Making an informed decision about cutting the cord

When it comes time for your baby to be born, you have the choice of whether or not you would like your baby’s umbilical cord to be cut or left intact. Leaving the cord and placenta attached together until they naturally separate is called ‘Lotus Birth’. Whilst there is not a lot of scientific research showing the benefits of this option, many families report a more settled, gentle transition from womb to world when Lotus Birth is done.

The role of the cord and placenta         

During pregnancy your baby’s circulation system involves baby-placenta-Mum. Baby receives all of his or her oxygen, nutrition and life support from Mum and the placenta, via the umbilical cord. In turn, baby sends all of his or her waste products and carbon dioxide through the umbilical cord and placenta to Mum’s circulation to be eliminated. Because of this, baby needs very little blood in his or her lungs, liver, kidney and gut. At birth, baby’s system changes over from this dependent system to one that is completely independent and for the first time all of baby’s organs must be fully functional.

The placenta is designed to support this change over during the ‘third phase’ of birth (the period of time between baby being born and the birth of the placenta). During this time, the placenta and cord provide a reservoir of blood to fill baby’s newly functioning organs. As well as activating the organs, this bountiful perfusion of blood from the placenta also helps protect baby’s organs from hypoxic injury at birth (harm from lack of oxygen). After several minutes baby’s umbilical cord will naturally clamp itself stopping blood flow between the placenta and baby.

 

When to cut the umbilical cord

Current research is showing a massive advantage for babies if you choose not to cut the cord immediately at birth. This option is called ‘optimal cord clamping’ (previously known as ‘delayed cord clamping’). Ironically this is nothing new! For generation upon generation cords have been left intact for sometime after birth. Erasmus Darwin wrote in 1801 that “Another thing very injurious to the child is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a part of the blood being left in the placenta which ought to have been in the child.” During the 20th century it became hospital policy to clamp and cut umbilical cords immediately at birth, due to a belief that it was dangerous for baby to receive all of his or her own blood.

If the umbilical cord is cut immediately at birth, up to 50% of baby’s blood can still be in the placenta. Babies who are born prematurely, or whose mother’s are lying back when giving birth are more likely to lose larger amounts than babies who are born at term or whose mother’s are upright when they are born.

 

Benefits of optimal cord clamping

  • Baby receives stem cells at birth via umbilical cord blood
  • Reduces risk of baby having breathing problems at birth, both for babies born vaginally or via caesarean
  • Baby has better levels of iron
  • Better outcomes for premature babies
  • Provides an attached life pack, perfusing baby’s organs with oxygenated blood if resuscitation is necessary

 

What if my birth doesn’t go to plan?

In many cases of both planned and emergency caesarean optimal cord clamping is still possible. In the situation that your baby needs any amount of resuscitation after a vaginal birth, leaving his or her umbilical cord intact can be life saving. Waiting for baby to take his or her first breath before cutting the cord means the tiny alveoli in your baby’s lungs fill with blood, making that first breath easier to take. An intact cord also will ensure that your baby is supported with oxygenated blood whilst he or she gets breathing established.

It is important to talk to your LMC during pregnancy about what you would like to happen in an emergency. Ask for portable resuscitation gear to be available for your birth, rather than equipment that is fixed to the wall at the far end of the room.

 

How can I find out more?

If you are interested in finding out more information about this important topic, you can do so from the comfort of your home. The Birthing Room’s free online mini course Optimal Cord Clamping & Care of the Placenta offers information on:

  • The benefits and risk of cord clamping
  • How long to wait before cutting the cord
  • Traditional Maori birth practices
  • Choices of how to birth your placenta
  • Choices of what families can do with their placenta after birth
  • Birth plans for the umbilical cord and placenta
  • Parents sharing stories about their own birth experiences

To find out more check out https://the-birthing-room-online-antenatal-courses.teachable.com/p/optimal-cord-clamping-care-of-the-placenta

 

 

By Rosemary Joyce (Nurse, Childbirth Educator, Doula)
Bump & Baby
Bump & Baby
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