I’m, what you might call, thrifty (read: cheap). I love a good deal. Groupon and Living Social, they’re my date-night planners. Goodwill and Savers? My Nordstrom and Neiman Marcus. It’s all about value.
Being the deal hunter I am, I am always looking to get the most bang for my buck.
Enter: delayed cord clamping.
When it comes to value, 90 seconds is all it costs to provide your child a huge advantage as far as IQ, immunity, lifespan, quality of life, vitality, and so much more.
By delaying the clamping of the umbilical cord after birth until it stops pulsing (usually around 90 seconds), you instantaneously invest in your child’s future by:
· Increasing your baby’s blood supply at birth by 32%[i]
· Increasing the amount of oxygen they received in their first moments of life[ii]
· Boosting their iron stores to prevent anemia and other iron deficiency disorders[iii]
· Boosting their stores of genetically-powerful stem cellsii
· Increasing their IQ, and, therefore, their future earning potential as adultsii
· Increasing infant birth weight (likely because they’re upping their blood volume by 1/3)[iv]
A Brief History of Childbirth in the United States
Up until 1913, delayed (or optimal) cord clamping was the norm. In the early 20th century, almost all births occurred in the comfort of home with a midwife.[v] The midwifery model views birth as a natural process and the woman’s body as the capable authority on this process. Midwives attended home births, assisting when necessary, but acting more as a support for the laboring mom than intervening unnecessarily.
In most cases, this is still the midwifery model of care – support, monitoring and empowerment – letting the woman’s body do what it was created to do – build and birth a tiny human.
However, the introduction and utilization of anesthesia (ether and chloroform) for pain relief in labor in the early 1900’s launched a shift away from home births and toward medicalized hospital births.[vi] With this shift doctors began to employ active management of labor, placing laboring women “on the clock,” pressuring with milestones and interventions if progression milestones were missed. The view that labor is inherently dangerous and, therefore, requires medical interventions and manipulations to ensure a safe delivery began to spread. With the adoption of this perspective came the practice of immediate cord clamping.
Doctors hypothesized that immediately clamping the umbilical cord would likely lower postpartum hemorrhage rates, and therefore, maternal mortality. However, controlled trials reveal that immediate cord clamping does not reduce the risk of postpartum hemorrhage[vii].Though it is still an unsubstantiated practice with no positive side-effects and loads of negative ones, immediate cord clamping remains the “norm” around the world today.
The Golden Minute
In his Ted Talk on delayed cord clamping “90 Seconds to Change the World” (which is, by far, the best overview I’ve found for delayed cord clamping) , Dr. Alan Greene mentions the “Golden Minute” – the first few minutes of a newborn’s life[viii]. I recall the first moments of holding my child in my arms, wet and fragile, waiting for what seemed like minutes for her first cry. In this first cry, as she announces her entrance into this world, the powerful and permanent handoff between the umbilical cord and the lungs is initiated. The cord, the life source of that tiny human in our wombs, the sole supplier of nutrition and oxygen until the Golden Minute, bows out as the powerful lungs take their permanent place.
When the cord is clamped before it finishes pulsating, infants are robbed of 1/3 of their red blood cells that usher loads of oxygen into their bodies. In infants that have delayed breathing reflexes, the oxygen provided from their cord can be instrumental in filling the gap until their lungs take over.
Common Arguments against Delayed Cord Clamping (and our responses)
1. Delayed cord clamping leads to much higher rates of newborn jaundice due to the extra bilirubin and red blood cells supplied.
- Though some small studies have found slightly increased rates of neonatal jaundice in healthy term infants when delayed cord clamping is practiced, most studies have identified no significant different between delayed cord clamping and immediate cord clamping.[ix] Though one would assume that increased levels of red blood cells and bilirubin would significantly increase the likelihood of jaundice, many practitioners believe that the livers of infants who experience delayed cord clamping are able to more efficiently process the blood and bilirubin, therefore reducing the likelihood of hyperbilirubinemia.[x]
2. Delayed cord clamping takes too much time.
- It takes 90 seconds – have a Kit Kat and chill out.
3. Immediate cord clamping helps prevent postpartum hemorrhage.
- Large studies have found no significant difference in the likelihood of postpartum hemorrhage between those who practices immediate cord clamping versus delayed cord clamping[xi].
4. A healthy, term baby gets very little benefit from delayed cord clamping.
- See above.
5. Iron deficiency is a second and third world problem, not a first-world problem.
- At least 10% of the US toddler population (between the ages of 1-3 years old) is iron deficient, rising up to 20% in select ethnic populations. Delayed cord clamping provides term infants with 3-6 months of stored iron, greatly reducing the likelihood of iron-deficient anemia for the rest of their lives.[xii]
6. Babies can lose blood volume back into the placenta if it’s not clamped immediately.
- Not likely in a healthy, uncomplicated birth. Babies are supplied with up to 1/3 more blood volume when delayed cord clamping is practiced.[xiii]
With not negative side effects and loads of positive ones, delayed cord clamping is an effortlessly quick and easy way to ensure your child has the best start in life possible. Because moms are educating themselves before they enter the delivery room, requesting (read: demanding) delayed cord clamping is making a comeback and doctors are becoming more comfortable with this practice. It is your body, your baby and your labor – give you child the gift of educating yourself on your options.
Have a question or comment? Was delayed cord clamping not an option for you? I’d love to hear from you! Send me an email at Kelsey@cordmama.com.
[v] Wertz RW, Wertz DC. Lying-in: A history of childbirth in America. New York: Schocken Books. 1977.
[ix] Hutton EK, Hassan ES. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA. 2007 Mar 21;297(11):1241-52.
[x] McDonald SJ, Middleton P. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD004074. DOI:10.1002/14651858.CD004074.pub2.
[xi] Andersson O, Hellstrom-Westas L, Andersson D, et al. Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstetricia et Gynecologica Scandinavica. Article first published online: 17 Oct, 2012. DOI: 10.1111/j.1600-0412.2012.01530.x
[xii] Chaparro, CM. Timing of umbilical cord clamping: effect on iron endowment of the newborn and later iron status. Nutrition Reviews. Volume 69, Issue Supplement s1, pages S30–S36, November 2011.
[xiii] Mercer JS, Skovgaard R. Neonatal Transitional Physiology: A New Paradigm. J Perinat Neonat Nursing 2002; 15(4) 56-75