Concerns about umbilical cord clamping

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The  National Children's Study

Placental blood is respiratory blood

Umbilical cord clamping, a human invention

Waiting for the first breath, a long tradition

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1.  Placental blood is respiratory blood

Circulation in support of aerobic metabolism arises early in embryogenesis.  The heart is the first functional organ circulating erythrocytes from the embryonic yolk sac.  The placenta becomes the respiratory organ of the fetus.  Placental blood expands the alveoli of the lungs at birth.

2.  Umbilical cord clamping, a human invention

Umbilical cord clamping is a human intervention, perhaps intended to prevent hemorrhage, but it has been the subject of controversy for at least 230 years.

3.  Waiting for the first breath, a long tradition

Textbooks of midwifery and obstetrics traditionally all taught that the umbilical cord should not be tied or clamped at least until the newborn infant is breathing on its own, and preferably not until pulsations in the cord cease.

4.  Recent change of opinion

Early clamping of the umbilical cord began gaining favor in the 1930s, though most obstetricians continued to practice "slow birth."  The Apgar score became a measure of the effectiveness of resuscitation for infants who failed to breathe before clamping of the cord.

5.  Hypovolemic shock

The frequent need for transfusions and blood volume expanders in neonatal intensive care units indicate that hypovolemia and hypovolemic shock are often encountered.

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6.  Ischemic brain damage

Monkeys subjected to suffocation and umbilical cord clamping at birth were found to have ischemic damage within the brainstem, most prominently in the auditory pathway at the midbrain level.

Posted: February 27, 2006 (a work in progress)

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7.  Language development

Ischemic damage of brainstem auditory nuclei may impair learning to speak "by ear" and prevent normal development of the later maturing language areas of the cerebral cortex.

8.  Evidence versus opinion

The long neglected data on monkeys subjected to asphyxia at birth remains as solid evidence of harm.  Umbilical cord clamping on the other hand is a procedure based on opinion.

9.  Increased prevalence of childhood disorders

Immediate clamping of the umbilical cord is now a published protocol, and included in new textbooks of obstetrics.  This should be considered as a possible cause of increased numbers of children with developmental disabilities.

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10.  Dependency and lifelong need for care

Developmental disabilities remain as lifelong handicaps, with ongoing dependency and need for care throughout the lifespan.  There is no cure for brain damage; it must be prevented.

11.  Factors in need of closer examination

a) jaundice, b) maternal-fetal placental barrier, c) cord pulsations are from the fetal heart to the placenta as an ongoing organ of respiration, d) the essential, ongoing need for oxygen is the most crucial environmental factor to investigate, e) greater vulnerability of males. f) human assisted births of thoroughbred foals, g) value of maintaining connection to the mother at birth until placental circulation stops.

12.  References