slow to initiate breathing or there are any emergency concerns with the parent. Keeping the cord attached to allow the blood transfusion to complete will circulate the lungs helping baby to breathe which is so important especially if the baby is slower to initiate breathing (which is more common in water births) and Rachel suggests are more wait and see response if baby is slower to initiate their first breaths. You can read more about the amazing transfer process here on Dr Rachel Reed’s blog post. It is absolutely incredible!