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We can't be bothered; Optimal Cord Clamping

Updated: Mar 23, 2019

I hear regularly from students and midwives that I meet on my travels that there remains a resistance in practice towards optimal cord clamping. Whilst I also want to recognise the exceptional work going on at some Trusts to include optimal cord clamping in all obstetric practice, from caesarean sections, to instrumental birth - its not just for midwifery led care! (blogs to follow soon)

Optimal cord clamping; the umbilical cord is not clamped or cut until after pulsations cease

The timing of cord clamping has an impact on initial and long-term outcomes for the mother and baby

Most guidelines suggest waiting at least 1-3 minutes, but the research says >5 minutes or until pulsations cease has the greatest advantages.

Advantages to the newborn

  • The baby will receive up to 30% more of the fetal-placental blood than it would with immediate cord clamping.

  • Increase in warm blood reduces the impact of newborn hypothermia alongside appropriate thermoregulatory care, drying neonate and a hat.

  • Increase in blood volume promotes perfusion of the lungs and brain, reducing impact of issues of hypovolaemia and hypoxia of baby at birth.

  • Increased haemoglobin levels improve oxygen and iron transportation around the body.

  • Iron is important for long term neurodevelopment of baby, myelination of axons and development of white matter in the brain.

  • Studies show improved fine motor function and social skills later in life.

  • Immune promoting stem cells provide lifelong protection to baby.

  • Keeps the mother-baby unit together facilitates neonatal benefits of skin to skin.

Significant neonatal benefits in preterm infants including;

  • Improved transitional circulation.

  • Better establishment of red blood cell volume.

  • Decreased need for blood transfusion.

  • Lower incidence of necrotizing enterocolitis and intraventricular haemorrhage.

Advantages to the mother

Maternal bonding and attachment to neonate are facilitated by skin to skin contact - see @JennytheM
  • Uninterrupted maternal-neonatal connection facilitates breastfeeding.