One of the most common surgical procedures in the world today – one that every human alive has undergone – is the clamping and cutting of the umbilical cord at birth. There is no dispute that we need to clamp and cut the umbilical cord. But there remains controversy over how soon after birth this should occur.
Early clamping of the cord began in the 1950s and 60s with the introduction of active management of the third stage (birth of the placenta) in order to lower the rate of haemorrhage after birth. This involves giving women an injection of Syntocinon (synthetic oxytocin) with the birth of the baby, clamping and cutting the cord and pulling the placenta out using controlled cord traction.
Interestingly, when the first commercial cord clamp device was released in the 1890s, instructions published in the Lancet directed that they should not be used until the cord stopped pulsating and blood flow ceases. Somehow over the years we have moved the process of cutting and clamping the cord closer and closer to the moment of birth.
The problem is, during the first few minutes after birth a baby can receive 80-100 millilitres of blood, which is nearly a third of their blood volume. The volume decreases with the height the baby is held in relation to its mother and the length of time before the cord is clamped. But most of the blood volume passes to the baby in the first two to three minutes.
