When Do You Initiate Cord Clamping?

Immediate or Delayed Cord Clamping?

Do you know whether your care provider chooses immediate or delayed cord clamping? Do they know the difference? Make sure you communicate with your obstetrical care provider your desire to choose delayed cord clamping and the benefits it offers under most circumstances. 


Do you do immediate or delayed cord clamping after the pulsation in the cord ceases?


With delayed cord clamping, baby gets the extra 1/3 of its blood that belongs to her/him, not the placenta, and the baby has less anemia at 6 mos. of age. The baby also has more intravascular volume to help the transition from fetal non-air dependent oxygenation to the newborn circulation that requires the baby to breathe.  Delayed cord clamping has become the standard of care when risks and benefits of both models are analyzed, and does mimic the natural, physiological model that has evolved during evolution.  If there is meconium stained fluid AND/OR the baby is limp, not breathing, or gasping, the cord must be cut immediately to begin neonatal resuscitation that may require intubation for suction of the newborn’s airway to prevent the meconium from being aspirated.  Any other scenario where the infant requires immediate resuscitation would require immediate cord clamping.

Sources:

  • cochrane.org: McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on mother and baby outcomes. 11 July 2013.