Restricted Umbilical Cord Problems

The most common source of restricted umbilical cord problems in childbirth is completely preventable and due to a procedure known to be harmful to the baby - early cord clamping.


What is Early Cord Clamping?

Early cord clamping (ECC) is defined as any method by which the cord is manipulated to stop the flow of blood to the baby while it is still pulsating.  This includes clamping, cutting, hand squeezing, tying or holding the baby too high or too low.


In a natural vaginal birth with no medications, the cord pulsates on average for 7 minutes.  In a medicated birth, including c-sections or babies with a compressed cord, the cord will pulsate for as long as 20 minutes.  Good practice is to leave the cord alone for 12 minutes or until it turns white/silver in color.



Serious Risks Associated with Early Cord Clamping

Whenever a pulsating umbilical cord is clamped,  20-60% of the baby's total blood volume is trapped inside the placenta.  A 9 pound baby manufactures only 10 ounces of blood during gestation.  It will take over 6 months for the baby to replenish the volume of blood lost by early cord clamping.


In essence, newborns become involuntary blood donors as up to half their blood volume is lost when their cords are early clamped.


This decrease in necessary blood volume causes babies to become anemic.   In most cases, the anemia is not diagnosed and the infant is sent home in a weakened state, more susceptible to a host of complications, including SIDS.


Restricted umbilical cord problems associated with anemia are Autism, heart perforations, thyroid disorders, brain tumors, leukemia, hormonal imbalances and liver/kidney disease.


Male infants suffer more than females.  They have higher metabolisms that require 10% more blood.  This trend is also seen in that males represent a greater proportion of children receiving special education services in schools and higher incidences of disabilities such as ADD, behavioral issues, and Autism.


Currently, 1 in 16 babies require some degree of resuscitation after birth to which early cord clamping is a contributing factor. Another critical correlation is the fact that the United States ranks 29th for infant mortality in the world and routinely practices early cord clamping.


Any baby whose cord has been early clamped is weakened.  Weaker babies become more susceptible to infection, especially at the site of the cut cord.  There are 25 known infectious strains resistant to all antibiotics and they are primarily found in hospitals putting newborns at undue risk of infection.


Another of the restricted umbilical cord problems is  engorged placenta, a direct threat to the mother and future pregnancies.  When the blood flow is restricted by clamping, the blood can pool in the placenta, causing it to rupture or backflow the baby's blood into the mother's.  This cause lead to serious side effects, such as maternal hemorrhage and can even prohibit future pregnancies due to blood mixing.



Why are Cords Early Clamped?

Restricted umbilical cord problems caused by early cord clamping occur for many reasons, the first of which is ignorance.  Many doctors are unaware of the risks of early cord clamping.  This is in part due to poor training.  Early cord clamping was first documented as harmful in 1801 and again in 1957.  It wasn't until after 1923 that it began to be mainstreamed. Some commonly-used medical texts still detail the use of early cord clamping.  ACOG guidelines now refute the routine practice of early cord clamping.


The second is convenience and time management.  Doctors want to be in and out of the birthing room.  Waiting an extra 20 minutes for the cord pulsation to stop naturally and the placenta to detach on its own may not fit into their surgical schedule for the day.


In some instance, doctors early cord clamp so the placenta and its cord blood can then be sold to the highest bidder.  When parents sign consent allowing the hospital to "dispose" of the placenta and other remnants of birthing, they can be sold for medical research as opposed to being burned, for as much as $30,000 each. This figure was reported by the Children's Hospital in Randwick, Australia.  This was confirmed in the 10th edition of the Principles of Anatomy and Physiology, 2003 page 1076.



False Reasons for Clamping

Short cord, maternal hemorrhage, c-section, and respiratory distress represent a few of the false reasons to clamp a cord.  A baby in distress can and should most often be revived with the cord intact.  It allows better access to the umbilical vein as it remains uninjured.  All of the restricted umbilical cord problems are usually the result of drugs given during labor, including pitocin, IV fluids, and pain medications, not a result of leaving the cord intact.



When Should a Cord be Early Clamped?

The only situations in which a cord should be early clamped is when the cord has torn or with a placenta previa.  Babies born via c-section can be delivered with their cord and placenta intact.   Multiples can also be delivered without risk of restricted umbilical cord problems.



Prevention of Restricted Umbilical Cord Problems

  • Birth in a warm room or warm water - cold temperatures cause blood flow to slow.
  • Wrap the baby immediately head to toe in warm blankets or allow skin-to-skin contact with the mother with blankets covering both.
  • Do not manipulate the baby to breathe.  While the cord is pulsating, the baby is receiving oxygenated blood, thus not triggering the need to take an additional breath.  As the blood travels into the baby's expanding lungs, once they become filled, the baby will feel its own signal to breathe and will do so with fully expanded lungs.
  • If the cord is wrapped around the baby's neck, have the birth attendant insert a finger between the neck and the cord, allowing the birth to proceed normally.
  • If you choose a hospital birth, request your placenta.  Take it home and plant it under a new tree that will grow as your baby does.


For more information on early cord clamping,  see article Leaving well alone: A natural approach to the third stage of labour by Dr. Sarah J. Buckley, physician and natural birther.


References

Rabe H, Reynolds G, Diaz-Rosello J.  Early versus delayed umbilical cord clamping in pre-term infants. Cochrane Database Syst Rev, 2004 Oct 18;(4):CD003248.

Wadrop CA, Holland BM. The roles and vital importance of placental blood to the newborn infant. J Perinat Med, 1995;23(1-2):139-43.

Simon N, Morley GM.  Brainstem lesions in autism: birth asphyxia and ischemia as causative factors. International Meeting for Autism Research. November 1, 2004, Available online at www.cordclamping.com/IMFAR/IMFARpaper.htm

Gunther M. The transfer of blood between baby and placenta in the minutes after birth. Lancet, 1957 Jun 22;272(6982):1277-80.

Peltonen T. Placental transfusion: advantage and disadvantage. Eur J Pediatrics 1981 Oct;137(2):141-6.


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Page Last Modified by Catherine Beier, MS, CBE

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