What is Delayed Cord Clamping?
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History of Delayed Cord Clamping
Delayed cord clamping (DCC) is the practice of waiting a period of time after birth before clamping and cutting the umbilical cord. Historically, immediate cord clamping was standard in many parts of the world despite limited evidence supporting its benefits. Early clamping has actually been associated with increased risks of neonatal anemia, intraventricular hemorrhage in preterm infants, and respiratory complications.
Recent guidelines have shifted to endorse delayed cord clamping. The World Health Organization (WHO) and other international bodies have updated their recommendations to support DCC, recognizing its benefits in improving neonatal outcomes.
Why Practice Delayed Cord Clamping?
Delayed cord clamping typically involves waiting at least a few minutes after birth or until the umbilical cord stops pulsating before clamping. This allows the baby to continue receiving blood from the placenta, a process called placental transfusion.
At Cincinnati Birth Center, we allow parents to decide when they want the cord clamped, but our policy is to typically wait about an hour.
After birth, the umbilical cord still contains a significant volume of blood—up to one-third of the baby’s total blood volume. As the baby takes its first breaths, changes in pressure within the heart and lungs help to draw blood from the placenta through the umbilical cord. The placenta continues to deliver oxygen-rich and nutrient-laden blood to the baby while their circulatory system transitions from reliance on the placenta to independent breathing and circulation.
DCC Benefits for Baby
Improved Iron Stores
Research shows that delayed cord clamping can significantly increase a newborn's iron stores. A study published in The Journal of Pediatrics found that infants who experienced DCC had higher ferritin levels at four months of age, reducing the risk of iron deficiency anemia—a condition that can impair cognitive and motor development [1].Better Circulatory Transition
DCC supports the baby’s circulatory system as they adapt to life outside the womb. By allowing blood flow from the placenta to continue, the baby receives more red blood cells and stem cells, improving oxygen delivery to vital organs during the critical neonatal period.Reduced Risk of Intraventricular Hemorrhage
Preterm infants benefit immensely from DCC, with studies showing a reduced risk of intraventricular hemorrhage (bleeding in the brain) and sepsis [2]. These benefits are particularly important for babies born before 37 weeks.Boosted Immune Function
The additional stem cells transferred during delayed cord clamping play a role in repairing tissue and boosting the immune system, offering long-term developmental benefits.
Benefits for Mother
Facilitates Natural Birth Processes
Waiting to clamp the cord may encourage a physiological third stage of labor. This helps the placenta separate naturally, reducing the risk of retained placenta, which can lead to postpartum hemorrhage.Enhanced Bonding Opportunity
Delayed cord clamping often pairs with immediate skin-to-skin contact, creating a calmer postpartum environment that supports maternal-infant bonding and successful breastfeeding.Improved Postpartum Outcomes
By allowing the placenta to fully deliver its blood supply, the process may lead to a more complete uterine contraction, aiding in reducing postpartum blood loss.
While DCC is beneficial in most cases, certain situations, such as severe fetal distress or maternal hemorrhage, may necessitate immediate cord clamping. Parents should discuss their preferences and birth plans with their care provider to ensure the best outcomes.
From improved iron levels in newborns to enhanced postpartum recovery for mothers, DCC is an important practice that should be part of informed discussions about birth plans.
