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Posted August 8, 2013 in BIRTHING
 
 

Newborns Benefit From Delayed Cord Clamping

Natural Home Birth | Water Birth | Midwife | Doula | Atlanta | Georgia | LeahAndMark.com
Natural Home Birth | Water Birth | Midwife | Doula | Atlanta | Georgia | LeahAndMark.com

Most mammals with pregnancy have a placenta that provides nutrition for growth and survival up to birth. During natural birth after the baby is born, both mother and baby remain attached via the umbilical cord which is part of the placenta. In nature with undisturbed birth, the chimpanzee mother will focus no attention on severing the umbilical cord, instead she remains still holding, nursing her baby with placenta and cord attached until it dries and separates within a day. However with human childbirth when it takes place in a hospital setting, newborns are separated by immediate clamping and cutting of this cord. This is a ritual intervention that is performed during the third stage of childbirth (duration from birth of baby to birth of placenta.) The timing of this third stage can vary from woman to woman, and is often interrupted from clinical policy or practice.

A new study released by the Cochrane Review shows several benefits of delaying umbilical cord clamping after childbirth. Even though early cord clamping has been taught as a means to reduce the risk of postpartum hemorrhage in mothers, new medical research findings are showing otherwise. This review included 15 randomized trials and involved nearly 4000 birthing women and newborn pairs. These results have shown no significant difference with postpartum hemorrhage rates when comparing both early and late umbilical cord clamping.

The study findings however do show several advantages when clamping is delayed in healthy term newborns, such as increased birth weight, early hemoglobin concentration, and increase of iron reserves are seen up to six months following the birth. According to research when delayed clamping is up to 3 minutes, placenta transfusion takes place pulsing an additional 20 to 40 ml of blood from the placenta to the newborn, with this come additional iron stores of 30 to 35 mg. This provides months of increased iron stores which can be especially helpful for a newborn that is exclusively breastfed by bridging a healthy transition to solid foods.

Researchers have disagreed on whether early immediate cord clamping puts the newborn at risk of hypovolemic damage, iron loss or possible blood disorders and type 2 diabetes as a result of loss of hematopoietic stem cells. Placental cord blood is known to be rich in hematopoietic stem cells which possess the ability to transform into other types of cells with a specialized function. These cells are similar to those found in bone marrow and have been used in the treatment of various blood disorders affecting immune system, leukemia, some cancers and inherited disorders. When collected from donors, these stem cells have been used to treat more than 80 different diseases. The practice of early cord clamping only to discard the placenta with cord blood that holds such valuable stem cells seems such a loss given the outcome of research benefits.

Previous medical theory has been that by delaying cord clamping, thus allowing additional blood flow would increase the risk of newborn jaundice, elevating bilirubin and the need for light therapy. While there may be a slight risk of newborn jaundice, this risk can be easily managed and much less of a risk than that of anemia. In clinical research, the findings have not shown statistical significance to warrant early cord clamping with term newborns; however the American College of Obstetricians and Gynecologists has not yet recognized late cord clamping as a standard of care. Interesting enough it is and has been common practice among independent home birth midwives to practice delayed cord clamping by waiting until the cord stops pulsation, thereby emptying and turning white. This routine delay last well beyond 3 minutes and most often up to 15-20 minutes. Numerous midwives have been known to leave the placenta, cord and baby attached well after birth before severance, leaving postpartum outcomes of both routine practices without an increased incidence of newborn jaundice.

Furthermore, increasing in popularity are parents that have chosen to practice un-disturbed birth, allowing the natural process of birth to unfold with the belief that the placenta blood, stem cells and nutrients belong to this child. Taking it one step further would be what is called a Lotus birth, this is when the baby with cord and placenta are never severed and are left to dry and separate naturally. Most may see this as extreme, however it is similar to that of the instinct of other mammals, with the focus and attention being on nursing and the bonding process and not the severance of the umbilical cord. No matter if undisturbed birth or Lotus birth is of interest or not the research results remain that newborns benefit from delayed cord clamping after childbirth.

Charlotte Sanchez (CPM) is a Certified Professional Midwife and Childbirth Educator
For Over 20 Years.

 http://jama.jamanetwork.com/article.aspx?articleid=206143  

http://summaries.cochrane.org/CD004074/effect-of-timing-of-umbilical-cord-clamping-of-term-infants-on-mother-and-baby-outcomes