Optimal Cord Clamping: The Difference 90 Seconds Can Make

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  • March 24, 2014

Optimal Cord Clamping: The Difference 90 Seconds Can Make

There are endless decisions to make when preparing for a birth, and it seems there are pros and cons on both sides of everything (and everyone has their own opinion!). Cord clamping however, is rarely discussed, has virtually no cons, a lot of pros, and is generally done without consulting the parents.

Since 1913 it has been common practice in Western medicine to immediately clamp the umbilical cord after birth, known as Immediate Cord Clamping (ICC)1 , a practice that has practically no known benefits2; other than the baby needing immediate medical attention, or perhaps simple convenience for the nurse and doctor to be able to evaluate and wash the baby immediately after birth.

Optimal Cord Clamping (OCC), also called Delayed Cord Clamping (DCC), is the practice of simply waiting an additional 2-3 minutes (some advocates say longer) after birth to clamp the cord.

Why? Up until the moment a baby is born, while in the womb, there is a continual flow of blood between the baby and the placenta, providing the baby with all the oxygen needed. At the time of birth, one third of a baby’s blood is still outside of its body, and inside of the placenta.

During labor and delivery, much of that blood is transfused from the placenta into the baby, driven by the force of uterine contractions. This transfusion continues beyond the moment of emergence from the vulva; and, if left undisturbed for a short 1-3 minutes, the placenta will deliver around an additional three ounces of blood to the baby.3

What does this blood provide? The two most important things are Oxygen and Iron…


-The first minute of a baby’s life is called the “Golden Minute” and the World Health Organization estimates that one million babies die every year due to birth asphyxia, or inability to breathe in the first minute after birth.4

-“One of the most time-sensitive and critical jobs a newborn must accomplish is to make the switch from gas/cord oxygenation to lung breathing. An understanding of newborn transitional physiology is emerging that stresses the importance of the blood volume and increased red cell supply provided by the placental transfusion to the start of lung breathing. Furthermore, while this transition to lung breathing is underway, the oxygen-rich blood flowing to the baby provides a potentially helpful secondary source of oxygen for the baby during the delicate process of switchover.”5


-“Three ounces of blood is equivalent to a three month supply of iron for the newborn. Iron is critical to brain growth and development; iron deficiency is a known cause of cognitive and social-emotional deficits in infants, which may be permanent. As breast milk alone may not supply a baby with all the iron he or she needs, it’s that additional iron that makes delayed cord clamping (DCC) so important.”6

-“Immediate cord clamping results in up to 10x the risk of developing iron deficiency anemia.”7

-“At least 10% of the general U.S. toddler population (1-3 years of age) is iron deficient, with the prevalence rising well above 20% in selected ethnic and socioeconomic populations. Immediate cord clamping is only one of many factors that contribute to iron deficiency in early childhood. But babies who start out life low on iron have a very difficult time catching up.”8

Even the World Health Organization has changed its recommendation to advocate for OCC9 Please do your research, ask for Optimal Cord Clamping on your Birth Plan, and talk to your medical provider about their stance and practices.

Here is the video from Dr. Alan Greene, one of the most vocal proponents for OCC, in conjunction with TED talks, and the reason I wrote this blog:

Kyra Bramble is a published writer, private chef, teacher, yogi, traveler, dancer and doula. She is deeply passionate about birth education and empowering women to see birth as a sacred journey. She sees many parallels between the commercialization of birth and food, and is committed to bringing love and awareness to both subjects. 

*Photo from Jeff the Bear via Flickr’s Creative Commons License.


  1. http://www.drgreene.com/ticc-tocc/ 

  2. http://www.scienceandsensibility.org/?p=5730 

  3. http://www.scienceandsensibility.org/?cat=468) 

  4. http://www.helpingbabiesbreathe.org/docs/An%20intro%20to%20HBB.pdf 

  5. http://www.thebirthpause.com/2013/02/optimal-cord-clamping-all-of-human.html 

  6. http://www.scienceandsensibility.org/?s=delayed+cord+clamping 

  7. http://www.drgreene.com/ticc-tocc/ 

  8.  http://www.scienceandsensibility.org/?p=5730 

  9. http://www.who.int/elena/titles/cord_clamping/en/ 


  • JudyC says:

    The other benefit not mentioned is the bonding. OCC allows the mother to hold her baby, smell her/him, start to take in the amazing feat she has accomplished, admire the baby and start immediate skin to skin contact. These might seem a bit airy fairy but there is more and more science coming out to prove the importance of leaving the mother and baby undisturbed at this crucial time.

    • Kyra Bramble says:

      ABSOLUTELY! I agree 100% with you and thank you for writing :)

      The initial moments after birth are very important for both mother and baby, and anything we can do to encourage SKIN to SKIN contact right away is a good thing!

      Another topic I didn’t touch on in this post is the abundance of stem cells in the blood transferred during this vital time…. I wanted to keep the blog as simple as possible to make a big point, but there are absolutely many more benefits than just oxygen and iron.

      Thank you again for writing and supporting us!

  • Kirsten says:

    I completely support this and thank you for your article. My question though is how does jaundice enter in to the discussion as, as a doula, i am often confronted with medical staff who say to parents that the research indicates a higher risk of jaundice if the cord is left to pulse and that the benefits of dcc simply don’t apply to term infants. Furthermore, for iugr babies, it can be ‘dangerous’ (apparently!?)
    I’d love to get some ideas/opinions and arguments. Thank you

    • Kyra Bramble says:

      Hi Kirsten,

      Thank you so much for your passion and for writing!

      There are ALWAYS exceptions, and for IUGR or other special needs babies, then OCC may not be a good option, depending on the circumstances. Every birth is different, and the more we know about different choices that may not be typically discussed with parents, the better we can empower parents to make their own decisions from a place of Informed Consent, not disinformation.

      As for jaundice and other common arguments, I found the Science and Sensibility website was a great resource for me: On this post, called Possible Ojections to Delayed Cord Clamping they offer rebuttals to typical arguments, ( it’s worth a read! http://www.scienceandsensibility.org/?p=5730), here is what they say about jaundice:

      “Since bilirubin, the source of neonatal jaundice, originates in red blood cells, it seems logical that the increased blood volume associated with delayed clamping could lead to severe hyperbilirubinemia. Yet while some studies have demonstrated mildly increased bilirubin levels in DCC babies in the first few days postpartum, most have found no significant difference between DCC and ICC. This seeming paradox—relatively stable bilirubin levels in the face of substantially increased blood volume—may have to do with increased blood flow to the neonatal liver that comes with the higher total blood volume associated with DCC. Yes, more blood means more bilirubin, which in turn could mean more jaundice, but better blood flow allows the liver to process bilirubin more efficiently.”

      I hope this helps you!

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