Delayed Cord Clamping
Have you heard about Delayed Cord Clamping (DCC)? If you are putting together a Birth Plan with your care provider or doula, this is one of the preferences that you will discuss. So…You may be wondering what the big deal is. After all, the baby is born… so, let’s cut that cord! But wait just a minute…Or, even better, 2-3 minutes!
There is increasing evidence to support the trend of delaying the cutting of the cord immediately after birth and here is why…
Your baby’s cord is about 20 inches long, a little bit stretchy, a little bit spiraled, and about as thick as your thumb. At birth, the cord can look puffy and creamy white with strands and little bumps of purple inside. Those purplish hues are 3 blood vessels: 2 arteries and 1 vein. The outer white part is called Wharton’s Jelly. The job of Wharton’s Jelly is to protect and insulate the cord blood vessels.
The 3 vessels of the Umbilical Cord
The arteries carry deoxygenated blood and “waste” away from your baby and the vein carries oxygenated blood and nutrients to your baby. This is the opposite of what happens in our bodies after we are born.
The Role of the cord vessels
Your Placenta is pretty clever, too…
It’s a huge filtration system that lets the good in and keeps the bad out —kind of like a bouncer at your baby’s nutrient bar. But that’s a post for another day and likely another website. LOL.
The Placenta acts as a filter and a transfer medium
Here’s the Clever Human Body part:
Allowing your baby’s cord to stop pulsating before it is cut gives baby a huge red cell boost! This is what happens…When air hits the Wharton’s Jelly, the “jelly” begins to constrict and cause the vessels to follow suit. The arteries close first, which stops the flow of blood out of the baby back to the placenta. The blood stays with your baby! The Vein is delayed in closing which allows for the remaining blood in the placenta to continue to be pumped to the baby (that’ the pulsation that you can actually feel if you touch the cord!). So, your baby continues to get what is left in the placenta! So smart, right? Usually, a cord takes just a few mins to stop pulsating, but I have personally seen a cord pulsate for 25 mins!
By the way, there are no nerves in the cord, so it doesn't hurt the baby at all! But the cord can feel a bit rubbery when cutting and that may feel funny to you!
So why is this important?
Did you know that at the time of birth, an average of 30% of your baby’s blood volume is still in the placenta. WOW!!
When you consider that a newborn has a blood volume of about 78 mls / kg, that 30% is a lot! One of the important outcomes of delayed clamping is increased blood volume, but even more important is the increased lung aeration of the newborn which is a factor in optimal cardiopulmonary transition. There is a slight increased risk of jaundice because of the extra red blood cells but in a healthy term newborn, the benefits are said to outweigh the risk of jaundice.
So, what does all of that actually mean? It means that newborns who have DCC tend to transition to newborn life better. They have higher hemoglobin and red blood cell volume at birth, higher iron levels and stores for months to come, higher myelin volume which is important for early brain development and processing. These benefits are life long!
Aren’t our human bodies are amazing and clever! So, if you weren’t thinking about DCC before… I hope you will now!
References:
Andersson, O., & Mercer, J. S. (2021). Cord management of the term newborn. Clinics in Perinatology, 48(3), 447-470.
Kiserud T, Acharya G. The fetal circulation. Prenat Diagn. (2004) 24:1049–59. doi: 10.1002/pd.1062
Mercer, Judith S., et al. “Effects of Delayed Cord Clamping on 4-Month Ferritin Levels, Brain Myelin Content, and Neurodevelopment: A Randomized Controlled Trial.” The Journal of Pediatrics, vol. 203, 2018, doi:10.1016/j.jpeds.2018.06.006.
Stenning, Fiona J., et al. “Transfusion or Timing: The Role of Blood Volume in Delayed Cord Clamping During the Cardiovascular Transition at Birth.” Frontiers in Pediatrics, vol. 7, 2019, doi:10.3389/fped.2019.00405.
“Umbilical Cord.” FamilyEducation, 24 June 2010, www.familyeducation.com/pregnancy/fetal-growth-development/role-umbilical-cord.
Wang, Y. (2017, June). Vascular biology of the placenta. In Colloquium Series on Integrated Systems Physiology: From Molecule to Function to Disease (Vol. 9, No. 3, pp. i-113). Morgan & Claypool Life Sciences.