Cutting the umbilical cord is a straightforward process: two clamps are placed on the cord a few centimeters apart, and the cord is cut between them with sterile scissors. In most births, a doctor or midwife handles this, though partners are often invited to make the cut. The real decisions that matter aren’t about the cutting itself but about when it happens and how the stump is cared for afterward.
When to Cut: Why Waiting Matters
Both the World Health Organization and the American College of Obstetricians and Gynecologists recommend waiting at least one minute after birth before clamping the cord, a practice called delayed cord clamping. Many providers wait until the cord stops pulsating, which typically takes two to three minutes. During that window, blood continues flowing from the placenta into the baby.
The difference is significant. A three-minute delay results in roughly a 30% increase in the newborn’s blood volume and a 50% increase in red blood cells. Since red blood cells carry 70 to 80% of the body’s iron, that extra blood provides enough iron to meet the baby’s needs for several months. For preterm infants, recent large-scale analyses involving thousands of babies have reinforced that delayed clamping reduces the risk of complications compared to immediate clamping.
If you have a birth plan, this is worth discussing with your provider in advance. In most uncomplicated deliveries, delayed clamping is now standard practice.
Where the Clamps Go
The first clamp is placed at least 5 centimeters (about 2 inches) from the baby’s abdomen. If the cord is particularly thick at the base, the clamp should go even farther out to avoid pinching the skin. A second clamp goes a few centimeters beyond the first, closer to the placenta. The cut is made between the two clamps, so neither end bleeds.
The clamp nearest the baby stays in place. It’s a small plastic device that locks shut and keeps the cord sealed while the remaining stump dries out and falls off on its own, usually within one to three weeks.
What the Cut Actually Involves
The cord has no nerves, so cutting it causes no pain to the baby or the mother. Hospitals use sterile, blunt-tipped scissors designed specifically for this purpose. UNICEF specifies single-use stainless steel scissors, typically 10 to 14 centimeters long, sterilized with ethylene oxide. The cord itself is tougher and more rubbery than most people expect, similar to cutting through a thick piece of calamari. It usually takes a firm squeeze rather than a clean snip.
If you’re a partner who’s been offered the chance to cut, the provider will position the clamps, hand you the scissors, and point to the exact spot. There’s very little you can do wrong at that point. The clamps prevent bleeding on both sides, and the provider is right there guiding you.
Emergency Births Without Medical Help
If a baby is born before medical help arrives, the cord does not need to be cut immediately. In fact, leaving it intact is safer than cutting it with unsterile tools. The cord will stop pulsating on its own, and the baby can remain connected to the placenta until paramedics arrive.
If you must act, the priority is keeping the baby warm and dry, skin to skin with the mother if possible. Cutting the cord with household scissors or a knife introduces a real risk of infection. If emergency responders are en route, simply wait. The cord and placenta are not causing harm while attached.
Caring for the Stump
Once the cord is cut, a short stump remains clamped near the baby’s belly button. In high-resource settings like the United States, Canada, and Europe, the recommended approach is dry cord care: keep the stump clean, leave it exposed to air or loosely covered with a clean cloth, and let it dry and fall off naturally. If it gets dirty, clean it with soap and sterile water.
The American Academy of Pediatrics specifically advises against applying alcohol, antiseptic ointments, or other topical substances to the stump in hospital births and high-resource countries. Counterintuitively, using antimicrobials in these settings doesn’t help and may actually encourage more harmful bacteria to take hold by wiping out the less dangerous ones. Fold the diaper below the stump to keep it dry and avoid irritation.
For births that happen at home in communities with high infection rates or in resource-limited settings, the WHO does recommend applying chlorhexidine (an antiseptic) to the cord. This distinction matters because the risk of cord infection varies dramatically depending on the birth environment.
Signs of Infection to Watch For
Cord infection, called omphalitis, is uncommon in developed countries but can become serious quickly when it does occur. The early signs are redness, swelling, and tenderness around the base of the stump. You may also notice pus or cloudy discharge, or the area may feel warm and firm.
A foul smell from the stump is a particular red flag that suggests a more aggressive type of infection. If redness begins spreading outward across the belly, this signals the infection is moving into the surrounding tissue and needs immediate medical attention. Fever, lethargy, or a baby who seems unusually unwell alongside any of these local signs warrants urgent evaluation. Caught early, omphalitis is treatable, but it can progress to involve the entire abdominal wall if ignored.