Attitude of obstetricians towards delayed cord clamping: a questionnaire-based study

Abstract

There is no consensus amongst medical and midwifery staff on the optimum time to cut the umbilical cord following childbirth. Studies have shown that delaying cord clamping for at least 30 seconds is associated with less need for blood transfusion and respiratory support. In 2004, Rabe et al. recommended delayed cord clamping for up to 120 seconds in preterm birth. The aim of our study was to ascertain whether or not obstetricians adopt this recommendation. Questionnaires were given to obstetricians from 43 different units in UK, other EU countries, USA, Canada, Australia etc. There was a 100% response rate. 53% adopted the recommendation only occasionally whereas 37% have never. Difficulty with implementation in clinical practice was the main reason for failure to adopt recommendation. Unawareness of the evidence of the benefits of delayed cord clamping was the reason in half of the non-compliant group. Obstetricians are reluctant to adopt the recommendation. Difficulty in clinical practice was the main reason. There is need for the Royal College of Obstetricians and Gynaecologists to produce guidelines for delayed cord clamping in obstetric practice.