Your baby is out, warm on your chest, and still connected to the placenta by the umbilical cord. Delayed cord clamping means waiting a short time before that cord is clamped and cut, so more blood can move from the placenta into your baby. This guide gives ACOG's and WHO's exact wording, the trade-offs, and the words to use in your birth plan.
If your baby is vigorous at birth, ACOG recommends waiting at least 30–60 seconds to clamp the cord, and WHO recommends not clamping earlier than one minute. The trade-offs are a small rise in jaundice needing light treatment and less cord blood for banking. Write it into your plan as a wish "if baby is well," so your team can act fast if your baby needs help.
Key Takeaways
- ACOG (2020, reaffirmed 2026) recommends a delay "for at least 30–60 seconds after birth" in vigorous term and preterm babies.
- WHO (2014) says "not earlier than 1 min after birth," and calls one minute the lower limit the evidence supports.
- Benefits include higher hemoglobin and iron stores in full-term babies and fewer transfusions in premature babies.
- Trade-offs include slightly more jaundice needing phototherapy, less cord blood for banking, and emergencies where the cord is clamped at once.
What Is Delayed Cord Clamping?
For a short time after birth, blood keeps moving from the placenta through the cord into your baby. ACOG describes studies in full-term babies where about 80 mL transferred by one minute, reaching about 100 mL at three minutes. Your baby's first breaths appear to help draw that blood across.
Clamping ends the transfer. ACOG notes that clamping within 15–20 seconds became common practice, partly because early studies suggested most of the transfer happened in the first few breaths. Randomized trials have since compared immediate clamping with waiting.
The extra blood carries iron, 40–50 mg per kilogram of body weight by ACOG's figures, which ACOG says has been shown to reduce and prevent iron deficiency during the first year. WHO's earlier guidance calls the practice "late cord clamping."
How Long Should You Wait Before Clamping the Cord?
ACOG and WHO word their advice differently, so here each one is in its own words.
ACOG (Committee Opinion 814, December 2020, reaffirmed 2026) "recommends a delay in umbilical cord clamping in vigorous term and preterm infants for at least 30–60 seconds after birth." It adds that the ability to delay "may vary among institutions and settings," and leaves those decisions to the team caring for you and your baby.
WHO (2014 guideline): "Delayed umbilical cord clamping (not earlier than 1 min after birth) is recommended for improved maternal and infant health and nutrition outcomes." The guideline reprints WHO's 2012 advice that late clamping be "performed approximately 1–3 min after birth," and calls one minute "the lower limit period supported by published evidence."
| Source | What it says | Applies to |
|---|---|---|
| ACOG, 2020 (reaffirmed 2026) | At least 30–60 seconds after birth | Vigorous term and preterm babies |
| WHO, 2014 | Not earlier than 1 minute after birth | Term and preterm babies who don't need help breathing |
| WHO, 2012 (reprinted in 2014) | Approximately 1–3 minutes after birth | All births, with essential newborn care started at the same time |
ACOG's range starts at 30 seconds and WHO's at one minute. Ask your OB or midwife which one your hospital's policy follows, and who keeps time in the room.
What Are the Benefits of Delayed Cord Clamping?
For full-term babies
ACOG says delayed clamping in term babies "increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes." ACOG calls the long-term data limited, so read that "may" as a real hedge.
The 2013 Cochrane review behind much of this advice pooled 15 trials and 3,911 mother-and-baby pairs. Babies whose cords were clamped early were over twice as likely to be iron deficient at three to six months.
For premature babies
ACOG lists "improved transitional circulation, better establishment of red blood cell volume, decreased need for blood transfusion, and lower incidence of necrotizing enterocolitis and intraventricular hemorrhage." In plain terms, that means fewer transfusions, less of a serious bowel illness, and less bleeding in the brain. You may also hear about cord milking, where the cord is squeezed toward the baby; ACOG says it should not be used for babies born before 28 weeks.
For you
ACOG reports that delayed clamping does not increase the risk of postpartum hemorrhage or the need for a transfusion. The Cochrane review found no significant difference in hemorrhage rates.
Risks and Trade-Offs of Delayed Cord Clamping
Here are the pros and cons of delayed cord clamping as ACOG and Cochrane describe them.
Jaundice and phototherapy
ACOG notes "a small increase in the incidence of jaundice that requires phototherapy in term infants." In the Cochrane data ACOG reports, 4.36% of late-clamped babies needed phototherapy (time under special lights) compared with 2.74% of early-clamped babies. ACOG asks hospitals that delay clamping to have ways to monitor and treat newborn jaundice, so ask how your hospital checks babies before discharge.
When clamping right away is needed
ACOG's recommendation covers vigorous babies. It lists situations where immediate clamping should be considered or care individualized:
- For the birthing parent: hemorrhage or unstable circulation, or placenta previa or abruption.
- For the baby: a need for immediate resuscitation, or a placental circulation that is no longer intact, for example after abruption or a torn cord.
WHO likewise does not recommend early clamping "unless the neonate is asphyxiated and needs to be moved immediately for resuscitation." ACOG also finds too little evidence to recommend for or against delayed clamping in twins and other multiples.
Cord blood banking vs delayed clamping
Delayed clamping and cord blood collection draw on the same blood. ACOG cites a public-bank study in which donations meeting initial screening fell from 39% with immediate clamping to 17% with a 60-second delay. With no directed donation planned, ACOG says the benefits to the baby "likely exceed the benefits of banking that volume for possible future use."
ACOG's cord blood banking opinion says collection should not "alter routine practice of delayed umbilical cord clamping," except for rare directed donations, and recommends public over routine private banking. If you plan to bank, ask your provider and the bank how they handle timing.
Delayed Cord Clamping in a C-Section
ACOG does not list cesarean birth among the reasons for immediate clamping. It describes how the wait works in the operating room: your baby can rest on your abdomen or legs, or be held by the surgeon or an assistant close to the level of the placenta, until the cord is clamped.
ACOG gives no separate time for cesarean births, so ask your surgical team what they do, including in an unplanned cesarean. Our c-section birth plan guide covers the other operating-room requests, from a lowered drape to skin-to-skin.
What About Waiting 10 Minutes, 30 Minutes or an Hour?
The trials tested far shorter waits than people search for. Cochrane describes late clamping in its trials as "generally between one and three minutes," and the preterm review ACOG cites capped the delay at 180 seconds. We found no ACOG, WHO or Cochrane recommendation for waiting 10 minutes, 30 minutes or an hour.
The UK's NICE intrapartum care guideline ties timing to delivering the placenta. For active management of the third stage, NICE says to clamp before 5 minutes. If the woman asks for clamping later than 5 minutes, NICE says to support her choice, without recommending a length. In NICE's physiological third stage, the cord is not clamped until pulsation stops or the placenta is out.
A long wait changes how your third stage is managed, so raise it with your OB or midwife well before your due date.
How to Ask for Delayed Cord Clamping in Your Birth Plan
Conditional wording keeps your wish clear without tying your team's hands. Adapt these lines:
- "Delayed cord clamping for at least ___ if baby is well." Fill the blank with the time you and your provider agree on.
- "If baby needs help breathing, please care for baby first."
- "My partner would like to cut the cord."
- "If I have a cesarean, I'd still like delayed cord clamping if baby is well."
- "We plan to bank or donate cord blood and have discussed clamping time with our provider."
Questions for your OB or midwife, and for hospital policy:
- Does the hospital follow ACOG's 30–60 seconds, WHO's one minute, or something else?
- Can my baby stay skin-to-skin during the wait? ACOG says immediate skin-to-skin is appropriate while waiting to clamp.
- Does the plan change for a cesarean or a premature birth?
- How are newborns checked for jaundice before discharge?
For complete sample plans, see our birth plan examples, and pack a printed copy in your hospital bag.
Add delayed cord clamping, and the rest of your first-hour wishes, to a one-page plan in Bloom. Pick it in the "Right after the birth" step, add a specific time under Special wishes, then download the PDF or email it to your care team.
The Rest of the First Hour: Skin-to-Skin, Vitamin K and the First Feed
Skin-to-skin. WHO's Ten Steps to Successful Breastfeeding call for "immediate and uninterrupted skin-to-skin contact" and support to start breastfeeding as soon as possible after birth. ACOG cites a trial of healthy term babies born vaginally in which babies lying on the parent's abdomen or chest received no less blood, so skin-to-skin and delayed clamping can happen together.
Vitamin K. The AAP recommends a single 1 mg vitamin K injection within 6 hours of birth for newborns weighing more than 1,500 grams (about 3.3 pounds). The CDC explains that babies are born with very little vitamin K and that the shot is the best way to prevent vitamin K deficiency bleeding. According to the CDC, newborns who do not get the shot are 81 times more likely to develop severe bleeding. You can ask to hold your baby during the shot.
The first feed. If you plan to breastfeed, ask for help with the first latch while your baby is still on your chest, then log feeds from day one with the Babysential breastfeeding tracker.
Then fill in your birth plan's after-birth section so your team sees every first-hour wish on one page.
Frequently Asked Questions
What is delayed cord clamping?
Delayed cord clamping means waiting before the umbilical cord is clamped and cut, so more blood moves from the placenta to the baby. ACOG recommends at least 30–60 seconds for vigorous newborns.
How long should you delay cord clamping?
ACOG recommends at least 30–60 seconds after birth for vigorous term and preterm babies. WHO recommends not clamping earlier than 1 minute, and its 2012 guidance describes late clamping as about 1–3 minutes.
What are the benefits of delayed cord clamping?
In full-term babies it raises hemoglobin at birth and improves iron stores for several months. In premature babies, ACOG links it to fewer blood transfusions and lower rates of necrotizing enterocolitis and brain bleeding.
Are there any risks or disadvantages of delayed cord clamping?
The main one is a small increase in jaundice needing phototherapy: 4.36% of late-clamped versus 2.74% of early-clamped babies in a 2013 Cochrane review. It also leaves less cord blood for banking.
Can you do delayed cord clamping with a c-section?
Yes. ACOG does not list cesarean birth as a reason for immediate clamping. During surgery the baby can rest on the parent's abdomen or legs, or be held near the level of the placenta, until clamping.
Is it safe to delay cord clamping for an hour?
No ACOG, WHO or Cochrane source recommends it or reports on its safety. The trials behind current advice mostly compared clamping within 1 minute against about 1–3 minutes. Discuss any longer wait with your OB or midwife.
Can I bank cord blood and still delay clamping?
Both are possible, with a trade-off. In a public-bank study ACOG cites, donations meeting initial screening fell from 39% to 17% with a 60-second delay. ACOG says collection should not change routine delayed clamping except for rare directed donations.
This article is for informational purposes only and does not replace professional medical advice. Talk with your OB, midwife or pediatrician about guidance specific to you and your baby.
How This Guide Was Made
The Babysential Team wrote this guide from the documents below, checked on September 22, 2026. AI-assisted drafting helped organize the page, and every number traces to a named source.
Sources
- Delayed Umbilical Cord Clamping After Birth, Committee Opinion 814, ACOG, 2020 (reaffirmed 2026)
- Guideline: Delayed Umbilical Cord Clamping, WHO, 2014
- Effect of Timing of Umbilical Cord Clamping of Term Infants, Cochrane, 2013
- Umbilical Cord Blood Banking, Committee Opinion 771, ACOG, 2019 (reaffirmed 2026)
- Intrapartum Care, NG235, NICE, 2023 (updated 2026)
- Vitamin K and the Newborn Infant, AAP, 2022
- Vitamin K Deficiency Bleeding FAQ, CDC, 2025
- Ten Steps to Successful Breastfeeding, WHO, 2018
