Likening routine immediate cord clamping to routine episiotomy, Dr. Nicholas Fogelson argues that delayed cord clamping should be standard practice in obstetrics, not immediate cord clamping. Although he would “humor” the occasional patient who requested delayed cord clamping, he accepted immediate cord clamping as being “the way to do things,” simply because that was what he had been taught to do — it was what all his teachers and mentors had done, so it was what he did, too.
Then he actually looked to see if the research bolstered his actions, and was disturbed by what he found.
“It feels like being a doctor 10-15 years ago looking to see if there is any data about episiotomy, and finding that there’s a lot, and it says we’ve been doing it wrong for awhile now.”
So he’s calling for a return to delayed cord clamping. I call it a “return,” because although immediate cord clamping has reigned in medical circles for as long as we can remember — probably as long as birth has taken place in hospitals — it is not what was normally or typically done prior to that time.
Considering this data, I have to think about evolution and function. I am a strong believer in evolution, but even under creationist thinking I have to believe that if the system meant for babies to have been phlebotomized of 50-100 cc of blood at birth, we would have been born with higher hemoglobins. Clearly the natural way of things is for this not to happen.
Obviously, as a creationist, I would agree with this statement (except for the “strong believer in evolution” bit). Surely it is not “natural” by either evolutionist or creationist standards to immediately clamp and cut the umbilical cord, since that is not what happens among placental animals, and babies are not born with a clamp in hand. 😉 What is natural is Wharton’s jelly that naturally closes the blood vessels in the umbilical cord after some period of time after birth.
We are all familiar with the statement included in the Hippocratic Oath, “First, do no harm.” It is not the delayed cord clamping (or physiologic cord handling, as some call it) that needs to prove itself, but rather that immediate cord clamping and amputation should be made to prove itself. It may be that immediate cord clamping is somehow more beneficial on average than delayed cord clamping — I’m not discounting that as a possibility. There may be a few babies who might benefit from ICC. But since the motto is, “first, do no harm,” we need to make sure that the non-physiologic action we are contemplating is actually 1) not harmful and 2) beneficial. Currently, the data just doesn’t seem to support it.