Thursday, May 19, 2011

Delayed Cord Clamping

The umbilical cord is the connecting cord of the fetus to the placenta. This cord normally contains two arteries and one vein which are buried within a protective substance known as Wharton's jelly.

The umbilical cord enters the infant body at the abdomen with the vein continuing inward, joining at the liver. Here the vein splits into two with the left vein carrying blood to the liver and the right vein carrying blood to the heart.

The two arteries contained in the umbilical cord carry deoxygenated and nutrient depleted blood away from the infant.

Shortly after birth the Wharton's jelly that surrounds the two arteries and vein making up the cord initiate a natural clamping that takes place in response to temperature reduction. It begins with a swelling of the Wharton's jelly and then eventually the cord collapses and contracts the blood vessels.

If left alone without any medical intervention this process will take between 5-20 minutes to occur. General obstetric practice in most hospitals impose an artificial clamping as early as 1 minute after delivery.

Following the clamping the cord is cut. The actual separation of the cord is painless as there are no nerves present in the tissue. However, the cord is thick and sinewy and requires very sharp instruments to perform the task.

Current data shows no there are NO adverse affects of delaying cord clamping. Studies indicate that delaying cord blood clamping is beneficial to the newborn because it improves hematocrit, iron count, and reduces risk of anemia.

Reports consistently show that early cord clamping increases incidence of the over production of red blood cells as well as higher risks of neonatal jaundice, both of which are treated with phototherapy.

Most obstetricians are willing to delay the clamping of the cord upon request. If you decide you'd like to delay cord clamping, be sure to include your preference in a written birth plan.

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