Benefits of Delayed Cord Clamping

Mar 01, 2021

Written by Maria Chow

Wow, you did it! Your baby was just born. Wait! Please don't cut the cord. It hasn't finished pulsating yet. Your baby needs a few minutes to complete the birth process and receive all of its blood from the placenta. This process is super important. Watch today's video to discover the benefits of delayed cord clamping and why it's so critical and how delayed cord clamping can save lives.

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If this is our first time meeting, my name is Maria Chowdhury, and I'm a midwife-herbalist. As a midwife, I've helped hundreds of babies be born safely at home, and as an herbalist, I created Birth Song Botanicals to serve women and children world wide.

The Baby and The Placenta

Let me show you how much blood is retained in the placenta when we cut the cord immediately.

The baby and the placenta are connected. The placenta is the baby's protector and lifeline. The baby and the placenta share blood circulation. The mother has her own circulation. The blood in the placenta is actually fetal blood. The amount of blood in the baby and the placenta is 450 mL. At birth, 2/3 of the blood is in the baby's body, (300 mL) and 1/3 of the blood is in the placenta (150 mL).

Let me give you a comparison for you to understand the significance of this better. The 150 mL of blood in the placenta seems small until you compare the size of a newborn to the size of an adult. If an adult suddenly did not have 1/3 of their blood, it is like not having 1000 mL. That is 4 cups of blood. It is considered a hemorrhage to loose 4 cups of blood. Hemorrhage results in feeling faint, rapid heart rate, difficult breathing, and unable to concentrate or think clearly. In other words, you may go into shock.

When we cut the cord immediately after birth, that means that 1/3 of the baby's blood volume is still in the placenta and cannot transfer into the baby's body. That means that the baby does not have all of its oxygen, blood volume, hemoglobin, or T Cells.

Delayed Cord Clamping

If we wait and allow the baby and the placenta enough time to complete their exchange process, the baby can have all of its fetal blood and has a much better time acclimating to life outside the womb.

Babies who receive all their cord blood have higher birth weights, better color, higher Apgar scores, have more time if they need to be resuscitated because they are still receiving oxygen via the umbilical cord. They also have higher hemoglobin levels that support higher iron levels lasting until they are 6 months old. The benefits of delayed cord clamping are immediate and long term.

For a long time, doctors thought that immediately clamping the cord would lower bilirubin levels and prevent jaundice in newborns. The medical community now understands what midwives have always known, that yes, delayed cord clamping does increase bilirubin levels. It does not, however, lead to problematic or pathologic jaundice.

For term babies that need to be resuscitated, delayed cord clamping allows more time for the resuscitation process to occur. The baby is still receiving oxygen through the placenta. You can leave the cord intact and provide care to the baby, instead of cutting the cord and taking the baby to the warmer to work on the baby. It is possible to keep the cord intact and work on the baby close to the mother.

For or those of you having a hospital birth, it's essential to discuss and honestly insist on delayed cord clamping as a part of your birth plan. As you just saw, it is crucial to allow 3-5 minutes for the cord to pulsate and transfer the fetal blood to the baby.

When we all insist that delayed cord clamping is a part of our birth plan, that is how we create change and improve hospital protocol, and ultimately that is how we improve birth and save lives. This is something that is evidence-based birth and within our ability to influence.

Delayed cord clamping

Photo credit Doctor, Adhi Arya

Let's take this one step further, and instead of watching the clock for 3-5 minutes, let's watch the umbilical cord. At the moment of birth, the umbilical cord will be full, thick, and have a blueish color. When you touch it, you will feel a steady pulsation. After a few minutes, once the placenta has transferred all the blood to the baby, the cord will look empty. It will be white, flaccid, and have no pulse. At that point, the cord has stopped pulsating, and it is considered an appropriate time to clamp and cut the cord.

What Delayed Cord Clamping Can Look Like at a Home Birth

Since I'm a licensed homebirth midwife, I want to show you what delayed cord clamping looked like in my midwifery practice.

Every birth is unique, generally speaking, this is how I approached the third and fourth stage of labor in regards to the delivery of the placenta and cutting the cord.

Immediately after birth, the baby and mother are skin to skin. We are still in that quiet, reverent place. We are not loud with bright lights and lots of talking. We are focused on maintaining an environment for the motherbaby dyad to be undisturbed and uninterrupted as much as possible.

As a midwife, we learn to assess and respond to situations at the level of care needed at the moment. When everything is normal, observation and space are all the mother needs.

We allow enough time for the cord to stop pulsating, and unless there is extra bleeding, we allow enough time for the physiological birth of the placenta. The delivery of the placenta is usually between 5 minutes to 60 minute minutes after birth. Most placentas seem to come about 20 minutes after birth. There will be a gush of blood, and the cord will get longer, the mother will cramp and push her placenta out. We are not pulling on the cord. We will offer gentle cord traction to help guide the placenta out. Once the placenta is out, we massage the mother's uterus to confirm that it is firm and that the bleeding is within normal limits.

At this point, if it seems appropriate to cut the cord, we will do it now. Or, if the motherbaby are focused on nursing, it seems better to allow them more uninterrupted time then, we examine the placenta, wrap it up in a chucks pad, and tuck the placenta close to the motherbaby so they can get comfortable and continue to nurse.

The natural moment will present itself, and it will be the obvious time to check for tears, cut the cord, do the newborn exam, and postpartum herb bath. When we cut the cord, we make it a special occasion. Often it’s the father who cuts the cord, sometimes it is a sibling or another family member, and sometimes it’s the mother herself who cuts the cord.

This is not a full lotus birth, but it is an example of allowing time for the natural process to unfold. The placenta is an amazing part of the birth process, and I love including it in the postpartum bonding experience.

And now that you've cut the cord, go ahead and watch our video about how to take care of the umbilical cord stump so it can dry and fall off faster. In that video and post, I share with you all about natural ways to help your babies belly button heal.

Remember, this is your body, your baby, your birth! It's best to know what to expect beforehand so you can create a plan aligned with your core values around birth. You've got this! We're here to support you as you prepare for your birth and as you recover.