Cutting The Umbilical Cord

     For a long time, Nurse Practitioners and Midwives have tried to convince medical doctors to delay cutting the umbilical cord after birth. Historically, the umbilical cord was not cut immediately after birth and in most third world countries cutting the umbilical cord is also delayed for over 1-2 minutes after birth. In contrast, in this country the umbilical cord is usually cut 10 to 15 seconds after birth.

     Not clamping the cord results in the infant getting extra blood that is pumped out of the placenta after birth. Medical doctors have believed that this extra blood was harmful to the infant because it caused the infant to have too much blood and it also increased the risk of jaundice in the first few days of life. Midwives have held that humans have always waited to clamp the cord because the extra blood is helpful to the baby.

     There are two studies in the August, 2014 issue of Pediatrics, the official journal of the American Academy of Pediatrics, which go a long way to support the opinion that clamping the cord should be delayed. The first is a very complex, scientific study that measures stress in the newborn.  The researchers found that not only did the extra blood from the placenta reduce the post-delivery stress of the newborn, but it also gave some helpful elements that helped the infants deal with the stress of delivery. The second study was done in a rural Tanzania hospital and it found that, even in healthy infants who were breathing on their own after delivery, the complication rate for the infants was decreased by 20% for every 10-second delay in clamping the cord after the infant started breathing.

     The current practice in most American hospitals is that immediately after birth the cord is clamped and cut and then the infant is given to the nurse, pediatrician, or nurse practitioner who is responsible for the infant’s immediate care. The doctor who is responsible for the delivery needs to concentrate on the mother’s care. Delaying the cutting of the cord would be difficult. The second study suggested that, even if the infant wasn’t breathing at first, delaying the cutting of the cord was still beneficial. But when an infant isn’t breathing after delivery, our current way of thinking is that the infant should immediately be given respiratory support with a bag-mask respirator. Doing this at the foot of the delivery bed would mean a significant change in the procedure.

     Modern medicine improves its care by continually questioning its practices and procedures. If these studies hold to be true, it may result in changes in every delivery room in the country.