Is Delayed Cord Clamping Possible with a C Section?
Until recently, the standard practice of labor has been to cut the umbilical cord right after the child is born. But now, that’s changed. Why?
What Is Delayed Umbilical Cord Clamping?
Doctors and medical researchers have found that there are many benefits associated with waiting 1-3 minutes before clamping the cord. Because of this, many women have started to include delayed cord clamping in their C-section birth plans.
Before we go into explaining the details of delayed cord clamping and C-sections, let’s take a look at its benefits.
- According to the WHO, delayed cord clamping improves “maternal and infant health and nutrition outcomes”.
- It helps to improve the baby’s iron levels for up to six months post-birth, thereby preventing iron deficiency anemia.
- It increases the baby’s blood volume.
- Studies have also shown that neurodevelopment of the baby may be enhanced when the cord clamping is delayed.
- For preterm babies, delayed cord clamping decreases the need for blood transfusion, the seriousness of respiratory distress and the incidence of intraventricular hemorrhage and late-onset sepsis.
There are also other potential benefits that are still being investigated.
Is Delayed Cord Clamping Possible with a C-section?
- Delay in cord clamping increases the volume of blood the new infant has and similar effects have been found in c-section births.
- A recent study showed when you delay cord clamping by 30 seconds in a cesarean section, the baby has higher iron reserves at 4 months than those who had their cords clamped early via vaginal delivery. In fact, it found that these caesarean delivered babies, whose cord clamping were delayed by 30 seconds had iron statuses comparable with those whose cord clamping was delayed by 3 minutes after vaginal delivery.
- Medical authorities are still not completely sold on whether or not there are actually great benefits of delaying cord clamping in c-sections. It’s important to note, though, that for the prevention of postpartum hemorrhage, the WHO recommends delayed cord clamping equally for both vaginal and cesarean section deliveries. That means there’s definitely one benefit of it confirmed. There are also trials underway looking into the other potential pluses of it for c-sections. Results of these trials are expected to be published soon.
- There are still lingering doubts as to whether delayed cord clamping is compatible with c-sections. This is because there is a risk of the mother hemorrhaging/bleeding excessively. Also, the uterus has been cut and does not contract the same way it would as in a vaginal delivery.
How Does Delayed Cord Clamping after a C-Section Work?
There are different ways delayed cord clamping can be achieved in a cesarean section.
The doctor can make the incision on your belly and deliver only the baby’s head initially. When the baby starts breathing and crying, it’s eased out of the incision and the cord remains intact until delivery is complete.
- Alternatively, it can be achieved by having a lotus birth. In this, the baby is delivered completely with the placenta and cord still attached to it. The lotus birth can be completed by waiting for the cord to fall off naturally after some days or it can be cut after a few minutes.
- The ACOG recommends that in order to promote skin-skin contact along with delayed cord clamping in a c-section, the baby can be placed on the abdomen or legs of the mother. Alternatively, the surgeon can hold the infant close to the level of the placenta until the cord is clamped.
- Recent research shows that with c-sections, the physician shouldn’t just delay cord clamping, he should also manually milk the cord and push more blood into the baby. This is because the uterus doesn’t contract the same way as in a vaginal delivery and the transfer of blood needs to be helped along. This process is called cord milking and should be considered by a physician along with delayed cord clamping when a cesarean birth is underway.
- The positioning of the baby during delayed cord clamping is irrelevant. Studies have shown that there’s no difference in the amount of extra blood that gets passed to the baby whether it’s placed on the mother’s abdomen or held at vaginal level.
How To Ensure The Cord Clamping Is Delayed in a C-Section
Delayed cord clamping is a practice that is really just gaining recognition. This means that a lot of physicians or surgeons may either have not heard about it or have limited experience with it. Also, a lot of obstetricians and medical staff are unwilling to allow delayed cord clamping in c-sections because of the reasonable risks associated with it.
If you’re having an elective c-section, make sure to discuss your preference for delayed cord clamping with your obstetrician way before your due date. He/she will then discuss the procedure with you and you’ll decide if it’s really the best choice for you. It’s better to have this conversation earlier, instead of waiting till you’re being taken to the theater to speak. It gives you the opportunity to be better educated about the pros and cons of delayed cord clamping, especially as it relates to your personal medical and pregnancy history. It also gives you the time to change your care provider in case your current one refuses to do it and delayed cord clamping is very important to you.
It’s super important to note that delayed cord clamping is not recommended in situations where the c-section is performed because the baby has a low heart rate or is in some form of distress. Also, where some form of placenta disorder like previa or accreta is present and has necessitated a c-section, delayed cord clamping should not be done.
Delayed Cord Clamping is a great way to ensure that your child has a healthy childhood. It is a myth that delayed cord clamping can not be done with Cord Blood Banking. Cord Blood Banking helps keep baby safe. Learn more about the potentially life saving benefits of Cord Blood Banking.
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Polin, Richard A., William W. Fox, and Steven H. Abman. Fetal and Neonatal Physiology. Philadelphia, PA: W.B. Saunders, 2004. Print.
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- Fetal and Neonatal Physiology E-Book
- NCBI, Pubmed: Delayed cord clamping in cesarean section with general anesthesia
- NCBI, Pubmed: Elective caesarean: does delay in cord clamping for 30 s ensure sufficient iron stores at 4 months of age? A historical cohort control study
- CTG labs - NCBI. (n.d.-g).
- CBEd, S. M. D. (2023, September 17). Lotus Birth: 7 Reasons Why Parents-To-Be Have One. BellyBelly.
- AAP: Umbilical Cord Milking Versus Delayed Cord Clamping in Preterm Infants
- The Lancet: Effect of gravity on volume of placental transfusion: a multicentre, randomised, non-inferiority trial
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