Delayed cord cutting has great benefits for the baby and assists in their transition to breathing on their own.
“In the interim between birth and the natural occlusion of the blood flow in the cord, the infant’s brain and body are nourished with oxygen-rich blood from two sources, ensuring a healthy transition to neonatal life. If the cord is cut immediately following birth, blood within the cord and placenta, which the baby would normally use to establish lung circulation, remains trapped in the placenta. The infant will then divert blood from the other organs to fill the vessels in the lungs.”
Midwife Rachel Reed assesses the risks of a common condition which many parents fear.
“Only very occasionally will a nuchal cord prevent the baby descending once the head is born, in which case the midwife can use a ‘somersault’ manoeuvre to free the baby so that the cord can remain intact.19 If this manoeuvre is unsuccessful, the worst case scenario is that the cord snaps as the baby descends, and requires clamping.”
The Somersault Technique promoted to assist births where the cord is short and/or tight
Nuchal cords are rarely found to be the cause of adverse outcomes in studies of pregnancy and birth. Several authors have concluded nuchal cords “ordinarily do no harm” (5,6,7).
Some studies have associated nuchal cord with an increased rate of variable fetal heart rate decelerations during labour, and tight nuchal cords to a higher proportion of fetal distress and low Apgar scores. (3,4,8) However, in these retrospective studies the definition of tight nuchal cord were those ‘clamped and cut before delivery of the shoulders’ – therefore short-term morbidity was more likely caused by the interventions rather than the presence of nuchal cord (3).
(To learn more about nuchal cords, how babies can and are born with loose/tight/multiple nuchal cords, and why they aredisproportionately associated with risk and adverse outcomes, please read Nuchal Cords: the perfect scapegoat.)
Practitioners that respond clinically, not routinely, to a nuchal cord – and with the least intervention possible – are more likely to protect normal physiology and anatomy and avoid iatrogenic injury.”
”Our study demonstrates that late clamping of the umbilical cord has a beneficial effect upon the antioxidant capacity and reduces the inflammatory signal induced during labor, which could improve the development of the newborn during his or her first days of life.”
I have watched umbilical cords be left intact, by trusting midwives, until the placenta is released. This can take upwards of 30 minutes. During that time I can see the cord change from a rich thick purple cord to a limp white cord that is obviously not transferring any blood. How I know it is not transferring any blood is because the placenta is no longer attached to the mothers uterus. It is usually sitting in a bowl close to mom and baby.
Completely hands off I can see that the cord is transferring oxygenated blood to the baby for longer then 2 minutes, which is what most care providers believe delayed cord clamping is. The image below is 45 seconds post birth, 12 minutes post birth and 23 minutes post birth, retrospectively.
Prolapse of the umbilical cord is a true obstetric emergency, and understanding of its predisposing factors can assist in speedy diagnosis and treatment. Although cord compression occurs routinely in normal labors and is commonly seen during fetal heart rate monitoring, severe cord occlusion can result in dangerous alterations in fetal and placental circulation. Historically, the incidence of cord prolapse has been reported as approximately 1 in 300 deliveries. More recently, however, the reported incidence has fallen to about 0.2%, or 1 in 500 of all deliveries, mainly as a result of changing obstetric management, including antenatal ultrasound diagnosis of funic presentation or vasa previa as well as almost universal use of continuous electronic fetal monitoring.”
“To get this blog going I decided to write about a slight obsession of mine: The fear of, and routine midwifery management of nuchal cords at birth (umbilical cord around the neck). I have written and presented about this topic and have bored the pants off many a person who has made the mistake of mentioning the subject. So, despite telling my colleagues that I had put away my ‘nuchal cord’ soap box I am bringing it out to launch this blog. The content of this post is based on part of a literature review I carried out for my PhD thesis. If you are interested in finding out more you can download a journal article here, a poster here, or my full literature review in my thesis here.”
Below is a minimally assisted hospital birth. The baby has the cord wrapped around 4 times and is doing great!
“A nuchal cord (cord around the neck) is one of many things that mothers-to-be fear about childbirth. The thought of their precious baby being ‘strangled’ by their umbilical cord can cause so much worry.
Luckily, unborn babies get nutrients and oxygen via the umbilical cord, not by breathing it in through their nose and mouth, which may eliminate some fear right there. They don’t need their neck to breathe.”