Delayed cord clamping during child birth

We do this routinely at our hospital. It may already be the norm where you are delivering. Delayed cord clamping provides more red blood cells to the baby at birth. It gives them a little more reserve.

Here's how we do this part of delivery. We deliver the baby and the baby is place right on mom's abdomen. Everything happens there from any basic resuscitation, drying off the baby, etc. Once the cord stops pulsating, it is cut and clamped. Everything else continues to happen while the baby is on mom and that includes things like vital signs, the antibiotic ointment and even the vitamin K shot. Obviously, the latter two do not happen immediately. Our babies are not even weighed right away. They stay skin to skin with mom until later.

If there is a situation where the baby will need immediate attention and possibly more than the basic resuscitation methods, the cord is cut an clamped as soon as we know the baby will need to be moved to the warmer. Sometimes that is a few seconds after the baby is placed in mom's arms, sometimes minutes and sometimes we know this at the second the baby is delivered.

I asked about it for my third child and was told that they don't like to do it for too long because it can increase risk for jaundice. I had an experience very much like the above description. I was seriously impressed with the team. I delivered 5 minutes after walking into Labor and Delivery. thankfully I had been in a couple hours before so they knew my name and had a chart already started.

The increased risk of jaundice is because there are more red blood cells in the circulation. It's not an overdose of vitamin K by any stretch. It has been clearly shown that there babies who had delayed cord clamping (1 minute or more after birth, instead of just seconds) have higher hemoglobins and iron levels even 6 months out. Iron deficiency is a common issue in infancy and this seems to have a longer impact that one might have guessed.

The truth is that there is not enough evidence for or against delayed cord clamping at birth in term infants. For preemies, delayed cord clamping is clearly beneficial according to the data. The studies that showed the increased risk of jaundice were of insufficient statistical power to make an actual recommendation against the procedure. Delayed cord clamping is usually not terribly long- a minute or so longer than the old way of clamping and cutting immediately.

Oh yes, that!!! I had people in my childbirth classes that would have their birth plans to take to their doctors, and request delayed cord clamping, or no this and no that, etc. I encouraged them to have a conversation with their doctors not to go in their requesting things because the plan changes and things happen. It's a team effort not one-sided. I had a LOT of great families I worked with but there were always the ones that were sticklers.