Keywords

Delayed cord clamping; Immediate cord clamping; Newborn vitality; Vaginal birth; Neonatal outcomes; Umbilical cord management

Abstract

Umbilical cord management at birth is a critical component of neonatal care. Historically starting in the 1950s–1960s, hospitals have utilized immediate cord clamping (ICC), the practice of clamping and cutting the umbilical cord within the first 1–30 seconds after birth, to speed up postpartum care and newborn assessments (Ceriani Cernadas et al., 2006; Ceriani Cernadas et al., 2010; McDonald et al., 2013). This approach gained popularity in the mid-20th century due to concerns about maternal bleeding, the need for rapid neonatal evaluation, and the drive for more efficient delivery room workflows (Weckert & Hancock, 2008; Mohammad et al., 2019). Before ICC became routine in hospitals, many traditional birth attendants and midwives typically waited until the umbilical cord stopped pulsating before clamping it, which is what we now call delayed cord clamping (DCC) (WHO 2014). The change to early clamping was mostly influenced by hospital routines and the desire for efficiency, rather than strong evidence showing it was better for newborns. As more research has been conducted, healthcare providers have started to reconsider DCC because of its potential benefits related to continuous placental blood flow and improved neonatal outcomes (ACOG, 2020).

Managing the immediate postpartum period through cord clamping is crucial for optimal newborn health. With the appropriate management of cord clamping, newborns may obtain improved health outcomes. Numerous research studies have investigated the timing of umbilical cord clamping, but there is a lack of consensus on cord clamping protocol within hospital systems.  Recent evidence recommends DCC, a technique that involves postponing cord clamping for 30–60 seconds in healthy term newborns (ACOG, 2020). DCC allows continued placental transfusion to the newborn, which has been linked to better cardiovascular stability, increased iron stores, and higher neonatal hemoglobin levels (Ceriani Cernadas et al., 2010). Despite recommendations from the World Health Organization (WHO, 2014) and the American College of Obstetricians and Gynecologists (ACOG, 2020), that support the use of DCC for optimal maternal and newborn health, many hospitals still use ICC because of outdated practices and system barriers. This literature review aims to assess recent studies comparing newborn vitality outcomes of DCC versus ICC in healthy infants born vaginally and explore opportunities for updating clinical practice based on current evidence. Ten studies, comprising various study designs executed across diverse countries, were incorporated in this review.

Thesis Completion Year

2026

Thesis Completion Semester

Spring

Thesis Chair

Dr. Navarro, Kimberly

College

College of Nursing

Thesis Discipline

Nursing

Language

English

Access Status

Open Access

Length of Campus Access

None

Campus Location

Orlando (Main) Campus

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