Don’t Change Your Birth Plans! Delayed Cord Clamping After a C-Section is Safe

Have you read about the benefits of delayed cord clamping but wonder if it’s possible after a c-section? While simple, we know that this practice offers many benefits, but it can be difficult in a surgery setting. 

In a traditional birth setting, waiting to clamp the umbilical cord isn’t a big deal, but it can be trickier for those with c-sections. Not all doctors currently offer this to patients, but as the benefits become more evident, more women push this practice to be universal.

Ready to learn more and decide if this should be in your c-section birth plan? Let’s dive in together!

What is Delayed Cord Clamping? 

Until recently, doctors cut the umbilical cord directly after birth, but evidence shows it’s not the best practice to continue. 

Delayed cord clamping is the practice of waiting 1-3 minutes to place a clamp on the umbilical cord. Studies indicate that when doctors wait to clamp the cord, over 115ml of blood is transferred from the placenta to the baby after three minutes. That’s compared to only 80ml of blood transferred one minute after birth.

This is important:

When doctors clamp the umbilical cord directly after birth, it prevents blood flow and decreases your baby’s iron intake. Currently, the recommendation is to wait for three minutes and no longer because the evidence doesn’t show any benefits after three minutes. 

The Benefits of Delayed Cord Clamping

So, why would you want to delay the cord clamping during a c-section? Research shows us many benefits to this simple practice, such as:

  • Decreases the risk of iron deficiency anemia 
  • Improves iron levels for up to six months after birth 
  • Reduces the risk of needing a blood transfusion
  • Increases the baby’s blood volume 
  • Might lead to enhanced neurodevelopment 
  • Decreases the risk of bleeding in the brain and necrotizing enterocolitis

Are There Risks of Delaying? 

In general, delaying is safe and leads to more benefits than risks. One risk you should know occurs in a small percentage of infants.

The practice slightly increases the risk of jaundice, potentially leading to the need for phototherapy in term infants. That’s why the OBGYNs monitor term babies for any sign of neonatal jaundice if the clamp is delayed.

Is Delayed Cord Clamping Possible with a C-Section? 

Yes! Even if you have a c-section, delayed cord clamping IS possible, especially with a supportive doctor. Your baby can reap these same benefits in a few ways during a c-section.

Current recommendations by the World Health Organization state that waiting to clamp the cord is JUST as crucial during a c-section as during vaginal birth. So, don’t let your doctor try to discourage you or tell you that there are no benefits.

Experts state that the benefits are real, even during a c-section.

Here are some ways your doctor can delay cord clamping during a c-section.

  • When your doctor makes the incision into your uterus, he can just remove the baby’s head and wait a few moments. This might seem a bit strange, but doing so keeps the cord intact. Once your baby starts to cry or breathe, your doctor will remove the baby the rest of the way from your uterus. 
  • Your doctor might offer you a lotus birth when the baby is delivered with the placenta attached. That means that the umbilical cord is attached as well. Then the cord can be cut after the appropriate waiting time. Some parents who opt for a lotus birth leave the cord and placenta attached for several days until it dries naturally. 
  • Since the ACOG and AAP recommend skin-to-skin contact and delayed cord clamping, your doctor can place your baby on your abdomen or legs. Then, he waits three minutes to clamp the cord. 
  • Some evidence suggests that OBGYNs should manually milk the umbilical cord rather than delay clamping. Milking of the umbilical cord is beneficial during a c-section because it can help deliver blood to the baby faster. It works well because the uterus doesn’t contract during a c-section as it does during vaginal birth, and those contractions push blood to the baby. 

How Long Should You Wait to Clamp The Cord?

Cutting the umbilical cord between a newborn baby and placenta

Most hospitals in the United States clamp the cord 10-15 seconds after birth, but that wasn’t always the case. Before hospital births were common, the standard practice left the cord alone for one to five minutes. As the number of hospital births began to increase, the time the cord was left alone decreased.

In general, the delay length was yet to be standardized. By definition, if the umbilical cord is left alone for more than 30 seconds after birth, it’s considered to be a delayed clamp. We know that leaving the cord alone for three minutes leads to your baby receiving 100ml or more of blood

The current recommendation by the American College of Obstetricians and Gynecologists states that providers delay umbilical cord clamping in term and preterm infants for at least 30-60 seconds after birth.

It is important to note that your baby’s position does NOT affect blood flow. Several years ago, the prevailing thought was that gravity affected the blood flow from the placenta to the baby. A study completed in 2014 observed over 390 babies and indicated that there is no difference in the baby’s position after birth. 

That means your baby may be safely placed on your legs, abdomen, or chest and still reap the benefits of delaying.

When Is Delayed Cord Clamping Not Recommended?

Just like anything else, there are times when this practice is not recommended.

During a c-section, if the baby has a lower than average heart rate or has indications of being in distress, it’s not a good idea for doctors to delay cord clamping. These are situations when your baby needs to be accessed immediately. 

Other times that might not work is when the mother has forms of placenta disorders, such as placenta previa or placenta accreta. These situations often increase or require the use of a c-section, and it’s not an ideal time to wait for clamping.

Talk to Your OBGYN 

No matter whether you deliver vaginally or have a c-section, delaying is a possibility that all providers should consider. While the standard practice in many hospitals is to clamp early, talking to your OBGYN can encourage policy changes. 

Remember that this is YOUR birth, and you can advocate for what is best for your baby. Evidence states that, in most circumstances, delayed cord clamping is the safest and healthiest option for your baby, c-section births included.

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