Quickly cut the umbilical cord after birth. This is still the reflex of many healthcare providers once the baby is lying on its mother’s tummy. Such a shame. Research shows that it is better to wait at least a minute for this.
The baby has barely been born when the scissors appear to cut the umbilical cord. In many cases this already happens 15 to 30 seconds after the delivery. Sometimes even before the full birth of the baby! This could be approached differently. In fact, it is even better to wait a while.
The World Health Organisation (WHO) advises that the umbilical cord should only be cut after 60 seconds, or when the umbilical cord has stopped pulsing. You can see this clearly: the colour of the umbilical cord changes from blue to white. According to the WHO, waiting 60 seconds after birth is a minimum. At that time, the baby has gained about 50% of the benefits.
As midwives, we call cutting the umbilical cord ‘clamping the cord’. What happens exactly if you wait a little while? By letting the umbilical cord pulse out you allow physiological transfusion of the blood from the placenta to the baby. In other words: the blood from the placenta ends up in the baby’s body. When the umbilical cord is cut quickly, up to 30% of your baby’s blood remains in the placenta or placenta.
What are the benefits to your baby of getting that blood?
Having the umbilical cord pulsed out means:
- more red blood cells and thus better transport of oxygen in the body. This also means an easier transition from the uterus to the ‘outdoors’, where the baby needs to learn to breathe independently.
- more iron, which reduces the risk of iron deficiency (anaemia) in the first six months after birth. From 6 months onwards, your baby receives iron through solid food. Iron plays an important role in brain development and the development of the nervous system.
- an increased number of stem cells (important for growth and recovery in disease)
Good to know: Waiting for the umbilical cord to pulse out before clamping has no effect on the birth of the placenta, possible postpartum bleeding or the mother’s blood reserve.
Advantages for premature babies
Clamping ‘late’ – you could also say ‘optimally’ – is not only an option for women who have given birth vaginally to full-term babies. Even if you give birth by caesarean section or to a premature baby, it is often possible and worthwhile not to cut the umbilical cord immediately.
A premature baby can take extra advantage of the blood that is still in the umbilical cord. Research (ACOG) has shown that premature babies in whom the umbilical cord had the chance to pulse out after birth are at less risk of a serious infection (sepsis), bleeding in the brain (intraventicular haemorrhage) and a serious intestinal disorder (necrotising entercolitis). These babies also have 39% less need for a blood transfusion after childbirth if they received this extra blood through the umbilical cord. In the case of premature babies too, it is therefore advisable to let the umbilical cord pulse out for 30 to 60 seconds.
Mercer, J. S., Erickson-Owens, D. A., Collins, J., Barcelos, M. O., Parker, A. B., & Padbury, J. F. (2017). Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants : A randomized controlled trial. Journal of Perinatology, 37(3), 260-264.