"Many women have described their experiences of childbirth as being associated with a spiritual uplifting, the power of which they have never previously been aware...To such a woman childbirth is a monument of joy within her memory. She turns to it in thought to seek again an ecstasy which passed too soon."

Grantly Dick-Read

Wednesday, February 24, 2010

delayed cord clamping

what is delayed cord clamping?

delayed cord clamping is the process of waiting until the umbilical cord stops pulsating (approximately 5 minutes) and/or waiting until the placenta is delivered (approximately 30 minutes) before the cord is cut after the baby is born.

in today's hospitals, most OB's and some midwives routinely clamp and cut the umbilical cord almost immediately after delivery (about 30 seconds). why? what are the benefits?

after researching, the biggest benefit i can see is that it is convenient and a routine. it is not necessarily harmful, but why not wait to cut the cord?

“The cord is often cut immediately, but a recent scientific analysis has found benefit to waiting for at least two minutes or until it stops pulsating—in five minutes or so.  Less likelihood of anemia for as much as six months exists in babies whose cords are cut late.  Until the cord is clamped or stops pulsating, blood passes back and forth between the baby and the placenta.  It goes from placenta to baby when ever the uterus contracts, squeezing blood from the placenta through the umbilical cord to the baby.  Between these contractions, with each beat of the baby’s heart, blood is pumped from the baby through the umbilical cord and back to the placenta.  This transfer stops when the cord is clamped or stops pulsating, which occurs when the blood vessels close down.  The best way to make sure that the baby has the right amount may be to place the baby on the mother’s belly and wait for the cord to stop pulsating.  Exceptions to this are when the baby needs immediate medical attention, when the cord is tightly wrapped around the baby’s neck, preventing delivery, and when you have decided on cord blood removal and storage.”

- Penny Simkin, author of The Birth Partner

there are some risks associated with clamping the cord early:

"Newborn anemia, respiratory distress leading to brain damage and/or death (rare, yes, but it happens), inadequate blood supply resulting in a need for transfusion, possible heart defects resulting from problems closing off the hole in the heart valves following birth. There are a few doctors now theorizing that the rise in autism is due to brain damage caused by early cord clamping.

"Early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change occurs at no other time in one’s life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns."

info from here.

these risks may not be extremely common (other than newborn anemia) but through researching, i feel that delaying clamping the cord is an extremely smart option because it allows the baby to receive so much more blood and oxygen. and really, if there is no danger to the baby or the mother, why not just wait 5 minutes to cut the cord? of course, this is something you need to discuss with your care provider and if you truly feel that delaying cord clamping is what you want to do, advocate for that to happen because i can guarantee you, if you are birthing in a hospital, the cord will most likely be cut quickly after birth. so, make it happen if that is what you feel is best!

i believe delaying clamping the cord also allows extra time to have that special bond. the baby was inside of you for 9 months, it is probably such a shock to come out and all of the sudden be quite literally cut off from you, the mother. perhaps it is gentler to take things slowly. just a thought.

this is just a very short overview of delayed cord clamping. if this is something that interests you, please educate yourself about it. here are some great resources to get you started:

http://nursingbirth.com/2009/05/17/the-deal-with-delayed-cord-cutting-or-%E2%80%9Chey-doctor-leave-that-cord-alone%E2%80%9D/
http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/
http://www.whale.to/a/butler7.html

3 comments:

  1. In my hypnobirthing class, we were taught a little more of the history behind early cord clamping that makes a lot of sense. A century or so ago, they started giving narcotics to women during birth for the pain. (Which is a vast improvement to letting them suffer in fear and pain because, well, they're only "women" [scorn]. Original sin, remember?) Because they didn't want the narcotics to get into the baby's bloodstream they waited until the end of labor and gave it to the mom just before the pushing stage. So she could at least have a pain killer during the ring of fire. But they also realized that narcotics move quickly through the bloodstream and that, so long as the umbilical cord was still attached, the drug-laced blood would still quickly get into the baby. So, to prevent the baby from being born with narcotics rushing through the blood, they would clamp the cord ASAP. Which, I'll be honest, I'm grateful for.

    Now doctors clamp cords early because it's tradition. It's what they've always done. Thus, that's the way it should be. Most doctors have no idea why they started clamping cords; they just know that it happens, and so it must happen for a good reason. And let's put it in perspective here. It's not that the doctors are willfully ignorant, but rather, a doctor has to learn an awful lot of stuff. They can't know everything, so some things they just have to take for granted and assume that it's tradition for good reason.

    Anyway, just thought you might be interested in why they started doing it.

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  2. thanks tianna! i had read that actually but didn't include it in this post because it was just a quick overview, but i should have.

    it was definitely a good thing to start clamping the cord, i agree. and i also agree that they can't know or do everything because they learn SO much so that's why it's so important for us to be educated so we can have them do things like that if that's what we want!

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  3. This is a great post, Kami. I wanted to add that for women who are interested in donating or saving cord blood, you can most likely still do that if you delay cord clamping.

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