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When Should You Cut The Umbilical Cord

by Dan Hughes
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When Should You Cut The Umbilical Cord

When Should You Cut The Umbilical Cord

It’s a decision many new parents are faced with immediately after giving birth: Do you cut the umbilical cord? If so, when do you decide to make that final, irrevocable act of severance?
As it turns out, there is no definitive answer for this momentous choice — just like there isn’t a hard-and-fast rule about how long to breastfeed or whether it’s better to potty train your baby first — but we can offer some guidelines. Here are a few tips on when you should cut the cord.
First off, let’s talk about why you’d even want to cut the cord at all. It’s not just because you’ve got an annoying string tying you down anymore; in fact, cutting the cord has important benefits for both mother and child. For starters, the placenta (that little ball of blood, tissue and muscle) acts as nature’s shock absorber, helping ensure proper oxygen and nutrient flow to the developing fetus. Without it, babies would be prone to breathing problems due to low levels of carbon dioxide in their bloodstreams. But the main reason to keep the cord intact for as long as possible is to provide direct access to the newborn via breastfeeding. Cutting the cord prematurely makes feeding more difficult, since the cut ends have to heal before they’re reattached and reconnected surgically. This means less time spent bonding with your baby. And if you choose to use a pacifier during those early days, don’t bother. Pacifiers shouldn’t be used once the cord stump begins to close up.
So what’s the best way to go about making this life-changing decision? The most widely accepted recommendation from organizations such as the World Health Organization, which recently updated its recommendations on safe practices for childbirth, states that “the procedure should be carried out by a skilled attendant whenever feasible.” In other words, doctors and midwives should take care of the actual delivery, but women who give birth without medical assistance can always ask someone else to clip the cord.
But if you’re worried about getting things wrong or simply prefer to perform the task yourself, here are some guidelines to follow:
1. Never try to cut the cord yourself if you see any sign of blood loss
If you notice bleeding or excessive tearing, wait until trained professionals come into contact with the newly delivered baby. They’ll know exactly how to handle the situation. Don’t worry too much about having scissors ready. Even though these instruments might look sharp, they aren’t really designed for delicate human flesh.
2. Consider the timing
Most professionals recommend waiting to cut the cord until after the baby has been cleaned up and placed on his or her chest. That doesn’t mean you have to spend hours bathing, dressing and cleaning up afterward, however. A clean diaper will suffice, and you can move onto this step fairly quickly. Just remember to wash your hands thoroughly and change into fresh clothes or a new pair of underwear. Make sure everything is disinfected, including the surrounding area where the cord was clipped. Also consider using gloves, particularly if you plan to hold the baby right away. Wiping surfaces down with alcohol wipes is another good idea.
3. Use clamps rather than clips
Clamping the umbilical cord usually takes longer than clipping it, but it also prevents accidental cuts and nicks, which could ultimately lead to infection. Clips, on the other hand, tend to slip around and cause unnecessary slippage over time. There are lots of different types of clamps available, and each one features various safety mechanisms such as locking jaws and spring-loaded blades. Your local hospital may stock them already, but if not, you can find them online at sites like Amazon or Etsy.
4. Avoid tourniquets
Tourniquets are generally considered unsafe, especially when applied directly to the base of the umbilical cord. Not only does that increase the risk of hemorrhaging, but it also deprives the baby of needed nutrients. Tourniquet use should be limited to cases where the mother’s life is actually threatened and/or the baby appears to be in danger of sudden death. Once again, you should consult a professional medical expert for guidance.
5. Wait until the cord stops pulsating
Once the baby’s head emerges from the vaginal canal, the umbilical cord will begin to pulsate. As soon as the scalp can touch the skin, or the pulse slows down, it’s probably time to cut the cord. If you wait too long, however, the blood pressure inside the vessel may drop below acceptable levels. When in doubt, wait for the cord to stop pulsating altogether. While the baby breathes through the mouth, he or she won’t need the umbilical vein anyway. After the cord stops pulsating, the mother can start pushing.
6. Check the clock
Make sure you check the clock before you start cutting the cord. Most hospitals have a standard time limit for doing so, but it varies according to location. Some places require cords to be cut within 90 seconds, while others allow 120 seconds. Whatever the number, keep track of it and make sure you hit that deadline. Otherwise, you run the risk of leaving the cord uncut for too long, potentially causing harm to either the baby or the mother.
7. Take a break
While it sounds counterintuitive, taking a short break between steps is smart. It gives you a chance to catch your breath, regroup and relax. Plus, if you get interrupted or something goes awry, you can put things back on schedule pretty easily.
8. Remember to breathe
You may feel tense, anxious or overwhelmed during this process, but make sure not to forget to breathe. Stay calm, stay focused and keep moving forward. Breathe deeply and rhythmically. Try to maintain a steady pace throughout.
9. Keep distractions to a minimum
Remember, nobody likes being rushed. Give yourself enough time to complete the job properly and safely. At the same time, don’t distract yourself by playing music or watching TV. You should focus solely on the task at hand.
10. Plan ahead
Have all your tools nearby and organized. Always wear sterilized gloves, and make sure you have plenty of gauze pads on hand. Have extra lances or scissors on standby. Ideally, you’ll be able to work uninterrupted for several minutes straight, so prepare accordingly. It helps to set goals for each stage along the way, such as identifying specific landmarks or time markers. It keeps you on target and motivated.
11. Know your limits
Your body is capable of producing certain amounts of adrenaline, noradrenaline and cortisol. These chemicals are essential for responding to emergency situations, but they can become toxic if released excessively. Therefore, it’s important to monitor your stress level and avoid overexertion. Listen to your body. If you experience extreme fatigue, dizziness, headache or nausea, you may need to slow down.
12. Be aware of your surroundings
This is true for everyone involved, but it’s particularly vital for new mothers. Many people don’t realize it, but hospitals are often noisy environments. Other patients and staff members may seem oblivious to what’s going on, but you need to pay attention to your environment and adjust accordingly. If you hear crying coming from somewhere unexpected, for example, it could be a warning sign. Turn down the television volume or cover your ears. If you’re feeling faint, sit down.
13. Keep the wound clean
After the cord is cut, apply antiseptic ointment to the site to prevent infection. Wash your hands carefully with soap and water, then dry them well. Clean the wound gently with warm water and a soft cloth. Change the bandages regularly. If you have stitches, keep the suture lines moist and free of dirt.
14. Follow up with your doctor
Whether you had an elective caesarean section or gave birth vaginally, ask your obstetrician or nurse for advice on caring for yourself and your newborn. Find out how to register with the state and file for Medicaid.
15. Get help
Don’t hesitate to seek medical attention if necessary. Call 911 if you think your partner needs immediate medical care. Contact your family physician or ob-gyn if you have concerns about complications related to pregnancy or delivery.

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