Delayed Clamping of the Umbilical Cord: A Review with Implications for Practice

Gina Eichenbaum-Pikser, CNM, MSN; Joanna S. Zasloff, CNM, MSN

Disclosures

J Midwifery Womens Health. 2009;5(4):321-326. 

In This Article

Implications for Clinical Practice

The practice of delayed cord clamping has shown many benefits to the newborn with no documentation of significant risk. As such, it is incumbent upon clinicians to educate their clients about the physiologic impact of the practice of delayed cord clamping and to involve women in this decision, as we do in so many other clinical scenarios. In the case described at the beginning of this article, S.N. had not been counseled prenatally regarding the options for cord clamping, nor was she involved in the decision after her birth.

There are currently no formal clinical guidelines for the timing of umbilical cord clamping.[15] Therefore, the amount of time between birth and cord clamping is a decision made by the individual provider based largely on personal preference. It is essential for midwives and other obstetric providers to establish a clear definition of delayed cord clamping, along with a set of clinical guidelines. Likewise, further research should be done on delayed cord clamping and its impact on both breastfeeding and bonding. An intact umbilical cord inherently necessitates physical closeness between the mother and baby and can therefore aid in immediate bonding by disallowing separation. As professionals, we need to be open and eager to participate in carefully designed studies that might further increase our understanding of the implications of delayed cord clamping.

It is vital that clinicians seek to provide evidence-based care. This ensures better care for the women and babies we serve, and emphasizes a culture of attentiveness to clinical evidence. Based on currently available published studies, we conclude that delayed clamping of the umbilical cord should be routinely considered for all women. Waiting 1 to 3 minutes (or until pulsations stop) to cut the umbilical cord has been shown to have numerous benefits for the newborn without additional risk to either the newborn or mother.

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