Editorials

Umbilical cord clamping after birth

BMJ 2007; 335 doi: http://dx.doi.org/10.1136/bmj.39282.440787.80 (Published 16 August 2007) Cite this as: BMJ 2007;335:312
  1. Andrew Weeks, senior lecturer in obstetrics
  1. School of Reproductive and Developmental Medicine, University of Liverpool, Liverpool L8 7SS
  1. aweeks{at}liv.ac.uk

    Better not to rush

    Early clamping and cutting of the umbilical cord is widely practised as part of the management of labour, but recent studies suggest that it may be harmful to the baby. So should we now delay the clamping?

    Early clamping of the cord was one of the first routine medical interventions in labour. Its place in modern births was guaranteed by its incorporation into the triad of interventions that make up the active management of the third stage of labour. The earliest references are clear about the other two components of active management—oxytocin to contract the uterus and prevent postpartum haemorrhage, and controlled cord traction to prevent retention of the placenta.1 But early cord clamping had no specific rationale, and it probably entered the protocol by default because it was already part of standard practice. When this package was shown to reduce postpartum haemorrhage in the 1980s early cord clamping became enshrined in the modern management of labour.

    But it has not been accepted everywhere. In Europe, although 90% (1052/1175) of units …

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