The imperative of implementing delayed cord clamping to improve maternal and neonatal outcomes

The third stage of labour begins at the time the newborn is delivered and continues until the placenta and membranes are expelled. Immediately after birth, the newborn remains attached to the mother and placenta via the umbilical cord. The blood volume transferred from the placenta to the newborn during this time is known as placental transfusion. Active management of the third stage of labour is widely practiced and involves a package of interventions aimed at reducing the incidence of postpartum haemorrhage (PPH) (Prendiville et al, 2009), which is a leading cause of maternal morbidity (Lewis, 2011).

The package of interventions include: routine administration of prophylactic uterotonic drugs, early cord clamping (ECC) and cutting, and controlled cord traction (National Institute for Health and Care Excellence (NICE), 2007), although the timing of each component varies. Active management can lead to a reduced risk of PPH, but it is crucial to establish which individual component reduces the risk or if indeed the full ‘package’ is necessary (Soltani et al, 2010; McDonald et al, 2013).