When making the decision to get pregnant, all parents wish for a safe delivery with a happy, healthy baby at term. Unfortunately, this will not be the end result for everyone. Currently 1 out of 10 babies born in the U.S. is born premature. This means they are born at less than 37 weeks gestational age. Black women especially are at increased risk for preterm birth. While the overall preterm birth rate is 9.6 percent in the U.S., the rate of preterm birth in black women is 13.3 percent. This rate is significantly higher compared to women of other ethnic backgrounds. This disparity has been present for decades and there is still no concrete answer as to why.
While there is no way to prevent early delivery for every mom, there is something that can help improve a preemie’s transition to life outside the womb. Delayed cord clamping is one way to help give your preemie a jumpstart after birth.
So what is delayed cord clamping? This is when the umbilical cord is not clamped until 30 seconds or more after the baby is delivered. During pregnancy the umbilical cord is what connects the baby to the placenta inside the womb. At delivery, when the baby comes out, the umbilical cord is clamped and cut to separate baby from the placenta. Delayed cord clamping is not a new practice and was performed more regularly several decades ago.
Over time, it became common practice to clamp immediately after birth. However, research now shows that preemies benefit from the delay. Delayed cord clamping leads to increased blood volume, iron stores, birth weight and decreased need for blood transfusions. Research also shows that delayed cord clamping in preemies may lead to decreased intraventricular hemorrhage or bleeding in the brain as well as necrotizing enterocolitis which involves infection and injury to the baby’s intestines.
As a result, the American Academy of Pediatrics supports delayed umbilical cord clamping as recommended by the American College of Obstetrics and Gynecology. The Neonatal Resuscitation Program released an update in 2015 that recommends delaying cord clamping for at least 30-60 seconds for preemies and term infants.
Despite this, delayed cord clamping is not without risk.
There has been concern for increased jaundice or yellow coloring to the skin and eyes; polycythemia, where there are too many red cells in the blood; and hemorrhage or bleeding in mothers after delivery. Studies have shown only a minimal increased risk in jaundice, which was treated with phototherapy, and no greater risk of polycythemia. There was also no increased risk of postpartum hemorrhage. Therefore these potential risks do not outweigh the benefits of delayed cord clamping. It is also not guaranteed that every preemie will experience this benefit. In some instances where the baby is limp and not breathing or if there is concern for maternal bleeding then delayed cord clamping should not be performed.