In the UK, as in the US, standard medical procedure is to clamp the umbilical cord immediately after the baby is born. A medical expert in the UK has come out against this policy, calling for change. According to Dr. David Hutchon, a retired consultant obstetrician from Memorial Hospital in Darlington, clamping the cord so quickly may put the baby at higher risk for iron deficiency, anemia, and blood loss (which can, in extreme circumstances) lead to shock and possibly death.These concerns were published in a paper in the British Medical Journal, in which he also criticizes the British hospital system for dismissing advice from the World Health Organization and International Federation of Obstetrics and Gynecology, both of which recommend waiting before cutting the cord.
I remember hearing something about this idea before my son’s birth and planning to ask my doctor to wait before clamping the cord. But when the time came everything happened so fast. The baby was born, the cord was clamped. Those risks sound frightening. But is this really something to worry about?
As usual, it depends on who you ask. Most OBs would probably tell you that there is no benefit to keeping the cord attached for any longer than current practice dictates. According to the U.S. medical community, there is no evidence that cord clamping has anything to do with iron deficiency or blood loss. For one thing, there has been little medical research into this area. Cord clamping has been a fairly ubiquitous practice in modern western obstetrics, so they have few firsthand examples of the other way of doing things.
In the midwifery community, it is common to leave the cord to pulse until it stops by itself. Below is an excerpt from a piece by a midwife. She gives 5 reasons for holding off on cord clamping, different from the ones the doctor cited in his British Medical Journal article:
Five Good Reasons To Delay Cord Clamping, by Gloria Lemay (from gentlebirth.org)
- 1. Leaving the cord to pulse does “no harm” and therefore should be encouraged. If you can think about what Nature intended, our ancestors way back before scissors and clamps were invented must have had to wait to deal with the cord/placenta until the placenta was birthed. They probably chewed it, ground it with rocks, or burned it through with hot sticks from the fire. The little teeth on the clamps indicate the traumatizing of the vessels is necessary to quell bleeding. [Editor's Note - Some midwives say that if you delay cutting the cord until an hour or so after the birth, there will be no bleeding at all from the stump.]
- 2. Leaving the cord to pulse slows down the “fire drill” energy that many birth attendants get into after the baby is born. Leaving off the busyness of midwifery for a half hour allows the mother and baby undisturbed bonding time without a “project ” going on i.e. the cord cutting instructions, explanations, jokes, etc. The father, too, is undisturbed and able to enjoy this “high” time without focusing on a job at hand.
- 3. Educator Joseph Chilton Pierce in his book “Magical Child” makes ref to studies that were done on primates who gave birth in captivity and had early cord clamping. Autopsies of the primates showed that early cord clamping produced unusual lesions in the brains of the animals. These same lesions were also found in the brains of human infants when autopsied.
- 4. In Rh neg women, many people believe that it is the clamping of a pulsing cord that causes the blood of the baby to transfuse into the blood stream of the mother causing sensitization problems. Robert S Mendelsohn, M.D., in his book “How to Have a Healthy Child. . . In Spite of Your Doctor” blames the whole Rh neg problem on too quick clamping of the cord. Especially in Rh neg mothers I urge midwives to wait until the placenta is out before thinking about cord clamping.
- 5. I think it is interesting that scientists are now discovering that umbilical cord blood is full of valuable T-cells which have cancer fighting properties. A whole industry has sprung up to have this precious blood extracted from the placenta, put in a cooler with dry ice, and taken to a special storage facility to be ready in case the child gets cancer at some time in the future. This is human insanity of the first order. That blood is designed by Nature to go into that child’s body at birth, not 30 yrs later! We need to acknowledge that there are things about the newborn circulation and blood composition that we just don’t know and we need to bet that Mother Nature had things figured out pretty well for us to survive this long. Maybe the supposed need for Vitamin K in the newborn comes out of early cord clamping?
So if leaving the cord is healthier for babies and has no ill effects, why isn’t it done more frequently? The practice of cord clamping is pretty ingrained in American hospitals, as it seems to be in the U.K. Cord cutting and clamping has even evolved into a special honor for the father of the newborn, a way for him to feel involved in the birthing process. Hospital policies are very slow to change, even when there’s indication that there might be a better way. And some might say the decision is a monetary one, as clamping and snipping the cord moves things along more quickly than letting it pulse out in its own time. And now the business of cord blood banking benefits from the cord being clamped as soon as possible to preserve the contents for the blood bank rather than pumping them into the baby’s body.
If you’re interested in waiting to cut the cord, it’s a good idea to talk to your practitioner beforehand. You will want to find out how she or he feels about the practice. And you’ll also want to get your preference on the table before things are too crazy to assert anything. No matter how important you think it is now, there’s a pretty good chance you won’t be able to make it happen in the heat of the moment. photo: Herkie/flickr