Why do Obstetricians Still Rush to Clamp the Cord?
By Dr. Mercola
December 02 2010
For many years, the World Health Organization and the International Federation
of Gynecology and Obstetrics have advised against early umbilical cord clamping.
But obstetricians have been reluctant to change their habits.
Although no clamping occurs in nature, cord clamping has become such an accepted
norm that delayed clamping is generally considered a new or unproved
Basic teaching of physiology could be a factor -- most textbooks state or imply
that the cord circulation closes only because of the application of the cord
clamp, which is not accurate.
Writing in the British Medical Journal, Dr. David Hutchon argues:
A separate review in the Journal of Cellular and Molecular Medicine also
highlights the importance of delayed cord clamping, stating:
- "Clamping the functioning umbilical cord at birth is an unproved
intervention. Lack of awareness of current evidence, pragmatism, and
conflicting guidelines are all preventing change. To prevent further injury
to babies we would be better to rush to change."
- "Many clinical studies have revealed that the delayed cord clamping
elevates blood volume and hemoglobin and prevents anemia in infants.
- Moreover, since it was known that umbilical cord blood contains various
valuable stem cells such as hematopoietic stem cells, endothelial cell
precursors, mesenchymal progenitors and multipotent/pluripotent lineage stem
cells, the merit of delayed cord clamping has been magnified."
Journal November 10 2010
Journal of Cellular and
Molecular Medicine March 2010; 14(3):488-95
iVillage.com June 1, 2010
Dr. Mercola's Comments:
- In U.S. hospitals, the clamping and cutting of the umbilical cord is
typically performed within 30 seconds of birth, sometimes sooner. This is
done because immediate cord clamping is generally believed to reduce the
mother's risk of excess bleeding and the baby's risk of jaundice … but this
practice may actually be detrimental to the baby's health.
- When a baby is born it must transfer from receiving oxygen from the
placenta to receiving oxygen from its lungs. For this to happen, the baby's
lungs must first expand, and the burst of blood from the umbilical cord
helps to get the newborn's lungs to expand properly.
- Without the burst of blood from the placenta, the infant suffers a drop
in blood pressure as its lungs fail to open as they should, creating a chain
reaction of effects that can include brain damage and lung damage. Immediate
cord clamping can cause hypotension, hypovolemia (decreased blood volume)
and infant anemia, resulting in cognitive deficits.
- Some have even theorized that the rise in autism could be linked at
least in part to premature cord clamping.
World Health Organization, Extensive Research Supports Delayed Cord
- In the United States there is absolutely no consensus about the optimal
time to clamp the umbilical cord after birth, yet research is increasingly
revealing that clamping the umbilical cord prematurely, before two or even
three full minutes have elapsed, robs your baby of much-needed blood and
- The World Health Organization's (WHO) policy
supports delayed cord clamping, stating:
- "The optimal time to clamp the umbilical cord for all infants
regardless of gestational age or fetal weight is when the circulation in
the cord has ceased, and the cord is flat and pulseless (approximately 3
minutes or more after birth)."
- They continue:
- "Clamping the umbilical cord immediately (within the first 10 to 15
seconds after delivery) prevents the newborn from receiving adequate
blood volume and consequently sufficient iron stores.
- Immediate cord clamping has been shown to increase the incidence of
iron deficiency and anemia during the first half of infancy, with lower
birth weight infants and infants born to iron-deficient mothers being at
particular risk …
- Waiting to clamp the umbilical cord allows a physiological transfer
of placental blood to the infant which provides sufficient iron reserves
for the first 6 to 8 months of life, preventing or delaying the
development of iron deficiency …
- For premature and low birth weight infants, immediate cord clamping
can also increase the risk of intraventricular hemorrhage and late-onset
sepsis.13 In addition, immediate cord clamping in these infants
increases the need for blood transfusions for anemia and low blood
- Numerous research studies and experts are also confirming that waiting
to clamp the cord offers significant benefits. Among them:
- Andrew Weeks, senior lecturer in obstetrics,
advises it's "better not
to rush" umbilical cord clamping after birth.
- In the Journal of Cellular and Molecular Medicine, researchers say
delayed cord clamping is "mankind's
first stem cell transfer and propose that it should be encouraged in
- In a BMJ editorial, James Neilson, professor of obstetrics and
gynecology, states that
delayed clamping should be practiced.
Why is Immediate Cord Clamping Routine?
- This is a question many experts are now seeking to answer, but it seems
this is another example of an outdated medical practice that has become
routine before anyone stopped to consider if it was actually beneficial.
- As David Hutchon, retired consultant obstetrician,
said in BMJ:
- "Cord clamping has become the accepted norm so much so that delayed
clamping is generally considered a new or unproved intervention.
- Thus, showing that immediate or early cord clamping offers no
advantage to the baby is not enough; it has to be proved beyond
reasonable doubt that it is harmful. Other interventions such as routine
episiotomy were quickly abandoned when it was shown that they gave no
- Very often cords are now also clamped early to collect cord blood and
cord stem cells to be used for various medical and commercial purposes. But
the evidence is clearly emerging that the most beneficial use for cord blood
may be to allow it to transfer to the baby immediately at birth.
- While most full-term babies have enough blood to establish lung function
and prevent brain damage from early clamping, the process often leaves them
pale and weak. For premature babies, the process can be even more
devastating. And no matter what, immediate cord clamping will cause some
degree of asphyxia and loss of blood volume because it:
- Completely cuts off the infant brain's oxygen supply from the placenta
before lungs begin to function.
- Stops placental transfusion -- the transfer of a large volume of blood
(up to 50% increase in total blood volume) that is used mainly to establish
circulation through the baby's lungs to start them functioning.
- Keeping valuable oxygen and blood from an infant by clamping the
umbilical cord prematurely increases the baby's risk of brain hemorrhage and
breathing problems. It has also been implicated as a contributing factor to:
- Cerebral Palsy
- Learning disorders and mental deficiency
- Behavioral disorders
- Respiratory distress
Remember, You Have a Choice
- As with many areas of medical care it's easy to get swept up in the
system once you enter a hospital setting. But if you are currently pregnant
and weighing your birth options, it's important to know that you have a
- First and foremost, you can choose a practitioner, such as a midwife or
holistically oriented obstetrician, who is aware of the benefits of delayed
cord clamping and will work with you on your desire to have this during your
- Next, be sure and make it known to your practitioner both before you go
into labor and again when you enter the hospital that you desire delayed
cord clamping. If you
choose to give birth at home you should discuss this choice with your
practitioner in advance as well.
- If your practitioner tells you that he or she will only perform
immediate cord clamping, and this is not in line with your beliefs, it's
time to find a new practitioner who will work with you on these potentially
life-changing birth choices.
Premature Clamping of the Umbilical Cord may Result in Brain Damage to Newborns
Are Doctors Causing Infant Brain Damage by Clamping the Umbilical Cord
How the Cord Clamp Injures Your Baby’s Brain