Wednesday, November 4, 2015

What's Gravity Got to Do with It? Delayed Cord-Clamping Evidence

I was recently at a birth where the mom didn’t even request delayed cord-clamping, but the OB did it anyway.  I asked him why he waited, and his response was, “Why not? There’s great evidence that it is beneficial.” I almost hugged him, but stopped short when I realized that he was wearing a sterile gown and covered in birth goo. 

Delayed cord-clamping is a BIG issue that many parents don’t even talk to their provider about or even put into their birth plan.  There have been numerous studies published on the benefits of delayed cord-clamping, so much so that it really doesn’t make sense that it isn’t common practice.  Though, as we know, there is a lag of YEARS between research and policy change. 

Most recently, we have been hearing about moms who are being forced to choose between immediate skin-to-skin contact with their baby and delayed cord-clamping, based on the misguided theory that a baby must be lower than the placenta in order to get the blood from it.  We find this extremely interesting considering so many facts and research that states that this is NOT the case at all. 

A long time ago (1969), this gravity interference theory was a commonly held misconception.  So much so, that there was a real dearth of research even looking into the idea.  But, that really is no longer the case at all.  There has been a Cochrane Review out since 2010 that discusses the ridiculousness of thinking that a baby must be lower than a placenta to receive the 25-40% of the baby’s blood that could be left in it.  Even older than that is Mercer & Skovgaard’s publication analyzing the physiology of cord clamping and blood transference.  More recently (2012)Mercer & Erickson-Owens published an article calling for a change in practice with regards to umbilical cord clamping.

What is our take on the issue:
1.      There is ample evidence to support the fact that delayed cord-clamping is a GREAT idea.
2.      Gravity is NOT an issue, and thinking so means you are misinformed.

3.      We need to DEMAND delayed cord-clamping and specifically discuss it not only in the office setting before birth, but also during labor, and immediately following the birth! 

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