03/01/2022
When I was first attending births in 1984, the obstetric model was to cut the umbilical cord immediately after birth and take the baby away for evaluation and a first bath. This was based on the belief that placental blood flow would increase birth complications for babies.
Even back then, we midwives knew to do it differently - we waited until the placenta stopped pulsating - 10 or more minutes -- before clamping and cutting the cord. Baby’s did great, placentas came out readily, and all was good - even if our methods were considered silly by doctors.
Times change, science has caught up. The midwives were right. We now know that immediate cord cutting, unless there’s a medical emergency that requires it, is not recommended. The American College of Obstetricians and Gynecologists now recommends a delay in umbilical cord clamping for at least 30–60 seconds, and the WHO recommends 2-3 minutes.
The benefits of waiting include:
❣️ Transfer to baby immunoglobulins and stem cells, essential for tissue and organ repair
❣️ Extra iron, which has been shown to prevent iron deficiency in the first year of life
❣️ Possibly reduced risk of hemorrhage and easier placental delivery for mom
While jaundice can develop from delayed cord cutting due to this influx of blood, this type of jaundice is not usually a medical problem. Baby will naturally clear this excess iron with pooping. Your midwife or pediatrician will keep an eye on baby over the first few days to make sure it’s clearing. However, the benefits of delayed cord cutting are more beneficial for baby than the risk of this jaundice.
Unfortunately, immediate cord clamping/cutting are still common practice in hospitals. You have to let your midwife or doctor know that you want to wait, with baby tummy to tummy on you, while you do. I recommend bringing this up with your care provider in advance to ensure that they are on board to do ‘delayed cord clamping and cutting’. Get specific with exactly how long you want baby to be connected to the placenta. Unsure how to advocate for yourself? Want guidance on pregnancy, birth, and newborn care? Join the Mama Pathway for all the support you need to be in the know. https://www.facebook.com/groups/ideservebirthsupport/
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