Delayed cord clamping

danuli8 · December 2012

I had my 24-wk appointment today, and the OB and I agreed last time that we would go over my birth preferences list (I hate calling it a birth plan because if there is one thing you can't plan, it's a birth). I envision a low-intervention, low-key natural birth despite having an OB and going to a hospital. She seemed fine with everything except my request for delayed cord clamping. She said that in her experience, she seems to end up with anemic babies when she delays clamping. I was all "?????" Seriously, I was just flabbergasted. How can you possibly end up with an anemic baby if the baby is getting all that iron-rich blood from the placenta?? My doula sent me a link to this article, and I printed it out and gave it to the OB, but I don't know if she will budge: Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 : https://www.scienceandsensibility.org/?p=5730#.UKJExdYhQNk.facebook

I can't tell my OB her experiences are wrong, but... ???? By what mechanism could delayed cord clamping result in an anemic baby?? Can anyone provide some thoughts? Insight? Anything?

danieleandwayne · December 2012

All the articles and studies I've read have shown nothing but benefits-- including less time under lights to correct bilirubin issues because there are fewer (if any) bilirubin issues.

I'm planning on waiting until the cord stops pumping before it gets cut.

Can you ask her to show you studies that show babies are more anemic when the cord's cutting delayed? Experience can be misleading-- I can tell you what SEEMS to be the case in my experience, but then I see the numbers and get surprised. If she can't provide studies or evidence-based practice to support her position, then I don't see a reason why she should have any right not to follow your wishes.

dhreczuck · December 2012

Wow you ladies make me feel like I have alot more planning and reading to do about all this stuff, I had no clue that was even an option! My OB told me yesterday I need to start getting ready to give birth, I guess it's time to start doing my own research so thanks for bringing this to my attention..

mama2many · December 2012

She's either wrong, misinformed, has had babies who would have had issues anyway...something.

Your baby, your choice on it's treatment/interventions.

pfluby · December 2012

My MW said the same thing, that the blood could flow back into the placenta. Which is understandable if you think about pressure in atube. She also said that their standard practice is to wait 2 minutes but we could wait until the cord stops pulating if we wanted.

danuli8 · December 2012

pfluby, the article I linked to in my original post includes an explanation of why backflow bleeding is extremely unlikely in an uncomplicated birth (I think it's objection #7).

I poked around some more and found this article from the July/Sep 2012 issue of the Journal of Perinatal and Neonatal Nursing: https://www.nursingcenter.com/prodev/ce_article.asp?tid=1409724 These sentences from the abstract really made me sit up and pay attention (emphasis mine): "Delay of cord clamping substantively increases iron stores in early infancy. Inadequate iron stores in infancy may have an irreversible impact on the developing brain despite oral iron supplementation. Iron deficiency in infancy can lead to neurologic issues in older children including poor school performance, decreased cognitive abilities, and behavioral problems."

So, in short, I have this wonderful one-time opportunity to ensure my baby has enough iron for his brain to develop optimally. Why the heck would I pass that up?

I think the root of the problem is that I am expecting my OB to think and act like a midwife, and she just plain isn't one. It's like buying a cat and expecting it to bark at strangers who come to the door. I have decided to make the switch to a CNM, and I think everyone will be much happier that way.

danieleandwayne · December 2012

Interesting that you compare your OB and a midwife-- my OB is very tuned into my wants, needs, and expectations about how I want my baby's birth to go (with the idea that a plan is just that-- a plan and not a given). I know my OB's practice has a fantastic nurse midwife, too, if not two.

I agree with you, though-- why wouldn't a mother want to delay the cord clamping with all the positive benefits? It's certainly enough to make your decision to change providers to someone who is more in touch with your choices a very sound one!

drpayne · December 2012

I've heard that delaying for too long can cause jaundice. I can't remember why..

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