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Ob-Gyn Group Finally Gets on Board With Waiting to Cut the Baby's Cord

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For years, doctors denied laboring women's requests to wait a few minutes after birth before cutting the baby's umbilical cord.

Delayed cord-cutting, as it's called, was thought of as fringe or unncessary. Instead, hospital and doctor protocol would prioritize putting surgical scissors in Dad's hand for a quick snip and then whisking the baby away to be cleaned, weighed and vitamin K'd.

Well, not so fast—literally.

The American College of Obstetricians and Gynecologists has recommended in its new round of guidelines (many of which upend long-standing labor and delivery room protocols) that doctors delay cutting the cord in a normal, healthy birth—which is pretty affirming for the supposed hippies who have long been asking for them to wait.

There are benefits to not clamping the cord right away, the new guidelines acknowledge, including lower risk for iron deficiencies and a possible boost in brain development. ACOG recommends waiting the cut the cord not only after normal, vaginal births, but also for babies delivered via C-section and premature babies.

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"Waiting at least 30 to 60 seconds allows more blood to return to the newborn during the birth process, when blood vessels leading away from the baby start to constrict, and delivers extra iron, which is critical for a baby’s brain development," The New York Times' Alice Callahan writes.

This new recommendation is endorsed by other medical groups, including the American Academy of Pediatrics, the World Health Organization and the American College of Nurse-Midwives. AAP recommends doctors wait between 30 and 60 seconds before clamping, whereas the WHO pushes them to go the full 60 seconds. The ACNM, however, encourages doctors and midwives to wait between 2 and 5 minutes before clamping and cutting the cord in oder to give the baby the full benefits.

“As more and more evidence accumulated, I think our comfort level with saying this looks like the right thing for all babies, term and preterm, seemed the right thing to do,” said Dr. Maria Mascola, a maternal and fetal medicine specialist in Marshfield, Wis., and the lead author of the group’s new recommendation.

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A longer delay used to be the standard, and evidence from a study in Sweden underscores the benefits of the minutes-long wait. In a trial six years ago, researchers found .6 percent of full-term babies whose cords weren't clamped until the 3-minute mark were iron deficient at around 4 months old. For babies whose cords were clamped nearly immeidately, the rate of iron-deficiency was significantly higher, at 5.7 percent of full-term infants in the study.

By 4 years old, the children whose doctors or midwives wait to cut the cord had slightly higher scores in fine motor and social skills, compared to the others.

Doctors are not required to follow ACOG guidelines, but they do carry weight in the labor and delivery world. For women writing their birth plans, they can now include the ACOG's stamp of approval when writing out their wishes.

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