The aim of the present study was to investigate cord clamping practice and treatment approaches for term vaginal births in Indian hospital, where the majority of births have an Obstetrician as the lead. A stopwatch was used to time the cord clamping interval at 55 term vaginal births in a tertiary hospital. The stopwatch was pressed once at the time of the birth and once when the first clamp was applied to the umbilical cord. Mode of birth, maternal position for birth and whether midwives and or doctors and neonatal health practitioners were involved in the birth was documented alongside the cord clamping timing. Cord clamping timing ranged from a minimum of 14 seconds to a maximum of 34 minutes. The median umbilical cord clamping time for all births in the study was 3.5 minutes. The median cord clamping time was likely to be longer when the woman had a spontaneous vaginal birth rather than an instrumental birth; when she birthed in a side-lying or upright position rather than a seated position; when a midwife facilitated the birth rather than a doctor and when there was no neonatal team present at the birth. The median cord clamping time of 3.5 minutes is aligned with current local, national and international guidelines. Midwives are likely to facilitate longer cord clamping times as they are more likely than doctors to attend spontaneous uncomplicated births which do not warrant immediate separation of mother and baby for preventative or resuscitative measures.
Keywords: Resuscitative measures, Cord clamping, Spontaneous vaginal birth, Behavior and Umbilical Cord Clamping, Neonatal Jaundice
FIGO good practice recommendations on delayed umbilical cord clamping
