HW # 41 - Independent Research

When to Cut the Umbilical Cord

I find this to be an appropriate “Normal is Weird” subject because
as part of a normal birth process the umbilical cord is cut right away
in spite of the fact that all the acquired knowledge to date and research
trials recommend waiting even as short a time as three minutes
for the good of the baby.


“Health risks, benefits come with delayed umbilical cord clamping.” Center for Advancing Health. 15 April 2008

This article reports on a review of 11 studies evaluating the benefits of delaying the clamping of the umbilical cord. Results showed that “in most cases the time difference between early and late cord clamping is just one or two minutes, but the delay allows for an additional infusion of blood from mother to child.” Benefit: additional blood going to baby provides more iron and counters risk of anemia. Risk: mild form of jaundice caused because immature liver cannot process all the bilirubin, a yellow byproduct of breakdown or red blood cells that gets pushed out to tissues and causes baby to look a little yellow. Generally, sunlight gets rid of it, but sometimes there is a need for phototherapy, requiring technology that is not always available in some parts of the world.


“Effect of Timing of Umbilical Cord Clamping of Term Infants on Maternal and Neonatal Outcomes.” RHL commentary (last revised: 2 March 2009). The WHO Reproductive Health Library; Geneva: World Health Organization

This article studies that have demonstrated that “there is a transfer from the placenta of about 80 ml of blood at 1 minute after birth, reaching about 100 ml at 3 minutes after birth.” It makes the case that late clamping is especially important in poor areas where there is not “access to good nuturition.”


“Care of the Umbilical Cord: A Review of the Evidence.” World Health Organization, 1999

This article talks about traditional beliefs about the cutting of the umbilical cord in other cultures. “In many cultures, people believe that all life from the placenta must be transferred to the newborn for otherwise they baby may die. Therefore the cord is usually cut after cord pulsations stop or after the delivery of the placenta.” The article also describes the umbilical cord as “a unique tissue, consisting of two arteries and one vein covered by a mucoid connective tissue called Wharton’s jelly and a thin mucous membrane. Blood flowing through the cord brings nutrients and oxygen to the fetus and carries away carbon dioxide and metabolic wastes.”


“Early or Late Cord Clamping?” Midwifery Today E-News 23 July 1999

This article states that clamping the umbilical cord too early is dangerous because when a baby takes its first breath the aeration of the lungs causes “a massive increase in pulmonary blood flow,” which is supposed to come from the placenta. If the cord is cut right away, blood has to come from the baby’s other organs and for some babies this could be fatal.


Forro, Chinmayo. “The Unbilical Cord Blood Controversy.” 2009

This article begins with some history – first person to say that the cord must be cut immediately after birth was a 17th century French obstetrician Francois Mauriceau. Even though there was no evidence at the time, most obstetricians today follow Dr. Mauriceau’s recommendation. The article quotes Doctors Barclay and Murata from an article they published in Pediatrics in 2006 that said cutting the cord right away “might deprive the newborn of some benefits such as an increase in iron storate…Iron deficiency early in life may have pronounced central nervous system effects such as cognitive impairment,” and that delaying cord cutting is also good because “the increase of hematopoietic stem cells transfused to the newborn might play a role on different blood disorders and immune conditions.”


“Scientist says Umbilical Cords Should Be Cut Later.” 25 May 2010

This article quotes Professor Paul Sanberg, the lead researcher in a study described in the Journal of Cellular and Molecular Medicine. It says, “Delayed cord clamping may have a host of positive consequences, including reduced risks for developing conditions such as respiratory distress, chronic lung disease, brain hemorrhages, anemia, sepsis and eye disease.”


“Benefits of delayed cord clamping.” Write About Birth. 9 July 2010

This article says that it is not true that delaying the cutting of the umbilical cord could bring too much blood to the baby’s system and overload it. It says that there is evidence that the newborn’s circulatory system “is capable of rapid adjustment to an increase in blood volume and viscosity by increased fluid extravasation and dilation of blood vessels.” It also says that midwives like to wait until the pulsing action stops in the cord because they they know that the blood has all gone into the baby.


Hughes, Pattie. “Should You Bank Baby’s Cord Blood?” Families .com 2001

This article talks about some parents who spend $1500 to put their baby’s umbilical cord blood in a bank with a storage fee of $100 each year in case their child ever develops a disease the stem cells in this blood could cure. This “blood banking” is not regulated so no one knows how long the blood would be effective. Also with some forms of cancer like leukemia and genetic disorders the blood stem cells might have the disease and not be helpful. Also the amount of blood might help a small child but not be enough for a grownup.


“Benefits of Delayed Cord Clamping.” Doula and Birth Services: Butterfly Birth. 12 July 2009

This article by a doula recommends waiting as long as an hour or an hour and a half for the placenta to come out and then cutting the cord. She says it is important for the baby to be lower that the placenta before it comes out so there can be effective blood flow.
The article also explains that the reason hospitals cut the cord immediately is out of habit from a time when most women were unconscious when they were giving birth and that doctors did not want the anesthetic to get into the baby through the cord. It also talks about the fact that when the cutting is delayed the blood in the placenta (up to 40% of the baby’s blood) will go into the baby and shrink the size of the placenta making it easier for it to come out faster and prevent more bleeding from the mother.