A DCC Conundrum

Delayed cord clamp is standard of care. On today’s episode, we are stepping into a high-pressure dilemma in the labor and delivery room. Imagine this (which doesn’t need a lot of imagination, because it is a real event which occurred to one of our podcast family members): A mother has carefully drafted a birth plan. One of her non-negotiable requests is delayed cord clamping for two full minutes. But the moment the baby is delivered, it becomes clear that the infant is non-vigorous: floppy, pale, and not breathing. The baby urgently needs immediate resuscitation.

The physician reaches for the cord shears, but the mother demands: "No! Wait the two minutes! It's my decision!" What happens next? Whose rights win out? Today, we’re exploring clinical guidelines, the core ethical principles, the legal mandates, and state FOUR established norms that govern the delivering professional’s actions.

1. American College of Obstetricians and Gynecologists Committee on Clinical Consensus–Obstetrics. ACOG Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates. Obstet Gynecol. 2025 Jul 24;146(3):442-444. doi: 10.1097/AOG.0000000000006020. PMID: 40706055.

2. Jabeen S, Salam SS, Gillespie S, Hasan M, Islam S, Chowdhury AT, Ameen S, Balen J, Rahman AE, Arifeen SE, Nahar Q, Anumba DO. Delayed cord clamping: Perceptions, practices and influencers among the healthcare providers of selected healthcare facilities in Bangladesh. PLoS One. 2024 Dec 5;19(12):e0313938.