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In the moments after birth, there’s often a flurry of activity: checking the baby, cleaning, measuring and of course, cutting the cord. But before that clamp clicks shut, there’s a critical opportunity to support your baby’s transition in a simple yet powerful way: by waiting for white.
Immediate cord clamping became routine in the 1960’s based on the belief it would prevent postpartum haemorrhage. We now know this is not true. Research has repeatedly shown that early cord clamping does not reduce bleeding for the mother. In fact, the practice was never supported by strong evidence, but like many medical interventions introduced in that era, it became standard and stuck.
More recent studies have turned that old belief on its head, and we now understand that delaying cord clamping, ideally until the cord has stopped pulsating and turns white, is not only safe, but incredibly beneficial for babies.
The placenta is an incredible organ – your baby’s lifeline throughout pregnancy. It transfers oxygen, nutrients, stem cells, hormones, and antibodies to your baby. But its work isn’t done the moment your baby is born.
At birth, about 30% of your baby’s blood volume is still in the placenta. That’s a significant amount of blood filled with all the things your baby needs to thrive in the outside world. When we clamp the cord too early, we essentially leave a third of their blood behind. When we wait, we give baby time to receive all of their own blood.
In the first 60 seconds, around 50% of the placental blood transfuses into the baby.
By 3 minutes, over 90% of the blood has moved from the placenta to the baby.
When the cord turns white and stops pulsating, it’s a clear visual sign that the transfer is complete.
This is known as optimal cord clamping, or what many birth workers now refer to as “waiting for white.”
The benefits of delayed cord clamping are even more pronounced for preterm babies. According to a review published in JAMA Paediatrics, preterm infants who had delayed cord clamping experienced:
Some neonatal units now practice “cord milking” (gently squeezing blood along the cord toward the baby) when time is short and resuscitation is needed urgently. But where possible, leaving the cord intact while initiating resuscitation is becoming more common, acknowledging the placenta as a vital support system even in those early critical minutes.
A growing number of companies promote private cord blood banking, where the umbilical cord blood is collected, frozen, and stored for possible future use. This is often marketed as “biological insurance” just in case the child develops an illness later in life.
But here’s the problem: when you choose to bank your baby’s cord blood, the blood is collected early, which often requires clamping the cord prematurely, denying your baby the stem cells, blood volume, and immune protection they would otherwise receive at birth.
In March 2019, the American College of Obstetricians and Gynaecologists (ACOG) updated their statement on umbilical cord banking. They stated:
“Umbilical cord blood collected from a neonate cannot be used to treat a genetic disease or malignancy in that same individual. Cord blood collection should not compromise obstetric or neonatal care or alter routine practice of delayed cord clamping. The routine use of private cord blood banking is not supported by available evidence.”
Source: ACOG Committee Opinion No. 771 – Summary
So, while private banking may sound appealing, the reality is most families never use the stored blood, and the real cost may be depriving your baby of what they need right now, at birth.
Delaying cord clamping gives your baby access to their own stem cells when they need them most to support organ development, build immunity, and possibly even repair damage caused during a challenging birth. These stem cells are designed for them and best used by them, in those first moments outside the womb.
It’s true that delayed cord clamping slightly increases the chance of a baby developing jaundice that may need treatment, but it’s important to understand what this means. Most newborn jaundice is physiologic, meaning it’s a normal, expected rise in bilirubin due to your baby’s immature liver and faster breakdown of red blood cells; it generally appears a few days after birth, peaks, and resolves within 1 to 2 weeks without issue.
With delayed cord clamping, your baby receives more red blood cells from the placenta. As those extra cells are broken down, bilirubin levels can be modestly higher early on, but studies consistently show this usually leads only to mild, physiologic jaundice, which is easily managed with phototherapy if needed.
For instance, the World Health Organisation data shows a small increase from about 2.7% with early clamping to roughly 4.4% with delayed cord clamping in babies who require phototherapy.
In caesarean births specifically, delayed cord clamping up to 60 seconds improved haematological benefits without increasing phototherapy needs.
In contrast, pathological jaundice presents earlier (within 24 hours), rises rapidly, or lasts longer than two weeks. It may indicate underlying conditions like haemolysis, infection, or metabolic issues and requires urgent evaluation and treatment.
The type of jaundice occasionally seen with delayed cord clamping is typically mild, transient, and manageable and most importantly the benefits of delayed cord clamping is better iron stores, stem cell transfer, and brain development, which far outweigh this mild risk, especially when newborn monitoring and phototherapy are available.
As the Cochrane Review points out:
“Delayed cord clamping is likely to be beneficial as long as access to treatment for jaundice requiring phototherapy is available.”
In short, we don’t avoid a proven benefit just because it may result in a minor, manageable side effect.
The World Health Organization (WHO) recommends delayed cord clamping for all births, including preterm babies, unless the newborn needs immediate resuscitation.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) also supports delayed clamping of at least 60 seconds for term and preterm infants.
Midwifery leader Dr Rachel Reed describes the placenta as “essential resuscitation equipment” reminding us that the baby and placenta are one unit until the cord has finished its job.
In many birth settings, delayed clamping is now becoming the norm – but not everywhere. If you want this for your baby, include it in your birth plan and discuss it with your care provider in advance. Use the phrase “wait for white” so there’s no confusion.
You might say:
“I’d like the cord to be left intact until it has stopped pulsating and turns white.”
“Unless there’s an emergency, please wait to clamp the cord – this is important to us.”
It’s also important to know that delayed cord clamping is possible during a caesarean birth. While the logistics are slightly different to a vaginal birth, many obstetricians and surgical teams are now supportive of waiting 1 to 3 minutes before clamping the cord in theatre, especially when requested in advance. This allows the baby to still receive that vital transfusion of oxygen-rich blood, iron, and stem cells from the placenta. If you’re planning or considering a caesarean, talk to your care provider about including delayed cord clamping as part of your birth plan as your baby deserves the same biological benefits, regardless of how they are born.
It carries the oxygen, nutrients, immune support, and stem cells they need to begin life strong.
Delayed and optimal cord clamping is not an alternative or a trend – it’s a return to what nature intended. By waiting for white, we honour the incredible design of the human body and give babies the very best start in life.
So when the time comes, take a breath.
Hold your baby close.
And wait for white.
Other links to relevant articles:
https://birthsavvy.com.au/cord-blood-banking/
https://www.sarawickham.com/research-updates/delaying-cord-clamping/
https://sarahbuckley.com/leaving-well-alone-a-natural-approach-to-the-third-stage-of-labour/
https://www.bellybelly.com.au/birth/delayed-cord-clamping/
https://www.youtube.com/watch?v=W3RywNup2CM
https://www.youtube.com/watch?v=cX-zD8jKne0
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki