Previous Post Next Post

Pregnancy

Brought to you by

New Research On Cutting The Cord, And Some Cool Pictures Too

By ceridwen |

Why cut off this oxygen and iron-rich blood so soon?

Last month the New York Times ran a piece about the new research on cord cutting. Since the 1950s (when moms were given strong drugs and babies were whisked immediately away) it’s been the routine practice to cut the cord ASAP. But research is now showing that delayed cord clamping–even just by a few minutes– may be beneficial to the baby. You can read more about why here and here but the basic gist of it is that by cutting so soon, we deprive the baby of a last blast of oxygen, iron and nutrient rich blood. Studies are showing that when babies get this blood they have larger stores of iron months later. It also just makes sense to let the baby continue to get oxygen-filled blood during those first few minutes when breathing is established. Nature seems to have thoughtfully designed this process, right? So today, I want to share some incredible pictures from this terrific educational website.

Here’s a picture of the cord right after birth, look how thick and full of blood it is. (The midwife could see the cord pulsing with the babies heartbeat. Cool. But also, it’s filled with Wharton’s Jelly, a gooey, elastic substance that lines the cord and prevents kinks and knots from happening in utero. Also cool.)

Right after birth, full of blood.

 

 

 

 

 

 

 

 

 

 

 

 

 

Look several minutes later: Less blood and the jelly is thinning out.

Several minutes after birth.

 

 

 

 

 

 

 

 

 

 

 

 

 

At fifteen minutes post-birth the cord is totally limp and the blood has stopped pulsing. It’s done it’s job, time to cut it.

Fifteen minutes after birth.

 

 

 

 

 

 

 

 

 

 

 

 

 

Ask your midwife or doctor about delayed cord clamping.

 

Thank you Nurturing Heart Birth Services for taking these pictures and giving us permission to use them!

More on Babble

About ceridwen

ceridwen

ceridwen

Ceridwen Morris is a writer, mother, and certified childbirth educator. She is the author of several books and screenplays, including (Three Rivers; 2007). She serves on the board of The Childbirth Education Association of Metropolitan New York and teaches at Tribeca Parenting in New York City. Read bio and latest posts → Read Ceridwen's latest posts →

« Go back to Pregnancy

Use a Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy. Your Facebook name, profile photo and other personal information you make public on Facebook (e.g., school, work, current city, age) will appear with your comment. Comments, together with personal information accompanying them, may be used on Babble.com and other Babble media platforms. Learn More.

32 thoughts on “New Research On Cutting The Cord, And Some Cool Pictures Too

  1. Lucy Juedes says:

    Wow, so cool! Can I share these in my Lamaze classes? thanks so much for sharing these photos!

  2. ceridwen says:

    Lucy– Check out Nurturing Heart Birth Services (link above) but my sense is that we can use them. The photographer says she took these for educational purposes. Very generous and very, very helpful!

  3. MadelinePetersen says:

    very cool!

  4. Meredith Fein Lichtenberg says:

    Great images!

  5. Kimberly Brown says:

    LOVE the idea!

  6. Hillary says:

    Great pictures–thanks for sharing! The link behind “great education website” is broken. Where was it supposed to go.

  7. ceridwen says:

    I fixed the link. Here it is though: http://www.nurturingheartsbirthservices.com

  8. http://shouldbethebeginning.com says:

    that is cool. we debated on this, and ultimately really wanted to donate the cord blood, for all of the good it could do. i vacillated for a while, knowing the delayed cutting would be a boost to my baby, but also knowing that my baby’s blood might do someone a tremendous amount of good (you can’t delay cutting AND donate). i still feel torn on the issue. thoughts?

  9. Melissa says:

    I would have loved to delay cutting with my 2nd (didn’t know about this for my first) but the cord was wrapped around her neck – twice – so it was a case of getting it cut and her free as quickly as possible. Great idea for those who can, but like anything birth related, it should be a preference rather than a set plan – you never know whats going to happen and need to be flexible.

  10. JoAnn Peistrup says:

    About that cord around then neck. I have been a midwife for 17 years, seen many cords around babies’ necks (occurs more often than most people realize – it’s normal). Cutting the cord prior to deliverying the shoulders can be very dangerous. It is the only source of oxygen for the baby. In the event that there is a shoulder dystocia (difficulty getting the shoulders out), the only thing the baby has as an oxygen is the blood from its cord. A better strategy is to somersault the baby up onto the mother’s abdomen and then gently unwrap the cord. Works every time. I’ve never had to cut a cord – even very tight ones.

  11. Marsha says:

    @ http://shouldbethebeginning.com- actually you can donate. The placenta has the same beneficial stem cell rich cord blood as the cord itself. So they’ll just extract it from there.

  12. Eileen says:

    I would love to know the statistics on how many of the delayed cord cuttings are related to hyperbilirbinemia/jaundice in the next few days after birth. Jaundice can cause problems fro the baby as well.

  13. Jen says:

    This is ANNOYING only because its SO OBVIOUS that we need to delay cord cutting but the doctors still refuse- I dont get it- makes me mad !

  14. Edmond Devroey MD says:

    It is worth mentioning that during the switching of the newborn blood circulation from the placenta to the lungs, the baby collects oxygen from TWO sources: from the mother through the placenta and from his lungs that gradually take over the whole process. That process involves the closing of an orifice in the heart and the gradual opening of blood vessels, as well as the opening and dilation of the airways in the lung. Meanwhile, the condition of the newborn is easily monitored by looking at the color of the skin, testing the muscle tone (in the legs) and the pulse in the umbilical cord.
    Precipitating the natural switching process by clamping prematurely the umbilical cord suffocates the newborn and causes the onset of brutal and painful gasps that makes the newborn cry in pain.
    More at http://www.betterchildbirth.com
    Edmond Devroey MD

  15. Windi H says:

    I really wanted to delay cutting and had cleared it with my OB, but then went from 3 cm to 10 in a matter of an hour and another OB ended up delivering as mine was en route; he was also supposed to be next door with another pushing mother, so in the rush we didn’t tell him to wait. Major bummer.

  16. candice says:

    Did this with my last child, as it was a home birth and I had so much more control, (wanted it with my other three, but hospital, no control). It was amazing, I was nursing him while he was still receiving cord blood. When it was empty and it stopped, my 9 year old cut the cord. What a miraculous moment!!

    God in His infinite wisdom knew babies needed this life giving 15 minutes.
    I am thankful He shared that wisdom with me, and now all of you. ♥.

  17. Rebecca says:

    Thank you Reading Birth and Women’s Center for knowing this and gifting my son with all the benefits of delayed cord clamping!

  18. Bethany says:

    I had the cord cut immediately with both of my children and they are both healthy babes. i really don’t think one way is better in the long run than the other. It’s just a personal choice.

  19. Jen says:

    I asked my OB about it and he was against it. It was in my birth plan, but since my son had passed meconium in utero, they cut the cord and whisked him off to be deep suctioned. Just another reason I will have any future babies with a midwife.

  20. Lizs says:

    already common practice in Canada (unfortunately not with my child cause she was breach and we had to have a c section but i even heard of hospitals that wait after a c section), america is really way behind regarding childbirth, a very good documentary about this is “the business of being born”, i can’t imagine a single women who wants to have a birth in a regular american hospital after seeing that, worth to watch!!!!

  21. Hyman says:

    My son is 4 months now but at birth he was laid on my chest right after coming out, breast feeding was established and the cord was delayed being cut until it stopped pulsing. I had a doula who assisted my obgyn in that.

    Oh and I can’t tell you how proud I am that my husband was brave enough to cut our cord and not the dr …

    I also declined the hep b and eye goo And wiped him off myself and declined him being bathed and bathed him myself the next day.. But that’s another story :)

    I just felt really confident that I had options to choose from and researched and did what I believe is best … And had my drs blessing.

  22. Lesley says:

    Wanted to do this and my OB was for it. However, I had an emergency c -section with a very dramatic drop in blood pressure so I have no idea if it was actually done (I was very woozy.) Considering all the drama that was going on, I think they wanted to get the babies out as quickly as possible. My little girl did have some trouble breathing on her own and I wonder if delayed cutting would have prevented that.

  23. Lissa says:

    Wow that is pretty fascinating. I had a C-section and this wasn’t offered to me (here in the U.S.) but it’s something to consider asking for next time. Amazing photos.

  24. Vanessa aka mamascribble.com says:

    Midwives have been practicing this forever now… So glad to see that ‘known’ source picked up on this.

  25. Stevie says:

    Jen I had a midwife & my son also passed meconium she still cut it quickly & handed him to the nicu team in my rm, no difference from ob to midwife. It needed to be done.

    This was my plan the whole time but it wasn’t possible, I hope we get to do it next time & I hope next baby’s cord is longer so we can allow it. & these pictures are awesome.

  26. Baby Friendly OB Nurse says:

    Yes, I am an OB nurse. I do believe in baby friendly practices. We do promote waiting until the cord has stopped pulsating until it is cut BUT in certain instances this is just not safe. In the case of meconium, it is more dangerous for the baby to take the firdt cry and inhale meconium into the lungs. Bulb suctioning only removes what is in the upper airway and mouth,deep suctioning is needed to clear all the meconium. And for the midwife that talks about somersaulting the baby onto the mom’s abd? Really? Guess you’ve never had a short cord. If the nuchal is tight with a short cord, the baby can be asphyxiated BEFORE the head even delivers. Wonder how bad the heart tones on those babies looked? If it is the safe option, then go for it, but it is not always the safest option! Just like not everyone gets a vaginal delivery. Birth is still very unpredictable. Everyone wants to down the hospitals and birthing, but we strive for what is best for the patient. Music, warm bath, massage, etc. But if it is a high risk pregnancy, we do constant fetal monitoring, but do invite position change. We encourage doulas. But, when a baby gets in trouble, we can act fast. Interventions are available. You may not have that at home. If it takes 10 miutes to drive to the hospital, if the baby drops its heart rate to 40, chances are that by the time intervention is preformed, it will not be a very favorable outcome. So, before you diss the hospital birth experience, check out some of the stories of babies that have been saved!!!!

  27. CNM says:

    To answer the OB nurse above, Yes, “really” on somersaulting the baby out. The benefits of this approach are well documented in the literature and it is the technique currently being taught to CNM students. I have delivered over 600 babies and have never cut a cord prior to delivery of the shoulder.

  28. Baby Catcher says:

    I agree with Baby Friendly OB Nurse, sometimes the cords are so short you can’t even separate the baby 3″ from the perineum, let alone place the baby on the mom’s chest.

    As for JoAnn Peistrup comment about the cord being the only source of oxygen during a dystocia: you don’t think a nuchal cord is being compressed during a dystocia? Unless you have a magic want that tells you cord length prior to delivery, you don’t know if you’ll end up avulsing the cord at the insertion point in the placenta or not, so cutting it seems a reasonable option.

    I haven’t seen anyone discuss the risk of jaundice and hyperbilirubinemia that comes with delayed cord clamping, if untreated, this can lead to kernicterus (ie permanent brain damage), the baby may need multiple blood draws (ie needles in a vein or a hole poked in the heel) to check bilirubin levels (this hurts by the way) and placement under bili lights (baby can’t be with you during this, he/she is alone under the lights, for as long as it takes for the bili levels to drop) with possible dehydration.

    And no, you can’t collect enough blood form the placenta for banking, it’s just not possible after the cord is empty. The blood is collected form the umbilical vein, not the parenchyma (placental disk), once the vein is empty, you can’t refill it. You usually need over 3 oz (100ml) for an adequate collection and at minimum 75 ml. Either the baby gets it at birth or when the baby or donor need it for a stem cell transplant; can’t have your cake and eat it too on this one.

    As for delayed clamping during a cesarean section: The uterus bleeds where it’s cut to get the baby out until it’s able to contract the muscle and compress the vessels that were giving blood flow to the placenta. As long as the placenta is inside the uterus, the contraction can’t happen, hence the muscle bleeds wehre it was cut. So you can’t wait until it stops pulsating or delay preventing the mom from hemorrhaging for this. Average blood loss for a cesarean section is 1L as it is, you don’t want to do anything on purpose to increase this.

    How about the happy medium of milking the cord towards the baby before cutting it? Takes 5 seconds, the baby gets the same benefit and can be done in vaginal or cesarean section.

  29. Kellie says:

    Wow! I wish I’d known about this when I gave birth to my son!

  30. Justine says:

    Anyone consider the risks of polycythemia? That along with hyperbili came along to mind, as a NICU RN. I work in a children’s NICU though, so I don’t go to deliveries.

  31. Merranda says:

    I don’t think it’s really horrible one way or the other.. I never really thought about it actually. I do know my son was given a few more moments with his intact because his father was so nervous he wasn’t sure what to do and the nurse had to explain it five times lol

  32. Gifted Birth says:

    Suctioning has not shown to make a difference in preventing meconium aspiration, since this is associated with fetal hypoxia (intrapartum hypoxia and cord clamping) and not just the presence of meconium. Healthy newborns that transition normally clear their own lungs, and the blood derived from placental transfusion is part of this mechanism.
    This brings me to cutting a nuchal cord because it is applied tightly around the neck – which most likely tightened as the head descended. Yes, the cord may be short and there could be a dystocia – neither of which can be known before contractions/maternal effort to deliver the shoulders occur. Yes, a truly compressed cord can result in temporary asphyxia – HOWEVER the point of keeping the cord intact is to ensure the compression can be relieved immediately after birth, the baby does not experience further oxygen-deprivation, the baby access to the placental circulation to correct low blood volume/academia, and avoid increasing the risk of meconium aspiration (gasping, vagal response from suctioning!).
    Most of the data shows delayed clamping is not the cause of clinical jaundice, polycythemia etc – the studies that showed any significance (still small) are unpublished and/or did not adjust for factors like labour induction and augmentation with oxytocics (which are associated with clinical jaundice).
    There is no biological evidence to prove that normal placental transfusion at birth causes hyperbilirubinemia leading to brain damage – the etiology of this disease has been shown in other primates to be preceded with severe fetal hypoxia which damages the blood/brain barrier. This makes it even more imperative to avoid obstetric interventions whereever possible that risk fetal hypoxia (prolonged contractions from induced/augmented labours, premature cord clamping of compromised infant).
    Avoiding the cord clamp during placental transfusion avoids terminating the normal, placental-mammal birth process and physiological transition at birth. There is no adequate evidence or justification for phlebotimising human infants at birth.

Leave a Reply

Your email address will not be published. Required fields are marked *.

Previous Post Next Post