Delayed cord clamping: benefits, costs, and societal implications for women and families

Introduction
Reproductive science has changed the lives of women and helped to restructure society in general, because it changes the roles that sex and parenthood play, by disassociating the two. Without reproductive technology, the role of women has typically been limited to bearing children, which then extended to rearing them. Reproductive technology has allowed women to be more selective about when and how they have children. As women gained social power from this freedom, they have extended this social power into a number of other spheres, creating substantial shifts in most societies with regards to things like gender equality (Sherwin, 2001). This shift is ongoing. Whether a new reproductive technology changes this dynamic further would be dependent on whether it functions in some way as to provide a benefit that existing technologies do not have. Society as a whole changes because falling birth rates disrupt the typical patterns of development, though these are occurring simultaneous to dramatic changes in health care that extend lives; society has had to adapt quickly to these changes in the general social structure. This paper will look at delayed cord clamping to analyze its impacts and costs to both women and society.
What Is Delayed Cord Clamping?
The American Pregnancy Association (2018) defines delayed cord clamping as “the prolongation of the time between the delivery of a newborn and the clamping of the umbilical cord.” Without the delay, the cord can be clamped almost immediately. Delayed cord clamping can be between 1-3 minutes after delivery, or even leaving the umbilical cord until it stops pumping. This technique is in line with World Health Organization recommendations and is becoming increasingly popular (APA, 2018).
There are no costs associated with this new concept. The existing clamping technology will be utilized, the only change here is that it will be done at a point in time a little later on. It will not cost any more to do it at that point, and the technique appears to create no extra burdens. The risks that exist are minor, and some of them have yet to be definitively. The technique therefore does not add cost to the giving birth procedure.
Risks and Benefits to the Mother
The logic of delayed cord clamping (DCC) is that it will increase the flow of blood to the baby, thereby increasing the newborn’s iron storage, said to be healthy for brain development (APA, 2018). This practice was normal for preterm infants, but in this case it is now becoming more common for full-term babies as well. This is because the higher rate of placental transfusion is beneficial for brain development. Further, there is a decrease risk of anemia caused by iron deficiency with DCC. Anemia at birth carries with it known risks such as cognitive impairment and central nervous system problems (APA, 2018).
There are three risks with DCC, however, and these should also be understood. The first risk is that of polycythemia, which is when there is an excess of red blood cells in circulation. This carries with it risks associated with breathing, and with circulation. A second risk associated with DCC is hyperbilirubinemia.
Hyperbilirubinemia is with bilirubin levels in the blood are too high. Basically, after birth the baby’s liver takes care of bilirubin, and inability to handle it can cause jaundice. This is also a risk with hyperbilirubinemia (APA, 2018). This risk is more hypothetical than it is documented at this point in time, however. More studies are required to demonstrate whether this risk is provable or not.
A third risk of DCC is respiratory distress. If there is insufficient liquid coating in the lungs after birth to keep airways open, then a buildup of carbon dioxide in the blood can occur and the baby will need to be placed on a ventilator (APA, 2018). So there are some significant risks associated with DCC that might outweigh the benefits. But on both sides of the debate, there is insufficient evidence for full-term births. There are no proven risks to the mother of DCC – the risk level does not change to the mother with this technique or without it.
Risks and Benefits to Society
The major benefit to society of looking at the issue of DCC is that it is an opportunity for evidence-based decision–making to be implemented. That the best medical science once determined that the umbilical cord should be cut immediately after delivery and now science is revisiting that decision based on new information is really a victory for the scientific method. The gaps in the data have been determined, so over time enough data will be gathered in order to make a clear determination about the risks and benefits of DCC in full-term infants. The other major victory here is that mothers and families will have greater choice over the birth of their child. The only real caveat is that having this choice gives the mother the ability to opt for a course of action that is not supported by the best available scientific evidence. But the ability to make informed decisions should usually be taken as a net positive.
There are not any other major, broad issues with respect to delayed cord clamping. The reason is mostly because at birth, all reproductive rights have been exercised, and the issue is mainly a medical one. Society will not be transformed by this, other than the fact that the scientific method will be affirmed as different studies explore the various risks and benefits of DCC. For women in the future, having more control over how they wish to give birth – especially if coupled with having full and complete access to information – is a modest, incremental gain, but a gain nonetheless. It’s not a game-changer, but there’s always value in a win.
Conclusions
One of the strongest things about reproductive science is that it is the application of science to something that matters and can change people’s lives. Power dynamics are shifted, and the structure of societies altered. As such, reproductive science has had a powerful impact on most countries in the world.
The strongest reproductive science is that which is based on the scientific method, and seeks to do what is best for both the mother and the child. When we apply the best science possible to delivering the best outcomes possible for mothers and children, all of society wins. When we give people the option to make informed decisions about their own reproductive health, we give people greater freedom, and enhance their basic human rights. So while there are doubtless bigger wins out there in terms of reproductive technology, delayed cord clamping is an example of science continually examining its practices in light of new evidence, and seeking to deliver optimal results. This not only enhances the power that women have to make the right reproductive choices for themselves and their families, but it also puts more power in the hands of society in general, when they know that they can rely on scientific inquiry to continually evaluate and re-evaluate standard practices, and renew its ideas based on the best and latest information that is available.
References
APA (2018). Delayed cord clamping: What are the risks and benefits. American Pregnancy Association. Retrieved March 28, 2018 from http://americanpregnancy.org/labor-and-birth/delayed-cord-clamping-risks-benefits/

Sherwin, S. (2001). Normalizing reproductive technologies and the implications for autonomy. Globalizing Feminist Bioethics. Boulder: Westview Press.