Delayed Cord Clamping During C-Section

Delayed Cord Clamping During C-Section

The many benefits of waiting until your baby’s umbilical cord has stopped pulsating before cutting it are well known.

In the moments following birth, your baby is undergoing a rapid and amazing change – adapting to breathing via his lungs and taking nourishment through his mouth. While this transition is underway, your baby is still receiving blood from the placenta.

Until recently, immediate clamping of the cord was standard practice in hospitals worldwide. Evidence showing the benefits of delayed cord clamping (DCC) for healthy babies is now leading practitioners to wait at least 5 minutes before cutting the cord.

And now, more women are also demanding delayed cord clamping as part of their c-section birth plan.

Delayed Cord Clamping During C-Section

So, what should you know about delayed cord clamping during c-section? Firstly, let’s go over the all important benefits of delayed cord clamping.

Benefits of Delayed Cord Clamping

When your baby is born, about one third of his blood volume might be in the umbilical cord and placenta. If the cord is cut immediately, this blood is no longer available to the baby.

During a vaginal birth, many women request the cord is not cut until the umbilical cord has stopped pulsating, which indicates the placenta has stopped pumping blood to the baby. The increased blood volume has many benefits, which has been repeatedly proven by a good number of studies:

Read more about the huge benefits of delayed cord clamping and why more parents-to-be are demanding it, here.

Delayed clamping of the cord in c-section is possible for many babies, and is becoming standard practice for a growing number of obstetricians.

Delayed Cord Clamping and C-Section

There is a number of ways delayed cord clamping can be facilitated during a c-section.

  • Your obstetrician makes the incision into your abdomen and delivers your baby’s head. The baby is given time to begin breathing while still attached to the placenta. When the baby begins to cry the obstetrician eases out the shoulders and helps the baby to push through the incision. The cord is left intact until the baby is completely born.
  • The baby is delivered and the placenta is removed and kept level with, or above, the baby. This keeps the baby, cord and placenta together, allowing for a lotus birth.
  • The baby is delivered and placed below the level of the placenta, still inside the uterus, for 30-60 seconds before clamping.
  • The umbilical cord is milked or stripped toward the baby, before clamping.
  •  The umbilical cord is kept covered with a towel, while the baby transitions to breathing, to prevent cord constriction from exposure to cold air.

Delayed clamping might not be beneficial, or even safe, for your baby in certain situations;  these include c-sections that are being performed because your baby has a slow heart rate, severe fetal distress, placental abruption, and placenta previa.

In these situations, if the baby is delivered and immediately shows signs of being well, it might be possible for the obstetrician to milk the cord blood toward the baby, before clamping.

How To Have Delayed Cord Clamping With C-Section

While there is a growing number of maternity health providers who are aware of delayed cord clamping with c-section, many have limited knowledge or experience of it. Some obstetricians might be concerned about the extra time that DCC takes, in case there are complications with either mother or baby.

Parents wishing to have a DCC with c-section can face many challenges, and resistance from staff. Finding an obstetrician who supports or is experienced in DCC with c-section could be difficult. If an obstetrician is willing to undertake the procedure, other staff who will be present at the surgery might not be comfortable with the idea.

If you are planning an elective c-section, you have some time to discuss DCC with your obstetrician. In the event of an unplanned or emergency c-section, you might not have as much time to discuss your wishes. It’s a good idea to make a plan just in case this happens, especially if you are at risk for an induction or other procedure that increases your chances for a c-section.

During your prenatal appointments, make sure you talk to your doctor or midwife about your wish for DCC if a c-section becomes necessary. It’s better to have the discussion earlier than to wait until you are about to be taken into theatre. It also gives you the opportunity to change care providers if DCC is important to you.

If DCC is not possible, due to caregiver reference or for medical reasons, ask your doctor to consider cord milking. Cord milking involves pushing the blood away from the placenta and toward the baby; it can be done quite quickly, taking much less time than DCC (about 20 seconds instead of 60 seconds).

While this process is not a slow and easy transition from womb to world, it still allows your baby to receive more placental blood than if the cord were clamped immediately. The other advantage of cord milking is that the obstetrician can pass the baby to waiting paediatric staff, who can do the milking. This allows the obstetrician to focus on finishing the surgery without delay.

Delayed cord clamping is now so widely acknowledged for improving babies’ health that it should be standard practice for all births. All women should talk to their care providers about cord management following birth, and find out about the protocol for leaving the cord intact, in a number of situations, including c-section.

Being prepared for all eventualities, and informed on the best procedure for your situation, can help you to make the right decision when the time comes.

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Sam McCulloch enjoys talking so much about birth that she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she watches Downton Abbey and has numerous creative projects on the go. She is mother to three beautiful little humans.

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