Intended for healthcare professionals

Rapid response to:


Qualitative study of evidence based leaflets in maternity care

BMJ 2002; 324 doi: (Published 16 March 2002) Cite this as: BMJ 2002;324:639

Rapid Response:

Informed Consent for Cord Clamping: Ask Erasmus Darwin!

Erasmus Darwin died 200 years ago this month; this is a quotation
from his publication, Zoonomia:

"Another thing very injurious to the child, is the tying and cutting
of the navel string too soon which should always be left not only until
the child has repeatedly breathed, but till all pulsations in the cord
cease. As otherwise the child is much weaker than it ought to be, a
portion of the blood being left in the placenta, which ought to have been
in the child."

Two hundred years later, NICU's are filled with anemic newborns, many
of whom require blood transfusion to keep them alive. Nearly every
preemie has its cord clamped immediately. The most common cause of
neonatal morbidity is respiratory distress syndrome, known under the name
of "shock lung" at any other age.

A fuller account of the injuries alluded to by Erasmus is available

Erasmus Darwin's comment should be on every maternity informed
consent form, and every midwife and obstetrician should know it by heart.

G. M. Morley, M.B., Ch. B.

Competing interests: No competing interests

01 April 2002
George M. Morley, MB ChB FACOG
Retired obstetrician
PO Box 181, Northport, MI 49670 USA