Timing of umbilical cord clamping: midwives' views and practice

Abstract

Early clamping of the umbilical cord is widely practised. Delaying clamping increases placental transfusion. Although this is associated with benefits when compared with early clamping, such as a reduction in anaemia in infancy, the overall impact on mother and baby remains unclear. To assess the feasibility of conducting a randomized trial we surveyed practice in a UK maternity unit with a policy of active management. Sixty-three delivery suite midwives were invited to complete a questionnaire. Fifty-two (83%) responded of whom 47 (90%) gave oxytocin with the anterior shoulder and 48 (92%) clamped the cord within one minute. Care was observed for 100 births; all received oxytocin and controlled cord traction. Cord clamping was within ten seconds for 32 births and within thirty seconds for 85. There is variation in timing of cord clamping. A trial comparing the effects of delayed, rather than early, cord clamping appears feasible.