Delayed Cord Clamping in Newborns
Recent developments in the topic of Delayed Cord Clamping got me to thinking. When I began teaching childbirth preparation classes years ago, the “movement” was suggesting many alternatives to accepted hospital protocol. At that time, the membership of Lamaze International or “ASPO”, (Association for Psychoprophylaxis in Obstetrics as it was originally named) was mostly comprised of members who were not nurses or doctors, but came from mostly non-medical backgrounds such as teachers, nutritionists, social workers, physical therapists etc.
The group emphasized “Family-Centered” birth, which meant allowing mothers and fathers to actively participate and make decisions about the birth of their child. Locally, both Community Hospital and Lewis Gale Hospital updated their birthing floors around that time, to accommodate the new idea of family-centered birth. As ordinary as this sounds today, it has been a long transition to what is now acceptable birth protocol in hospitals.
Lamaze advocates urged natural options such as freedom of movement during labor and opportunity to make choices about care. Reduced use of such interventions as confinement to bed, continuous fetal monitoring, IV, medications, stirrups, episiotomy were also emphasized.
The birth movement seems to have made great strides since that early time. Today, pregnant women have more leeway in choices of delivery and use of interventions for healthy, low-risk pregnancies. Many women are choosing free standing birth centers or home-birth options as well.
Meanwhile, professional organizations continue to urge medical personnel and hospitals to be more flexible in birth issues. Today, most members of Lamaze (and other national professional birth organizations) are nurses, doctors, chiropractors, midwives, doulas, physical therapists and other medically oriented professions. These professional change-agents can be even more effective than the “lay” persons who began to agitate for change in hospital births because they work in that very environment.
One practice, drawing attention recently, concerns whether to use Immediate Cord Clamping or Delayed Cord Clamping (DCC). I remember this as an issue from the early days of family-centered birth. As I recall, the discussion revolved around keeping the baby lower than the placenta before cutting the cord, so gravity would assist the blood to flow into the baby. Recently the idea of delayed cord clamping has again risen thanks to pioneer childbirth educator, physical therapist, author, and speaker, Penny Simkin. Her demonstration of why it is good to delay the cutting of the cord is a well-watched video on You Tube. The clip reminds me of a high school science fair demonstration it is simple but very effective and full of facts. (Search “delayed cord clamping” and/or “Penny Simkin”)
Page 2 Delayed Cord Clamping
Penny suggests that about 30% of the blood that circulates in the placenta through the cord to the baby, is deprived to the baby when the cord is cut soon after birth. Anyone questioning the benefits of DCC would be interested in the comments of Dr. Mark Stone, MD, a pediatrician who now is an Assistant Clinical Professor in the Department of Community and Family Medicine at the University of California, San Francisco. For anyone wishing more medically-oriented detail, check out an article and Q and A on the subject featured in the blog Science and Sensibility, from Lamaze International. (http://www.scienceandsensibility.org/?s=delayed+cord+clamping)
As it turns out, the opinion about babies not receiving much benefit from Delayed Cord Clamping is erroneous. Research even suggests DCC has benefits for compromised/sick babies as well. There have been numerous research projects over the past several years, many of which are documented in the above-mentioned article.
Delayed Cord Clamping is definitely one subject that interests parents-to-be. They are the ultimate “change agents” when they discuss with their care giver and request this practice for their own baby’s birth. I expect this common sense idea, backed by quality research will catch on and help newborns approach their new life with vigor. In closing, Dr. Stone’s own comments nicely pinpoint the importance of this subject.
Dr. Stone’s summary states:
Delayed cord clamping promotes a healthy neonatal cardiopulmonary transition, prevents iron deficiency at a critical time in brain development, provides the newborn with a rich supply of stem cells, and helps sick neonates achieve better outcomes—all with little apparent risk to mother or baby. The evidence of benefit from DCC is so compelling that the burden of proof must now lie with those who wish to continue the practice of immediate clamping, rather than with those who prefer—as nature intended—to wait.
By Vicki Honer BA LCCE IBCLC
Vicki has been working with new mothers for over thirty years, first in the capacity of volunteer La Leche League Leader and then Lamaze Certified Childbirth Educator and Int. Board Certified Lactation Consultant. She owns Lactation Connection, a shop with useful items for nursing mothers.