‘Optimal cord clamping’

Childbirth educator ROSEMARY JOYCE shares why cord clamping and when to cut the umbilical cord needs careful, informed consideration when making your birthing plans.

Birth is a momentous occasion in a baby’s life, as their circulatory system changes from one that is completely dependent on Mum, to one that is fully independent. And yet many families and health-care providers are unaware that a simple decision made in this moment has a significant (and sometimes life altering) impact on the health and wellbeing of their little one.

Numerous studies now show that choosing to leave the umbilical cord intact for a period of time (as opposed to immediate cord cutting at birth) offers huge benefit to a newborn, both at birth and long term. For example, research published in 2014 showed a baby whose cord is clamped and cut in less than 60 seconds after birth is over twice as likely to be iron deficient at 3-6 months versus a baby whose cord was clamped and cut later. 

Ironically, this ‘optimal cord clamping’, as it’s now called, was the norm until the middle of last century, when early clamping became popular with the introduction of active management of the third stage (the birth of the placenta) to lower the rate of hemorrhage after birth.

However, English physician Erasmus Darwin said, back in 1801, that the cord should be left intact until it stops pulsing, as clamping the cord too soon is “very injurious” to the infant and will leave them weakened.

Yet, somehow, immediate cord clamping and cutting became the gold standard in healthcare during the 20th century, and is still common practice in many hospitals worldwide. This practice can leave behind as much as 50 per cent of a newborn’s total blood volume in the placenta. It also severs baby’s connection to their natural ‘life pack’ (the placenta), which is designed to perfuse baby’s tiny organs with blood while their circulatory system changes over.

If you are expecting a baby, you are able to make an informed decision about if or when you would like your baby’s umbilical cord clamped and cut. Optimal cord clamping is an option in most circumstances – including caesarean birth, premature birth and with babies who require some resuscitation. In fact, it is even more crucial for infants whose births have deviated from normal because of the support the placenta offers them while they get breathing established.

Rosemary Joyce is a childbirth educator and doula, and has worked as a registered nurse for over 15 years. She created The Birthing Room in 2013. thebirthingroom.co.nz