Cord Clamping

Are you writing your birth plan? You may want to include your position on the clamping of your baby's umbilical cord.

What's Better: Immediate or Delayed Cord Clamping?
If the newborn is placed at or below the level of the mother's perineum or on her abdomen, about 80 cc of additional blood is transfused into the baby. This amount of blood contains about 50 mg of iron and reduces the risk of iron deficiency. This protection from anemia assists the baby's brain development during the first year of life. For this reason, many couples ask that cord clamping take place only after the pulsations in the umbilical cord stop.

On the other hand, it has always been believed that a preterm baby or a growth-restricted baby, or any baby who has suffered a compromise within the uterus, may not be able to adapt to such a transfusion of blood. In these circumstances, it's common practice to clamp the cord within a few seconds of the birth. Now, this practice is being called into question.

There are some instances when care providers might choose to immediately clamp the cord of a healthy baby, including:
-- Fetal distress
-- Low Apgar score
-- The presence of meconium-stained amniotic fluid requiring deep suctioning
-- A mother who is Rh-negative
-- The presence of a tight nuchal (around the neck) cord

Let's consider the case of the cord around the neck. Generations of midwives and physicians have been taught to check for a cord around the neck immediately after the birth of the baby's head and before delivery of the anterior shoulder. If the cord is too tight and cannot be "reduced" or pulled over the baby's head, it's a common practice to clamp the cord in two accessible places and then cut it. Since this effectively cuts off all circulation to the baby, birth must be accomplished quickly. If there's trouble delivering the shoulders, the baby may be in significant jeopardy.

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