Immediate and premature clamping of the baby’s umbilical cord is a ritual performed in many hospitals across the globe.
Premature clamping became standard clinical practice without evidence and without regard/ understanding of the physiological changes in the baby in the first few minutes after birth.
There is no scientific evidence that supports immediate clamping in vaginal or cesarean birth.
For those interested in achieving delayed clamping for their baby in hospital birth, this article contains some suggestions for research, discussion and possible inclusion in your birth plan.
The option of refusing immediate clamping is an important consideration for all parents, because delayed clamping can help:
- your baby to achieve a normal blood volume at birth,
- your baby to maintain a normal oxygen supply during the transition to breathing at birth,
- your baby to achieve a normal total body iron at birth,
- the mother to have a normal and uncomplicated placental birth and blood loss,
- both mother and baby avoid unnecessary trauma and harm.
The suggestions in this article are for you to consider and discuss with your birth team (partner, doula, midwife, obstetrician).
Please ensure your decisions about umbilical cord clamping are made in collaboration with a clinical care provider and you are fully informed of any contra-indications to delayed clamping.
Suggestions for Your Birth Plan
- Whether natural or medicated, my plan is to birth actively and upright wherever possible – and for our baby to make a full transition at birth with the umbilical cord intact.
- This may require staff to be prepared to assist away from a bed and have resuscitation equipment ready.
Do Not Consent
IN VAGINAL BIRTH
- I do not consent to umbilical cord clamping while the placenta is still functional/cord intact – I take full responsibility for this decision
- I do not consent to checking, pulling or cutting the cord in the event of nuchal cord – please somersault if tight
- I do not consent to routine suctioning of my baby at birth
- I do not consent to traction on the cord to deliver the placenta
IN SURGICAL DELIVERY
- I do not consent to umbilical cord clamping prior to my baby establishing respiration (unless there is damage to cord or placenta).
- Please slow the delivery of my baby or lower my baby and ‘milk’ the umbilical cord several times before clamping.
LABOUR AND BIRTH
- To use positions for labour, monitoring and pushing that ensures optimal blood flow and oxygen to my baby
- I prefer the umbilical cord is not touched without my verbal consent
- Immediate skin to skin, unless baby is born volume-deplete – then please temporarily lower baby to assist transfusion
- If baby is compromised or flat, please assess and provide support/initial resuscitation with the umbilical cord intact
- If the birth is physiological with no risk factors for hemorrhage, I would like to try for a physiological third stage – I request to be undisturbed for 60mins before discussing active management
- I would like __________ to cut the cord – after physiological cord closure
- No suctioning
- I wish for my baby to warmed directly skin-to-skin with me or my partner, and covered with warm blankets etc – prior to my baby being dressed or bathed
- Breastfeeding (essential if planning a natural placental birth)
- No circumcision*
(*This birth plan is designed to minimise trauma and protect your baby’s health, normal blood volume and total body iron. Parents are encouraged to research the blood loss, pain, major and minor long-term risks of circumcision - and explore possible alternatives – as well as consider their religious and cultural norms.)
- I would like to ensure my baby has a blood volume and number of stem cells as close to physiological as possible.
- Depending on circumstances, please consider:
- slowing the delivery to allow respiration to establish before full delivery,
- use of synthetic oxytocin to produce uterine contractions for placental transfusion,
- keeping baby below level of placenta and ”milking” the cord before clamping,
- or keeping the baby-cord-placenta attached (lotus c-section)
- or sourcing whole blood directly from the placenta for autologous transfusion in case of dire obstetric complication (abruption, rupture, need for immediate resuscitation etc)
(Please refer to this article Delayed Clamping and Cesarean Section - for discussion and links to evidence to share with your providers.)Please note this page does not constitute medical advice.
This site is for information sharing and discussion only – the web host assumes no responsibility for any loss/injury/damage arising related to any use of the content contained in, or linked to this website. It is up to the individual, in collaboration with their clinical care provider, to determine the appropriate course of action, treatment and management.