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When planning for birth, there's a lot to think about — and delayed (or deferred) cord clamping is one of those things that keeps popping up. But what exactly is it, and should it be on your birth plan? Let's break it down so you can decide what's best for you and your baby.
What is delayed cord clamping?
Delayed cord clamping (DCC) is exactly what it sounds like — waiting a bit longer before clamping and cutting the umbilical cord after birth. Traditionally, the cord was clamped and cut within seconds of delivery.
Instead, it’s left for a short period, usually between 30 seconds to a few minutes, allowing extra blood to flow from the placenta to the baby. This practice gives the baby a boost in blood volume and iron stores, setting them up with a healthy start.
For decades, the standard was to clamp and cut the cord almost immediately after birth. But recent research shows that waiting just a little longer can have significant health benefits. It’s not just a trend — it’s backed by science.
How long should you delay cord clamping?
The World Health Organization (WHO), the American College of Obstetricians and Gynecologists (ACOG), and several other studies recommend waiting at least 30-60 seconds before clamping the cord. Some experts suggest waiting until the cord stops pulsing, which typically takes about 3-5 minutes.
This extra time allows more blood to transfer to the baby, boosting iron levels and supporting overall health. But there’s no one-size-fits-all answer — it depends on your birth plan and your baby's needs. It's always a good idea to discuss timing with your healthcare provider.
What happens if you delay cord clamping for too long?
There’s a sweet spot when it comes to timing. If delayed too long, there’s a small chance of increased risk of jaundice, as the baby gets more red blood cells than needed. Jaundice is usually harmless and treatable, but it’s something to keep in mind.
To strike the right balance, most experts suggest a delay of around 1.5-2 minutes. After that, the benefits tend to level off, and the risk of jaundice might increase slightly.
How many inches in cord clamping?
Typically, the cord is clamped about 1 to 2 inches from the baby’s belly button. This leaves enough length for the cord stump to dry and fall off naturally without any issues.
The exact distance doesn’t impact the benefits of delayed cord clamping, so there’s no need to stress over the measurement. Healthcare providers are trained to clamp at a safe and comfortable length.
Benefits of delayed cord clamping
Delayed cord clamping comes with a host of potential benefits for your little one:
- Boosted iron levels: Babies get an extra dose of iron-rich blood, which can reduce the risk of anemia in the first year. According to a study published in JAMA Pediatrics, delayed clamping can improve iron stores for up to six months.
- Increased blood volume: More blood (up to 30% more, in fact) means better circulation and oxygen delivery to vital organs.
- Enhanced immunity: The extra stem cells and white blood cells help support the baby’s developing immune system.
- Improved transition to breathing: The additional blood flow can help your baby's lungs expand more easily.
- Preterm baby benefits: Preterm infants may benefit even more, with reduced need for blood transfusions and improved blood pressure regulation.
- Better developmental outcomes: Some studies suggest potential cognitive benefits in early childhood.
- Reduced risk of infant mortality: Some research has shown a link between DCC and “lower rates of infant mortality and morbidity”.
Negatives of delayed cord clamping
While the benefits are impressive, there are some potential downsides:
- Risk of jaundice: A slight increase in jaundice risk due to the higher volume of red blood cells. This is generally treatable with light therapy but can be worrying for new parents.
- Hospital protocols: Not all hospitals are on board with delayed cord clamping — not for any moral reasons, but more due to difficulty in the clinical practice of carrying out DCC, so you might need to advocate for it in your birth plan.
- Potential delay in skin-to-skin contact: In some hospital settings, delayed cord clamping might slightly postpone immediate skin-to-skin contact, especially if the birthing setup doesn’t allow for easy positioning. However, this largely depends on the hospital's practices and can be planned around with the right communication.
Why is delayed cord clamping controversial?
The controversy isn’t about whether it’s beneficial but rather about balancing benefits with potential risks, like jaundice. Some healthcare providers worry about delaying necessary medical interventions, especially in emergencies.
There’s also debate about its impact on cord blood banking. When delayed clamping is practiced, there’s usually less blood left for collection, which can affect the viability of banking for future medical use.
What are the contraindications for delayed cord clamping?
Delayed cord clamping isn’t always possible or recommended in every situation, including:
- Emergencies: If the baby needs immediate medical intervention or resuscitation.
- Maternal health complications: In cases of severe maternal bleeding or other medical emergencies.
- Placental issues: Such as placenta previa or abruption, where immediate delivery and care are prioritized.
- Cord avulsion: When the cord is torn from the placenta, that can mean that delayed cord clamping can’t be done.
- Tight nuchal cord: This is when the cord is wrapped tightly around the baby's neck, in which case, the standard medical practice is to prioritize the baby’s health at that moment.
- C-section complications: While delayed cord clamping is possible during a C-section, some situations may require immediate clamping for safety reasons.
- Cord prolapse: When the umbilical cord slips through the cervix ahead of the baby, immediate delivery is required to avoid complications.
- Twin pregnancies (sometimes): In twin births, especially if the babies share a placenta, delayed clamping may not be recommended for both babies due to potential complications. However, this depends on the specific circumstances and should be discussed with the healthcare provider.
- Emergencies: If the baby is in distress and needs urgent medical attention.
Can you do immediate skin-to-skin with delayed cord clamping?
Yes! Delayed cord clamping and immediate skin-to-skin are perfectly compatible. In fact, they complement each other. Skin-to-skin helps regulate the baby’s temperature and breathing while waiting for the cord to stop pulsing.
Many hospitals support this practice as it promotes bonding and breastfeeding initiation, even with delayed clamping.
Can you save cord blood if you delay clamping?
This is where things get tricky. Delayed cord clamping usually means less blood is left in the umbilical cord for banking. If cord blood banking is a priority, it’s worth discussing with your healthcare provider to find the best balance.
Some parents choose to delay clamping for a shorter period to allow for partial blood collection. It’s all about weighing the benefits and making an informed choice.
Can you have delayed cord clamping with a C-section?
Absolutely. Delayed cord clamping is increasingly practiced during C-sections. It might require a bit more coordination among the surgical team, and the process might look a little different than with a vaginal birth, but it’s possible, with the same benefits for your baby.
If this is important to you, discuss it with your healthcare provider and include it in your birth plan. Most hospitals can accommodate it unless there are medical complications.
Your birth plan, your choice
Delayed cord clamping is more than just a trend — it’s an evidence-based practice that can offer significant benefits to newborns. From boosting iron levels to supporting immune development, it’s worth considering as part of your birth plan.
As with any birth decision, there’s no one-size-fits-all answer. The best choice is the one that feels right for you and your baby. Having an open, informed conversation with your healthcare provider can help you navigate the pros and cons.
Every birth is unique, and so are your choices. Whatever you decide, you’re the expert on what’s best for your body and your baby.
Tassia O'Callaghan is an experienced content writer and strategist, having written about a vast range of topics from chemical regulations to parenting, for brands like Peanut App Ltd, Scary Mommy, Tally Workspace, and Office Christmas. She's an advocate for realistic sustainable living, supporting small businesses (author of A-Z of Marketing for Small Businesses), and equity across all walks of life. Follow her on LinkedIn or TikTok, or see more of her work on Authory or her website.