Today, I want to talk about something I’m incredibly passionate about: delayed cord clamping. You may have heard this term before, but understanding why it matters could change how you think about birth practices and their long-term effects on health.
What Is Delayed Cord Clamping?
Delayed cord clamping refers to waiting for a period of time after a baby is born before clamping and cutting the umbilical cord. This allows the blood in the placenta to flow back to the baby, completing an essential part of their transition to life outside the womb. But why does this matter so much?
During pregnancy, a baby’s circulatory system relies on the placenta for oxygen and nutrient exchange. At birth, the baby’s lungs take over, and their circulatory system undergoes a rapid transformation. A significant amount of the baby’s blood—about a third of their total blood volume—is in the placenta at any given time. For premature babies, this can be as much as half. As the baby’s lungs expand with their first breaths, blood moves from the placenta into their body, providing oxygen, iron, and stem cells crucial for recovery and growth.
Delayed cord clamping ensures that babies receive their full blood volume. Cutting the cord too soon—which is standard practice in many hospitals—deprives them of this, effectively causing a significant blood loss. Imagine losing 30% of your own blood! For adults, this is considered a hemorrhage, and for a newborn, it can be catastrophic.
Check out the images below. These were taken by my good friend and colleague Ariel with www.bloomingfootprints.com
In the first one you see what a baby's cord looks like right after birth. It is dark and full of baby's blood. That blood gets pumped back to baby after birth. Several minutes later the cord will look like the second picture. Its white and smaller. There are tiny little pockets of blood but for the most part baby had gotten all of their blood back.
Why This Matters for Babies
1. Oxygen Support During Transition After birth, babies experience a significant physiological shift. Their lungs, previously filled with fluid, begin to fill with air. This transition takes a few minutes, and during this time, the blood from the placenta provides a vital oxygen reserve. It’s like a safety net, ensuring that the baby gets the oxygen they need while their body adjusts to breathing on its own.
2. Essential Stem Cells and Iron Placental blood is rich in stem cells, which help repair and grow tissues—a critical factor after the stress of birth. It’s also loaded with iron, which is essential for brain development and overall health. Iron deficiency is a significant public health issue, affecting millions globally. Babies who don’t receive their full blood volume are at a higher risk of developing iron deficiency anemia, which can impair brain development and reduce cognitive abilities. In fact delayed cord clamping almost complete eliminates iron deficiency anemia in infants.
3. Long-Term Benefits Research has shown that delayed cord clamping can significantly reduce the risk of anemia in infancy and improve developmental outcomes. Babies who receive their full blood supply have better motor and cognitive skills. Globally, iron deficiency anemia costs billions in lost productivity and IQ points—a statistic we can change with a simple shift in birth practices.
Why Immediate Cord Clamping Became the Norm
Delayed cord clamping used to be standard practice. Ancient texts from Hippocrates to Galen emphasize its importance, and even the inventor of the modern cord clamp warned against using it too early. So what happened?
In the early to mid-1900s, birth shifted from home to hospital, and obstetrics became a surgical specialty. Practices centered around efficiency and convenience rather than health outcomes. Immediate cord clamping became routine, likely because it allowed doctors to move through births more quickly. Once established as standard, changing hospital policies became an uphill battle.
Even today, it takes an average of 20 years for research to influence hospital practices. While some hospitals now advocate for delayed cord clamping, especially for full-term babies, it’s still not the norm—particularly during cesareans or with premature babies who need it most.
Addressing Common Myths
1. “Delayed Cord Clamping Causes Jaundice” This is a common concern, but research doesn’t support it. While bilirubin levels may rise slightly in babies with delayed cord clamping, this increase is usually within normal ranges and resolves as the baby’s liver matures.
2. “Blood Will Pool in the Placenta” This myth, taught to some EMTs and even doctors, is simply false. Blood circulation isn’t governed by gravity; it’s driven by the baby’s circulatory system. Blood flows back to the baby naturally, regardless of positioning. When parents ask me about this I remind them that our blood doesn't pool in our feet when we stand up.
3. “It’s Not Feasible for Babies Who Need Immediate Help” There is some truth to this statement. In emergencies, hospital setups often necessitate cutting the cord to move the baby to the warmer. Their oxygen and resuscitation equipment is often located across the room and can't be accessed while baby is attached to their cord. This is a problem with a solution. In home birth and birth center settings we have portable resuscitation equipment. Everything that we need to do can be done on or next to mom so we don't have to cut the cord. In fact we NEVER cut the cord in an emergency. That is baby's lifeline. The last thing a compromised baby needs is a hemorrhage. It is possible to create a similar setup in a hospital environment. In fact some hospitals have already done this and have portable stations that allow full resuscitations without cutting the cord. Unfortunately this isn't the norm and babies that need it the most (compromised and premature babies) are often the lest likely to get it.
Advocating for Change
If you’re expecting, speak to your care provider about delayed cord clamping. For most full-term, healthy babies, a few extra minutes can make a world of difference. For premature babies or those delivered via cesarean, it’s even more crucial. Advocacy from parents and professionals can help push for systemic changes in how hospitals approach this practice.
As research continues to highlight the long-term benefits, I’m hopeful that delayed cord clamping will become the standard of care everywhere. Until then, let’s keep advocating for the best start in life for all babies.
Thank you for reading! If you found this information helpful, please share it with others—especially expecting parents or professionals in maternal and newborn care. Together, we can make a difference, one baby at a time.
You can listen to an incredible Ted Talk about this here.
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