The umbilical cord connects a developing fetus to the placenta during pregnancy. This flexible, tube-like structure facilitates the transfer of oxygen and nutrients to the fetus and waste products away from it. Typically, the umbilical cord contains two umbilical arteries and one umbilical vein, encased within a protective gelatinous substance known as Wharton’s jelly.
Cutting the Cord After Birth
Immediately following birth, healthcare providers cut the umbilical cord, separating the newborn from the placenta. They typically place two clamps on the cord before cutting between them. This procedure is painless for both the baby and the birthing parent as the cord contains no nerve endings.
While immediate clamping was historically common, current practices often involve a slight delay, with cutting generally occurring within minutes after delivery. After the cord is cut, a small stump remains attached to the baby’s navel. This stump, typically about 2 centimeters in diameter, will eventually dry and fall off on its own. The cord’s cutting marks the baby’s transition to independent respiratory and circulatory function, as they no longer rely on the placenta for oxygen and nutrients.
Delivering the Placenta
The umbilical cord is removed from the birthing parent during the third stage of labor, which involves the delivery of the placenta. This stage begins after the baby is born and typically concludes with the expulsion of the placenta and its membranes, usually within 5 to 30 minutes. Signs indicating placental separation include a sudden gush of blood, a lengthening of the umbilical cord outside the vagina, and a change in uterine shape of the uterus, becoming firmer and more rounded. To assist with placental delivery, healthcare providers may use controlled cord traction, gently pulling on the cord while supporting the uterus. Fundal massage, an external uterine massage technique, is also commonly used to encourage contractions and aid in expulsion, reducing the risk of excessive bleeding.
Caring for the Umbilical Stump
After the umbilical cord is cut, a small stump remains on the newborn’s abdomen, requiring specific care to prevent infection and promote healing. The stump typically dries, shrivels, and changes color before naturally falling off, usually within 5 to 15 days after birth, though it can take up to three weeks.
Maintaining hygiene is important for stump care. Parents should keep the stump clean and dry, ideally exposing it to air. Sponge baths are recommended until the stump has fallen off and the area is fully healed, avoiding submersion in water. Folding the diaper down below the stump helps prevent urine contamination and allows for air circulation. Parents should monitor for signs of infection, such as foul-smelling discharge, persistent bleeding, redness, or swelling around the base.
Important Cord-Related Decisions
Beyond immediate cord cutting and placental delivery, families may face decisions regarding practices like delayed cord clamping and umbilical cord blood banking. Delayed cord clamping involves waiting to clamp and cut the umbilical cord for 30 seconds to five minutes after birth, or until pulsations cease. This allows more blood to transfer from the placenta to the newborn, potentially increasing the baby’s blood volume and iron stores.
Umbilical cord blood banking is another consideration, where blood remaining in the umbilical cord after birth is collected and stored. This cord blood contains stem cells with the potential to treat certain diseases, including some cancers and blood disorders. Families can store this blood privately for their child’s future use or donate it to a public bank. The decision to pursue cord blood banking may influence cord clamping timing, as longer delays can reduce the volume of blood available for collection.