The umbilical cord is a tube-like structure that connects the placenta and the baby. It is the channel in which the baby receives food, nutrients and oxygen during pregnancy. The umbilical cord consists of three vessels - one thick vein, two smaller arteries, and Wharton’s Jelly. That is a jelly-like mass surrounding and protecting the vessels in the umbilical cord.
What is delayed cord cutting/clamping?
It means that the umbilical cord is cut and clamped by an elastic clasp after the delivery of the baby but before delivery of the placenta. The stump will then later dry out and eventually fall off after around a week. The other part of the umbilical cord connected to the placenta is delivered with the placenta.
For many years, it was standard procedure in the United states that the umbilical cord was cut off immediately after the baby came out. Then the baby was handed to mom. All of this usually happens within 30 seconds after delivery. Sometimes this was done to collect cord blood samples from the newborn. With delayed cord clamping, the umbilical cord is not cut right away. Your healthcare provider may wait 1 to 5 min to do so until the cord is white and not pulsating anymore.
When a child is born, the blood is still pumping through the cord. The blood remaining in the cord at birth comes from the child itself and contains oxygen, iron and stem cells, and they are all critical for the child’s development - both at the point they are born and later in life.
Standard procedure to wait at least 3 minutes
In 2008 scientists began to study the effects of clamping the umbilical cord off immediately. They discovered that children subjected to these procedures suffered increased risk for iron deficiency and delays in the development of motor skills both at birth and at 4 years of age. Therefore, delayed cord clamping began to gain popularity. Delayed cord clamping increases the baby’s blood volume and iron stores. Because iron is poorly transferred into breast milk, this extra iron helps prevent anemia. Anemia is a condition characterized by low red blood cell volume. Increased red blood cell count can lead to better development as the baby grows. The benefits are even greater in the premature babies.
There are no negative side effects from waiting more than 3 minutes to ensure that the child has received all the blood it needs. When the pulses have stopped, the cord will also look different. It will become thinner and white instead of thick and purple-blue, unlike when filled with blood. That is where the phrase “wait for white” comes from. Before, it was believed that waiting for too long could cause neonatal jaundice, but studies have shown no such correlation. The amount of blood the child shall have received is around 1 deciliter, which, for putting into perspective, would be equivalent to 5 ounces of blood for an adult. However, the amount of blood the child receives is essential, and the stem cells have a protective effect on
After a cesarean section
It is possible to wait to cut off the umbilical cord even after a C-section, but it will be more challenging to wait as long as you would otherwise have wanted to. Among the surgery team members involved in a C-section, you will find the midwife who can communicate your wishes about it. Studies have shown that the children after a planned C-section have higher blood levels after waiting only 60 seconds without negatively affecting the mother’s blood loss. It is, however, possible to wait for even more than 60 seconds.
Any thoughts you have before the birth you may want to write down?
Think about how you would want to give birth to your child. This is something you have the right to have a word about. When you write the letter it can be a good idea to include the following points as an example:
“I wish pulses in the umbilical cord shall stop before being cut for as long as possible, and be done in the safest way for my child and me.”
“I wish to wait at least 3 minutes or longer before the cord is cut off.”
“In case of an emergency, I wish to wait for as long as possible before cutting the umbilical cord unless it hinders or delays urgent care.”
“My wish is that the umbilical cord is cut after it has become white or the placenta is outside.”
"I wish to wait as long as possible before cutting the umbilical cord during a C-section.”
Sources:
- Lärobok för barnmorskor. Faxelid, E., m.fl. Studentlitteratur 2001.
- Ola Andersson, Judith S. Mercer, Cord Management of the Term Newborn, Clinics in Perinatology, Volume 48, Issue 3, 2021, Pages 447-470,