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I’m starting to make a birth plan, and have read about delayed cord clamping. Is it really necessary? What are the benefits, and how long should you wait?
— Anonymous
Short answer: very likely yes. But let’s go to the data to see why.
When my first child was born in 2011, delayed cord clamping was just starting to be discussed. It was more the purview of “natural birth” websites and something my doula mentioned once or twice. Since then, however, the recommendations for delayed cord clamping have gotten much stronger. ACOG now recommends a delay of at least 30 to 60 seconds for virtually all infants.
The reason for this is simple. When you wait to cut the baby’s umbilical cord after birth, during those 30 seconds or a minute, blood flows back into the baby from the placenta.
For preterm infants ( born before 37 weeks), the data is quite clear on the benefits. A 2023 Lancet article merged data from a number of randomized trials, covering 3,000 babies, and found that delayed cord clamping reduced the risk of mortality in these infants by about 30%. This seems to be due to lower rates of bleeding, fewer blood transfusions, and a lower risk of a common NICU complication called necrotizing enterocolitis.
The benefits for full-term babies are lower, likely because their risks are simply lower. A 2013 Cochrane review of randomized trials found that delayed clamping increased hemoglobin and improved iron stores at 3 to 6 months. There isn’t much evidence on longer-term outcomes. There does appear to be an increase in the risk of jaundice for this group, which is a trade-off, although the increase is small.
Bottom line: for a full-term baby, delayed cord clamping is probably a good idea and typically is an easy thing to do. For a preterm baby, it’s even more important and definitely worth raising with your provider.
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