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Delayed cord clamping

Delayed cord clamping


"Is there a risk with delayed cord clamping?"


I am just wondering what you can tell me about active third stage of labour & delayed cord clamping? My hospital has advised they will not allow a natural third stage and I must have the injection. I was willing to accept this if they allowed delayed cord clamping & don't administer the drug for third stage until after cord was cut.

Today after meeting with OB he said he will allow delayed cord clamping as long as I knew it caused jaundice (which he said because the baby would get too much blood) but the drug must be injected while baby is still being delivered (shoulder out), he assured me the drug cannot cross the placenta. So, after doing more research today I've read that administering the drug while baby still attached would mean that this would cause the placenta/cord to pump blood much faster so this is why they normally cut the cord immediately. So, in my mind, the baby would be more likely to develop jaundice, not because of the cord clamping being delayed but because the injection being administered while cord still attached.

I asked the OB surely they can wait for the baby to be born and a couple of minutes of delayed cord clamping before administering drug and he says no, the risk is too high of me hemorrhaging. I'm not sure if I can accept his theory as all the readings I've done suggest otherwise. Can you please give me your best opinion? I'm 37 weeks & really don't think I could deal with having to change hospitals at this late stage. Thank you


Our midwife Melissa says:


Hi, first off, this is your body, and no-one can tell you what to do with it; nor can any health practitioner inject you against your will if you are competent to refuse this. I am not sure if you have any risk factors for post-partum haemorrhage, but assuming you do not have any risk factors, then there is a lot of evidence to suggest that physiological third stage actually results in less bleeding than an actively managed third stage. 

With a physiological third stage, the cord is not clamped until after the placenta has been born and the injection is not used. You would need to be in an upright position for birthing your placenta as gravity (and sometimes a small push) is needed. 

It might not be hospital policy to “allow” a physiological third stage, however, this is very standard practice in birth centres and with care by private midwives. It is well within your right to decline active management unless you are losing too much blood. The only concern I have is that this is clearly a hospital that has very limited experience with managing a physiological third stage, and as with all types of birth care, your best outcomes will be with a care provider who is skilled in the type of experience you are after. 


This answer was written for Birth by midwife Melissa Maimann from Essential Birth Consulting.


Read more about labour and delivery

Last revised: Thursday, 30 August 2012

This article contains general information only and is not intended to replace advice from a qualified health professional.

 
 

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