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Labour and birth—cord clamping

Introduction

The umbilical cord contains the blood vessels that carry oxygen and nutrients between your baby and the placenta.  The timing of when the cord is clamped after your baby is born determines how much of the blood remaining in the placenta at the time of birth continues to flow to the baby. The majority of the blood that the baby can receive is transferred to the baby in the first 60 seconds after birth.

What are my choices for timing of clamping my baby’s cord?

Immediate cord clamping:  the cord is clamped as soon as the baby is born.

Delayed cord clamping: clamping of the cord is delayed after the baby is born

At Mater Hospital delayed cord clamping is performed one minute after the baby is born. Clamping the cord after one minute allows for most of the blood from the placenta to be transferred to the baby, while still allowing the chance of some blood remaining for either donation, storage or testing.  

There may be some circumstances where delayed cord clamping might not be appropriate, such as if your baby were to need immediate help with breathing at birth.

What are the advantages of delayed cord clamping?

Babies receiving extra blood from the placenta at birth have more body stores of iron at 3-6 months of age.  Iron is used by the body to build red blood cells and other cells.  While further studies are needed, delayed cord clamping may also be associated with minor improvements in childhood development.

Babies born prematurely may receive additional benefits from delayed cord clamping such as reduced need for blood transfusion and reduced brain and bowel complications.

What are the disadvantages of delayed cord clamping?

When babies are born, they need to change the proteins in their red blood cells to those which collect oxygen from the lungs rather than the placenta. When red blood cells are broken down during this change, a chemical called bilirubin is produced.  Jaundice is where there is a build-up of bilirubin in the baby’s tissues, making the skin appear more yellow.    Babies receiving extra blood from the placenta are more likely to have higher bilirubin levels in the days after birth. Some studies (but not all) have shown a small increase in the need to treat jaundice with ultraviolet lights (called phototherapy) in babies who have had delayed cord clamping. More information on jaundice and phototherapy can be found here. Premature babies do not have increased rates of phototherapy with delayed cord clamping

If you are choosing to donate or bank your cord blood, delayed cord clamping may mean there won’t be enough blood left in your placenta to donate and there is a reduced chance of collecting blood samples for testing if required.

What about the injection for the placenta?

The Mater Hospital recommends all women have an injection immediately after birth to reduce the risk of post partum haemorrhage.  This injection does not interfere with your choice for immediate or delayed cord clamping.

What if I want to clamp the cord later than one minute?

The Mater hospital recommends delayed clamping at one minute as studies have shown that most of the placental blood is transferred during this time. Speak with your obstetrician or midwife if your preference for cord clamping is for longer than one minute.

What if I am having a caesarean section?

Speak with your obstetrician about timing of cord clamping if you are having a caesarean section.  It may not be suitable to delay cord clamping if your baby needs immediate help with breathing, or if there are concerns regarding bleeding from the operation during this time.

What if I want to donate or bank my baby's cord blood?

If you are choosing to donate your cord blood, delayed cord clamping may mean there is a higher chance that there will not be enough blood left in your placenta to donate. Please speak to your obstetrcian or midwife if you would like more information. 

Umbilical cord blood gas analysis 

Taking a sample of blood from both the artery and vein in the umbilical cord for analysis of the acid levels (pH, lactate, base excess) is called cord gas analysis. Cord gas analysis provides valuable information about how the baby was using oxygen and removing carbon dioxide from their body close to the moment of birth. This helps health care providers to identify newborns that may need additional care, and better manage the care of these newborns after birth. At Mater Hospital, we recommend that a sample is taken and tested for all babies, particularly those at risk of needing additional support after birth. The sample can be collected and tested whether you have immediate or delayed cord clamping at one minute. If you request to have delayed cord clamping for more than one minute, the results will not be accurate. Please speak with your obstetrcian or midwife if your preference is for this test not to be performed. 


Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430180
Last modified 17/7/2023.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 05/7/2023
For further translated health information, you can visit healthtranslations.vic.gov.au/ supported by the Victorian Department of Health and Human Services that offers a range of patient information in multiple languages.
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