Umbilical Cord Clamping: beliefs and practices of American Nurse-Midwives, Judith S. Mercer
Umbilical cord clamping: beliefs and practices of American nurse-midwives
Mercer JS, Nelson CC, Skovgaard RL.
University of Rhode Island College of Nursing, Nurse-Midwifery Program, Kingston 02881, USA.
The optimal time for umbilical cord clamping after birth remains a critical unknown fact that has implications
for the infant, the
mother, and science. A national survey was conducted using a randomized sample (n = 303) of the active
membership of the
ACNM to determine cord clamping practices and beliefs of American nurse-midwives. The response rate
was 56%.
The respondents fell into three cord clamping categories:
early (EC) or before 1 minute (26%);
intermediate (IC) or 1 to 3 minutes (35%); and
late (LC) or after pulsations cease (33%).
The EC group believes that early clamping facilitates management of the newborn. The IC group believes
that a moderate delay
of clamping allows for a gradual transition to extrauterine circulation, although many think that the
timing of cord clamping is not
significant.
The LC group have strongly held beliefs that late clamping supports physiologic birth processes.
The majority of CNMs (87%) place the baby on the mother's abdomen immediately after birth and 96% avoid
clamping a nuchal
cord whenever possible.
Although Varney's Midwifery was cited most frequently as a reference, 78% of the respondents listed
no references reflecting, in
part, the absence of evidence-based recommendations for cord clamping practices.
J Midwifery Womens Health 2000 Jan-Feb;45(1):58-66
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