Remember life before pregnancy?

Sure, you had choices to make, big ones like whether or not to change job or whether or not to move flat, and smaller ones like where to grab dinner or whether or not to get those jeans.

And some of those choices were tough, I know. But most often, the only person impacted by your choices was you. And maybe your partner.

Enter pregnancy – and everything changes, right?

Suddenly it feels like you are making difficult choices daily; choices that will impact you and your beautiful baby. So I want to help you out with one of them.

When should you cut or ‘clamp’ the umbilical cord once your baby is born?

This is a choice you don’t want to make whilst you are lying in theatre – it’s a choice you want to make and discuss with your caregivers way before the day of your c-section.

So why should you even care about this?

Historically, the practice of clamping baby’s cord has taken place within seconds of baby being born and evidence shows that this might not be great for baby. This is because a whopping one third of baby’s blood is still outside of their body at the moment baby is born. The blood needs time to make its sweet way from the placenta to baby.

Yikes – that’s a lot of blood left in the placenta, I know, and once the cord is clamped, that blood is blocked from moving to your baby, where it is supposed to be.

Modern practice is moving towards ‘optimal’ cord clamping. This is the practice of leaving the cord unclamped for the most time possible, based on a medical assessment of you and baby. Usually this would mean waiting at least a minute. But whilst practice is moving that way, it’s still a discussion you will want to have with your caregivers. You want to be sure you’ve got all the facts and you are happy with how the cord clamping goes down on the big day. It’s your birth experience and it is super precious, after all.

What does the evidence show?

Evidence shows that optimal cord clamping has advantages for your baby including higher birth weight, early haemoglobin concentration and increased iron reserves for up to six months after birth. Some sources report benefits reaching even further into childhood. High fives to all of that!

Small studies have reported that delaying the cord clamping can lead to a slightly higher risk of jaundice, but there is strong evidence that shows that the benefits of optimal cord clamping outweigh the small risk of higher levels of jaundice.

As with every birth choice, it is so important to talk with your caregivers about the pros and cons of ‘optimal’ cord clamping in the context of your specific pregnancy.

Here are some questions you might want to ask:
  • Can you talk me through the benefits and risks of optimal cord clamping?
  • What can you offer to support me in waiting to clamp my baby’s cord at the optimal time?
  • How will you assess when the cord needs to be clamped?
  • What kind of situation would mean that the cord would get clamped immediately after birth?
  • Where will my baby be placed whilst the blood is moving from the placenta to the baby?

You might also want to ask about ‘milking the cord’. That sounds gross, I know. Milking, or stripping, the cord is the practice of manually moving the baby’s blood along the cord to speed up its journey to the baby. There is little evidence available around the pros and cons of doing this, so open up the conversation with your caregivers and decide what is right for you.

Asking questions like these upfront during your antenatal care is a great tool to get you to a place of knowledge and power.

I have a vision of a world where every mother and birth partner come away from their birth experience feeling heard, cared for, respected and valued. ‘Healthy mum, healthy baby’ is not all that matters. Those are the minimum outcomes we should be striving for. We should be aiming much higher and I believe this starts with making informed choices about birth.

I want to support you in making the birth of your baby the most empowering experience you can ever imagine. Please check out the next Birthsure course dates to jump onboard.

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