Contributed by Sara Bussandri:
One thing I wish I had known when my first son was born, nearly four years ago, is that waiting at least a few minutes after he was born before clamping his umbilical cord would have given him great benefits. Instead, I did not know any better, and I let the midwife make this decision for me and for my baby.
What is ‘delayed cord clamping’
‘Delayed cord clamping’ means to ‘delay’ the surgical intervention of clamping the umbilical cord at birth – traditionally, this procedure was carried out by midwives within the first 30 seconds after the birth. The definition of this ‘delay’ is still very much subjective and can range from 30-45 seconds or 2-3 minutes, but can also refer to clamping the cord once it has stopped pulsating or after the placenta has been delivered.
The World Health Organisation dropped early clamping from its guidelines about 5 years ago, when this procedure was classed as an unnecessary medical intervention in low risk births. However, there are currently no formal guidelines for NHS midwifes and staff about when exactly the cord should be cut.
Because of increasing evidence from clinical studies and because of an increasing number of women asking to delay cord clamping for their babies, the Royal College of Midwives (RCM) is in the process of formalising new guidelines, which will be delivered at the RCM conference in November this year. Guidelines drawn up by different organisations currently vary in their definition of ‘delay’, and it is still unclear how long midwives will be advised to delay cord clamping for. Most midwives will have to use their judgement in terms of the clinical situation they are facing.
Why wait?
Delaying this medical procedure allows for more blood to be delivered from the placenta to the baby, and this has several benefits:
It allows vital stem cells to be transferred to the baby;
It allows mum and baby to be connected for longer;
It allows for increased levels of iron; and therefore,
It lowers the risk of anemia in newborns, which can negatively affect brain development, and
It lowers the risk of iron deficiency, which affects about a quarter of preschool children globally
The quantity of iron which is transferred from the placenta to the baby is said to be the equivalent to 1-2 months of an infant’s iron requirements!
Any con’s?
Up until a few years ago it was believed that delayed cord clamping could cause jaundice in babies. However, it is now proven that babies are no more likely to become jaundiced by delaying cord clamping, and there is no relation to jaundice and the time of the cord being clamped.
What to do next
Provided that you and your baby are both well after the birth, and no urgent medical intervention is required, when to clamp your baby’s umbilical cord is one of the first decisions you – the parent – should be asked to make for your newborn baby.
Although most hospitals are likely to follow the upcoming RCM guidelines in the next few months and years, hospitals will still be able to decide on their own protocol, so, if you wish for your baby’s cord not to be clamped immediately after the birth, you should inform your birth partner, your doula (if you have one), and the medical staff delivering your baby. The best way to do this is to write your wishes in your birth plan – remember, unless a medical procedure is absolutely necessary for your health or for the health of your baby, this is your choice, so if delaying cord clamping is something that you want for yourself and your baby, make sure you don’t make the same mistake I made, and make your voice heard.
This posting was contributed by Sara Bussandri, a BabyNatal trained antenatal teacher who offers regular classes for expectant couples in Chiswick, Isleworth and Richmond. To find out more visit http://www.babynatal.co.uk or email Sara at [email protected]
Image by: Rachel Carter
