New evidence has shown that giving babies a few extra minutes before clamping the umbilical cord can improve their health and, for premature babies, even save lives.
The research has been gathered in a new Scientific Impact Paper, Care of the Newborn and Cord during the Third Stage of Labour, from the Royal College of Obstetricians and Gynaecologists (RCOG), which the Royal College of Midwives (RCM) helped to shape.
The paper brings together the latest evidence on care during the third stage of labour -the period after a baby is born until the placenta is delivered. It highlights how the first few minutes after birth are a crucial time as babies make the transition from receiving oxygen through the placenta to breathing for themselves.
Rather than clamping the cord immediately, in most cases waiting allows more blood to pass naturally from the placenta to the baby. For a full-term baby, that’s around 30% of their total blood volume. The evidence shows this can improve babies’ health, with the greatest benefits seen in babies born prematurely.
The paper also highlights that the timing of cord clamping should be guided by how well the baby is adapting after birth, rather than by a set time or whether the umbilical cord is still pulsating.
Rachel Drain, Quality and Standards Adviser at the RCM and who contributed to the paper, said: “The first few minutes after birth are an incredibly important time for babies as they adapt to life outside the womb. This paper brings together the latest evidence showing why, whenever it’s safe to do so, allowing that natural transition to happen before clamping the umbilical cord can make a real difference.
“We’re proud to have contributed to this work, helping ensure the experience and expertise of midwives was reflected. Having clear, evidence-based guidance supports maternity professionals to provide the safest and best possible care for women and their babies.”
The Scientific Impact Paper also encourages maternity professionals to avoid unnecessary intervention during those first few minutes after birth wherever possible, while continuing to provide essential care such as keeping babies warm and supporting them to breathe.
Five key takeaways from the paper
- Waiting before clamping the cord gives babies more blood
A full-term baby can receive around 30% of its total blood volume from the placenta after birth if the umbilical cord isn’t clamped straight away. Allowing this natural transfer can improve newborn health.
- The first few minutes after birth matter
The moments after birth are a crucial time as babies transition from receiving oxygen through the placenta to breathing for themselves. Avoiding unnecessary intervention during this transition can help babies adapt more smoothly.
- Premature babies benefit the most
The evidence shows delayed cord clamping can reduce illness and deaths in premature babies, making it one of the most effective ways to improve outcomes immediately after birth.
- Every baby is different
Rather than clamping the cord after a set amount of time, the decision should be guided by how well the baby is adapting after birth, including their breathing and heart rate.
- Routine care doesn’t have to wait
Keeping babies warm, drying them and undertaking initial assessments and observations can often all take place while the umbilical cord remains intact, allowing babies to continue receiving blood from the placenta as they make the transition to life outside the womb.
- The paper can be read in full here.
