Whether it's deciding to have a natural birth, a home birth, or making like a Kardashian and turning the placenta into a mood-boosting snack, there are a ton of choices to make when it comes to the birthing process. One topic that has been the subject of much debate is baby's first precious moments, and whether or not parents and professionals in the US are clamping and cutting umbilical cords a little too soon. Well, according to new guidelines just released by the American College of Obstetricians and Gynecologists (ACOG), the answer is yes — we've been hasty in our cord cutting. Delayed cord clamping is officially the way to go, when and where possible.
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Delayed cord clamping — the process of waiting to clamp and cut the umbilical cord for 30-60 seconds (and in some cases up to two minutes or longer) after birth — has officially been endorsed by the ACOG.
The new guidelines, which have also been endorsed by the American Academy of Pediatrics and the American College of Nurse–Midwives*,* will be published in Obstetrics and Gynecology in January. The ACOG officially recommends "a delay in umbilical cord clamping in vigorous term and preterm infants for at least 30-60 seconds after birth," for a variety of health benefits.
Read through our slideshow to learn more about delayed cord clamping and the new ACOG recommendations, and to see some incredible birth photos that truly showcase the wonder and beauty of birth — and the umbilical cord!
The Current Status Quo in America
According to Sherry Ross, MD, OB/GYN, and Women's Health Expert at Providence Saint John's Health Center in Santa Monica, California, the current average amount of time between the delivery and the cord's being clamped and cut is around 10-15 seconds.
"Since the umbilical cord is the lifeline from the placenta to the baby, if you delay clamping and cutting the cord the baby continues to receive blood from the placenta," explains Dr. Ross. "During this delay, there is an additional 20 to 40 ml of blood the baby receives, with an extra 30 to 35 mg of iron."
Added Bonus for Baby
"The end result is the baby will have a higher hemoglobin level, which decreases the chance of anemia through the first three months and higher iron stores through six months of life," explains Dr. Ross. "Having higher iron stores not only helps prevent anemia, but it also serves as an excellent source of iron for a breastfeeding baby until she or he starts eating solid foods."
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Advocacy
Registered general nurse and midwife Amanda Burleigh has long been advocating for delayed cord clamping through the #WaitforWhite campaign. Amanda told CafeMom that as far back as 2005, as a midwife, she "realized that although we were taught to clamp and cut the umbilical cord immediately, there was absolutely no evidence to support this practice." She created theOptimal Cord Clamping Facebook page in 2012 to educate moms and dads on the practice.
Baby-Friendly Movement
"While there are various recommendations regarding optimal timing for delayed umbilical cord clamping, there has been increased evidence that shows that the practice in and of itself has clear health benefits for both preterm and term infants," Maria A. Mascola, MD, lead author of the committee opinion and ACOG liaison to the AAP Committee on Fetus and Newborn, said in a news release. "And, in most cases, this does not interfere with early care, including drying and stimulating for the first breath and immediate skin-to-skin contact."
Premature Benefits
Preterm babies receive the most benefits from delayed cord clamping, according to both Dr. Ross and the ACOG statement. For a preterm baby there is a decrease in the need for blood transfusions and a lower risk of needing heart medications, intraventricular hemorrhage, and necrotizing enterocolitis (a serious disease that occurs when the intestinal tissue become damaged and begins to die), explains Dr. Ross.
#WaitforWhite
Some advocates of the cause, like midwife Amanda Burleigh, suggest that physicians wait until the cord completely stops pulsing and is white before clamping and cutting.
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Few Risks
As Dr. Ross explains, the main health risk associated with delayed cord clamping is an increased risk of jaundice, which is an over production of bilirubin. "High bilirubin production can lead to the baby needing phototherapy,” she adds.
In its recommendations, the ACOG urges the adoption of mechanisms to monitor and treat neonatal jaundice.
Worldwide Change
Back in 2012, the World Health Organization recommended waiting one minute before clamping the umbilical cord.
When It's Not a Good Idea
There are instances where the cord will need to be cut immediately. According to Sara Twogood, MD, FACOG, and assistant professor of clinical obstetrics and gynecology at Keck School of Medicine USC, delayed cord clamping may delay any necessary resuscitation efforts by NICU, especially for premature babies (such as giving oxygen, or helping with respiration, or deep suctioning).
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Mom's Health
Delayed clamping does not put mothers at greater risk of postpartum hemorrhage, according to the ACOG committee. However, they note, immediate clamping is necessary in certain circumstances, such as cases of maternal hemorrhage or abnormal placentation (also known as placenta accreta).
Parents Spread the Word
A number of parents have been adopting this practice, and many are letting their voices be heard on social media with the hashtags like #waitforwhite and #delayedcordclamping.
Kodak Moment
And of course, parents are sharing their experiences with some incredible images of their newborns attached to their umbilical cords. These fleeting seconds while baby is still connected to the cord are definitely art.
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Achieving Balance
The reason for the positioning here is that "keeping the baby at or below the level of the placenta lets gravity help with the transfusion of the blood from the placenta to the baby, so [it] potentially increases the amount of blood the baby could receive," explains Dr. Twogood.
On the Level
Just look at this photo of this baby, level with the umbilical cord and the placenta. Breathtaking!
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Brand-New Day
And as delayed cord clamping becomes more accepted, more parents and newborns will have the option to experience the benefits of beautiful moments like this one. Priceless!
