61. Cord blood banking vs delayed cord clamping. Can I do both – Hayley Oakes LM, CPM

The heart of my work as a midwife (and mother of two) is educating and informing clients about their options surrounding care in pregnancy, labor, birth and postpartum. This runs the gamut of discussing the pros and cons of out-of-hospital birth vs hospital birth to my recommendations for nursing bras.

Once a client is halfway through the third trimester (week 34), we discuss postpartum options and their preferences. Two hot topics surrounding the immediate postpartum period (aka the fourth stage of labor) are cord blood banking and delayed cord clamping.

What is cord blood banking?

Cord blood banking is the process of collecting blood from the umbilical cord immediately after the baby is born for storage and potential future use of umbilical stem cell treatment.

Cord blood banking can be beneficial if an immediate family member has a current health condition in which they could benefit from stem cell treatment. There is ongoing research about the vast treatment opportunities for diseases such as lymphomas, leukemias, Alzheimer’s, diabetes, heart disorders, autism and over 100 more conditions.

However, it’s not completely risk-free. Firstly, collecting and storing cord blood in a private bank is costly. One can expect to pay a few thousand dollars for the initial collection and then an annual fee of a couple hundred dollars. This is a lot of money for a very low likelihood of your child needing to use their cord blood. Secondly, and more importantly, it involves clamping and cutting the cord early — before a baby has received 100% of their oxygen-rich, red blood cells from the placenta.

During the final stage of labor when the baby has descended into the pelvis, they shunt about a third of their blood volume back to the placenta to help fit through the vaginal canal. Once the baby is born, the placenta immediately sends the blood back to the baby via the umbilical cord. This process can take up to 10-15 minutes. Honoring this physiological process is called delayed cord clamping.

Delayed cord clamping is the act of waiting to cut and clamp the cord until the cord has visually stopped pulsating and/or the placenta has been delivered.

The moment a baby is born, their respiratory and cardiac systems are altered in an instant. Waiting to cut the umbilical cord allows the baby to receive oxygen from two sources while undergoing that transition. They are breathing room air utilizing their lungs for the first time and receiving oxygen rich blood cells via the umbilical cord. I like to encourage clients to take note of the cord immediately after the baby is born as one can visually see the cord change from being full of blood and pulsating to white and drained within a few minutes. Also in this time, they will notice their baby start to darken and/or pink in color receiving a healthy amount of oxygen.

Another benefit of delayed cord clamping is decreasing the risk of childhood anemia, which can affect a child’s growth and development.

So, if one is a healthy candidate for cord blood banking (remember: a sibling or immediate family member with a current health condition that could benefit from stem cell treatment), and they would like to do delayed cord clamping, is this an ‘either/or’ situation? Not entirely!

My recommendation is to wait at least 90-120 seconds before the cord is cut. See this incredible TED talk about the benefits of waiting just 90 seconds. Then the remaining blood in the cord can be collected and stored.

There are so many options surrounding the childbearing journey and hopefully some clarification about a couple of these choices can make the decision-making process that much easier.

Hayley Oakes is a licensed midwife based in Los Angeles offering integrative pre- and postpartum care. She has been attending births since 2010 as a doula, midwife assistant, apprentice and midwife, witnessing and supporting birth in all settings: home, birth center and hospital. Hayley is the host and creator of Milk Trails — a podcast dedicated to the out-of-hospital birthing experience. In February 2019, Hayley became a mother herself and welcomed her second child in January 2022. As a midwife, educator and mother, she is committed to supporting childbearing folks in having a safe and satisfying pregnancy, birth and postpartum experience to help grow healthy, happy babies.