Hellobee Boards

I'm falling asleep but I had to jump in here and say something. Apologies for anything that comes across unclear because I'm bleary eyed - I can clarify things and answer questions in the morning.

It is a common (but rather outdated) misconception that the baby has to be held below the level of the placenta to reap the benefits of delayed cord clamping (or as I call it, optimal cord clamping). The idea is that the blood will simply stagnate or "run back" into the placenta if the baby is raised up to the chest for skin to skin.

This is extremely unlikely in an uncomplicated birth. Blood flow immediately after birth is primarily one-way, from placenta to baby. In a process that begins during labor and accelerates as the newborn begins to cry, the pulmonary blood vessels, which receive very little blood flow during pregnancy, open and fill. This relatively sudden change causes the newborn’s blood pressure to fall below the pressure in the placenta. Placental blood, driven by strong uterine contractions, follows the pressure gradient and flows through the umbilical vein into the baby.

As the newborn’s oxygen saturation increases, the umbilical arteries close, which stops nearly all blood flow from baby to placenta. The umbilical vein, which isn’t sensitive to oxygen, remains open somewhat longer, allowing a final bit of blood to flow from placenta to baby before it, too, closes.

The lack of significant “backflow bleeding” is confirmed by the fact that delayed cord clamping results in 30% greater neonatal blood volume than does immediate cord clamping.

Gravity DOES matter, but ONLY in terms of the speed of the placental transfusion. A baby held below the level of the placenta will receive a full transfusion in about 3 minutes; one held above the placenta (e.g., a baby in immediate skin-to-skin contact) will also receive a full transfusion—it just takes a little longer (about 5 minutes).

(Mercer JS, Erickson-Owens DA. Rethinking placental transfusion and cord clamping issues. Journal of Perinatal & Neonatal Nursing. July/September 2012 26:3; 202–217 doi: 10.1097/JPN.0b013e31825d2d9a
and
Yao AC, Lind J. Effect of gravity on placental transfusion. Lancet. 1969; 2:505-508.)

@Mummystar: They don't.

I've never heard of delayed cord clamping, or it's benefits! So love HB for learning stuff like this! And @arden: that was an amazingly informative answer!

Since I just went through this:

Yes, delayed cord clamping till it stopped pulsing (took only about 3 min I am guessing).

Yes, they placed her immediately on my stomach for skin to skin. Even stayed there for the clamping and cutting of the cord by daddy. Then they moved her up to my chest.

It's standard practice at my birth center to delay clamping.

@Arden: I'm glad you shared that, cause I wanted to put that info in, but since I just woke up, I didn't have the brain energy to do it, lol.

My midwife does delayed cord clamping standard. They placed her on my stomach until the cord stopped pulsing, then DH cut the cord and they put her on my chest for skin to skin.

Thanks for the info on this!! This is something I know I'm going to want, so it is very good to be informed in case the OB pushes back and says they don't do it that way.

We delayed a few minutes, which my midwife recommended, and she was just kind of on my belly during that time. Honestly, after labor, I didn't really care at that point!