Cutting The Cord

If you're working on your birth plan, you may want to include your ideas on cutting the baby's cord. Some couples ask that cord clamping be delayed. This is a relatively new idea that is gaining in popularity.

When a newborn baby is placed on the mother's abdomen, or just at or below the level of mom's perineum, a surplus of 80 cc of blood is transfused to the baby. The additional blood reduces the baby's risk for iron deficiency since it contains some 50 mg. of iron. Such protection from anemia means that brain development during the first year receives added insurance. This is why more and more couples are asking that the clamping of the cord take place after the umbilical cord cease its pulsations.

Devil's Advocate

Playing the devil's advocate, common medical belief holds that a premature baby, one with IUGR (intrauterine growth restriction), or any baby that has suffered any form of compromise while in utero might find it difficult to cope with this extra transfused blood. Doctors prefer to clamp the cord just after the birth in such cases. But even here, the practice of immediate cord clamping is being reexamined.

Care providers will probably want to clamp the cord right away if any of the following problems apply:

*The cord is wrapped tightly around the neck

*The mother is Rh-negative

*There is meconium in the amniotic fluid

*Low Apgar score

*Fetal distress

Tight Cord

Physicians and midwives have been trained to look out for a cord that is wrapped around the neck just after the baby's head is born and prior to the delivery of his anterior shoulder. If the cord is wrapped so tight around the neck that it cannot be pulled over the infant's head, standard operating procedure is to clamp the cord in two places, wherever it can be accessed, and to cut between the clamps. This practice, in effect, cuts off circulation to the infant so that he must be birthed right away. If the shoulders are difficult to deliver, the baby will now be in serious danger.

This type of immediate clamping may cause a loss of blood volume, can result in tissue damage, and may even damage the brain, lungs or other organs, sometimes permanently. Also, in such a case, the infant loses out on the continuing placental flow that can help replenish the newborn during and just after the birth.

You can include your wishes regarding the clamping of the cord on your birth plan and include the words: "if possible," to protect your baby should early clamping be deemed a necessity. Sometimes the doctor or midwife will allow the father to cut the cord. This can help your partner feel involved in the birth. You may wish to record your feelings about this issue in your birth plan, too.