No baby should die due to an entrenched routine.

I’ve been collecting research articles on “delayed cord clamping”, “optimal cord closure” and variations on this theme for over 20 years.

There is nothing new under the sun.

This month’s rant comes from a Scientific Impact Paper (No. 78) on the Care of the Newborn and Cord during the Third Stage of Labour published in the British Journal of Obstetrics and Gynaecology in July 2026 (Bewley et al., 2026).

The authors begin with, “The minutes after birth are now recognised as a time of remarkable change within the baby and we have learned that interfering with this natural process can cause potential harm.” Let me clutch my pearls. After all these centuries of co-opting and controlling women’s physiology for power and profit, after these several decades of research, they now recognise that something significant is happening during those minutes and that they are causing harm with their hasty interventions? Say it isn’t so.

Essentially the paper acknowledges that cord clamping is a surgical procedure that should have sound justifications for performing. Timing should be based on how the baby is doing rather than the clock.

Truthfully, I had a hard time picking up one more study on this topic and subjecting myself to one more medical epiphany that they should stop routinely harming babies.

I’m not alone in my frustration and helplessness as the idiotic ritual of early cord clamping continues to deprive babies of needed blood volume, stem cells, oxygen, iron, glucose, and more. I sit with my ever-present rage that babies continue to needlessly die as early clamping results in higher neonatal death and impaired physical and neurological development.

For example, a meta-analysis (Seidler et al., 2023) looked at the impact of immediate (less than 15 seconds), short deferral (15-45 seconds), medium deferral (45-120 seconds) and long deferral (over 120 seconds) cord clamping in preterm infants. Waiting for just 2 minutes or longer resulted in a 69% reduction in babies dying before discharge. In another systematic review, waiting to clamp the cord was associated with at 27% reduction in neonatal mortality across all gestational ages (Watson et al., 2024).  Think of all those parents who went home with no baby and only burial plans due to a stupid intervention that has been known for over 200 years to cause harm.

“Another thing very injurious to the child is the tying and cutting of the navel string too soon: which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a portion of blood being left in the placenta which ought to have been in the child.” (Erasmus Darwin 1801). 

While 200 years ago, visual observation of the cord pulsing was an indication of blood flow, it’s now known that the pulse is a pressure wave in the cord vessel wall and not its content, meaning pulsations are not an adequate assessment of optimal blood transfer between the placenta and the baby. Neither is the clock.

Because interrupting the extrauterine adaptation of the newborn by amputating the flow of blood from the placenta results in less ferritin needed for optimal neurodevelopment, it’s no surprise that children who are subjected to early cord clamping show worse fine-motor and social skills at 4 years old compared to those who were allowed to receive more of their own blood, especially boys (Andersson et al., 2015).

This fixation over the “exact” timing of cord clamping within the literature is mind-boggling. Some institutions consider 60 seconds “delayed” cord clamping whereas Sweden has recommended more than 2 min since 2008 with the median time of delay being 6 minutes for vigorous babies.

In our human arrogance, we assume that the transfer of blood is the only function of the placenta after the baby is born. The placenta is the baby’s organ and it’s another avenue of communication between the mother and the baby. Does this communication continue once the baby is outside the womb? Are there electrical, magnetic, or energetic exchanges of information between the baby and their womb-mate once the placenta is born if left intact? We don’t know because on one asks.

It's been my experience that if someone other than the mother decides the cord should be clamped and the placenta amputated, the baby most often cries. If the mother looks at her baby and intuitively knows that the baby is ready to be separated, the baby seldom cries. And in our work with families, this seldom comes before 2 hours post-birth. This has me wondering more about the energetic connection between the baby and their placenta and the wisdom of the mother.

Until recently, neonatal resuscitation guidelines included immediate clamping of the cord in a non-vigorous baby to take them to the resuscitation station for ventilation. The reason for this being that quick ventilation saves babies and the resuscitation station is located across the room away from the mother who is still holding the baby’s placenta within her womb. The solution is, of course, alongside resuscitation trolleys where the baby can receive breaths from an ambubag while still receiving oxygen from their placenta. Babies whose cords remained intact for possible resuscitation tend to have less need for resuscitation, improved Apgars, and better oxygenation saturation with better immediate outcomes (Raina et al., 2023).  

The problem here is that an alongside trolley is “new” and medicine tends to take a full 17 years to adopt a reasonable and sound approach to improving outcomes. On the other hand, they’ll take a half an hour to uptake something that fits their bias and contributes to needless harm (Term Breech Trial and the ARRIVE Trial come to mind). Institutional delivery rooms are designed to work around the staff and their practices, not the physiology of safer birth.

The Impact Paper includes the issue of alongside trolly resuscitations for homebirths:

“Planned births at home or in midwifery units usually enable keeping the baby close and avoiding clamping. Newborn resuscitative measures can be achieved with an intact cord, although the baby may be removed to a firm, flat surface. Low-cost platforms are in development to facilitate bedside resuscitation.”

These low-cost firm platforms already exist. We call them “cookie sheets” and “baking trays”.

The authors acknowledge, “Avoiding harmful intervention may also avoid unnecessary resuscitation efforts, although it is unknown if there is too long a wait.” It seems Sweden is unconcerned with a median of 6 minutes. More institutions accept 60 seconds as a reasonable delay and anything past that presents a danger to the baby. None of this make sense when women in our care generally choose to wait over 2 hours and we’ve yet to see anything injurious to the baby. In fact, with adequate maternal nutrition (yes, it’s in the academic literature), and without the use of synthetic oxytocin or intramuscular vitamin K, we don’t see much jaundice either.

The authors also acknowledge that “knowledge alone is not enough to change practice”. Which is heart breaking as the “knowledge” is that babies needlessly die. They cite various barriers to changing ingrained practices and how a multidisciplinary campaign with senior support is required to change and maintain better practices. Not too long ago, we had that campaign. It was called “Wait for White”. The current practice of “delaying” for 60 seconds is not waiting for white and is still part of the early cord clamping culture. It continues with no valid justification.

Solutions can include not working with practitioners habituated to early cord clamping. Ensuring you and your practitioner agree on what “delayed” means. Choosing attendants who understand and respect maternal instincts and wisdom. Only including people who have the skills to help a baby breathe if needed while still attached to its placenta (neonatal resuscitation is a parenting skill – anyone can learn it).

If enough customers choose another service that knows and practices safer care of the baby, their cord, and their placenta, more babies will live. And the loss of income to those who are still entrenched in dangerous practices will motivate them to get with the program.

No baby should die because a practitioner is too set in their ways.