Cord clamping, blood banking…

small_4424101920A week or two ago, a friend asked me what my current understanding of the value of cord blood banking was and whether there was a resource I would recommend to women who were wanting to read more about the pros and cons of this.  As is often the case in commercial ventures, the marketing materials produced by those charging for such services tend to over-emphasise the selling points, sometimes spinning data in a rather emotive fashion.  It is then perhaps inevitable that many of us who work with women and babies do not view those supposed advantages in quite the same way and are instead more likely to seek to redress the balance and stress the disadvantages, especially where (as in this case) they are direct and potentially invasive as far as interrupting normal physiology is concerned.  Having shared my thoughts with my friend, I thought it might be useful to share a few resources more widely…

One of my go-to resources on the topic of cord blood banking is Sarah Buckley‘s (2009) book, Gentle birth, gentle mothering.  Sarah finds that there is little chance that this kind of ‘biological insurance’ will ever be used by the parents who pay for this service.  This was also the position taken in the RCOG’s information for parents leaflet.

birthing your placentaAlthough they are now a few years old and the second relates to previous editions of books and guidelines mentioned in this post, I considered this and other cord-related issues in a couple of Practising Midwife articles; To feel, or not to feel? in 2003 and Cord blood banking: who benefits? in 2007.  Nadine Edwards and I also wrote about related topics in the AIMS booklet that we co-authored, Birthing Your Placenta.

All of the above resources that take a position agree that it is difficult to recommend private cord blood banking for many reasons.  Unless there is already a known medical need for cord blood (i.e. in a close family member), the chances of it ever being used are remote.   It is also an expensive process which carries no guarantees; the success of collection is dependent on a number of factors outside of anyone’s control, contamination is hard to eradicate and current storage methods and facilities may not ensure prolonged viability.  Sarah, Nadine and myself go somewhat further than the RCOG in stressing the way in which the process of cord blood banking, whether for private or public ends, can interfere with normal physiology and deprive the baby of its own blood.  It is hard to justify taking away something that the newborn baby can definitely use now just in case the baby or someone else might be able to use it later.

This leads me nicely into sharing a related resource that I spotted earlier this week; the Cochrane Collaboration have released a Cochrane Journal Club (CJC) page looking at their review of the effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes (McDonald et al 2012).  The CJC is a regular feature (although, as Cochrane covers a wide variety of health-related topics, pregnancy and childbirth-related topics only feature now and again) and the launch page for the journal club that asks ‘Is delayed cord clamping likely to be beneficial?’ offers a link to the review itself as well as relevant presentations, discussion questions and a facility to ask questions of the authors.  This could be a useful starting point for discussion of this topic in areas which haven’t yet moved to a policy of late cord clamping…

heart i-cord photo credit: Salihan via photopin cc

3 comments for “Cord clamping, blood banking…

  1. November 29, 2014 at 5:26 pm

    As a midwife and mother, I fully understand the reasons why women may chose a physiological third stage – indeed when I birthed my last baby in 1999, I insisted on it and enjoyed the experience. However there will also be those who, for whatever reason, wish to investigate the possibility of cord blood banking and so I felt it was my responsibility to research this complicated subject in more detail. The resulting overview of cord blood banking was published in 2008 and it might help you to better understand all aspects of this topic. In it I say:
    “The field of UCB donation is relatively new and it raises emotive ethical, medical, scientific and social issues. For practising midwives, their prime consideration must always be to provide optimal care for the mother and her baby. The Midwives Rules (NMC 2004) states: “Except in an emergency, a practising midwife shall not provide any care or undertake any treatment which she has not been trained to give”.
    The collection of UCB during or after the third stage of labour could be complicated by a series of factors including: multiple birth, prematurity, the cord around the neck, risk of post partum haemorrhage or emergency caesarean section. Furthermore, it has the potential to disrupt the initial period of bonding when skin-to-skin contact and early breastfeeding should be allowed to progress unhindered.”
    You can read the full article here:http://www.sharontrotter.org.uk/midirs2008.htm

  2. Susan Carroll
    July 15, 2016 at 5:00 am

    I wish I had known this before the births of my 6 babies. But my daughters can still benefit. Thank you… With horse births attended by vets, sometimes the foal gets “the staggers”, a condition where the foal is slow to stand, and wanders around not able to find his mama’s teat for a prolonged period. Turns out this does not happen without a vet there. Why? Because the vet clamps the cord immediately. Normally the cord is only broken by the movement of the mother and foal after a period of time. Foals with staggers have low oxygen and iron levels because they did not get enough blood from the placenta and cord. This has been found in the last decade.

Leave a Reply