PIMS Short Case Study - Optimal Cord Clamping and Intact Cord Resuscitation

Optimal cord clamping

AIMS supports midwife Amanda Burleigh’s campaign for optimal cord clamping “Wait for White”. Optimal cord clamping is a key part of physiological birth, providing the neonate with a full blood volume and important in helping the transition to extra-uterine life.

See waitforwhite.com for further details.

Collecting Cord Gases with an intact cord

See www.bloodtobaby.com for further details

Bedside resuscitation with the cord intact

Bedside resuscitation with the cord intact allows ventilation to be started before cord clamping, which can help to compensate for hypoxia.

Improved outcomes include:

  • earlier stabilisation of blood pressure
  • increased blood volume
  • increased haemoglobin and iron levels
  • reduced risk of anaemia

(Rabe et al, 2019, Robledo et al, 2022).

See waitforwhite.com/intact-cord-resuscitation for further details.

For preterm neonates

For preterm neonates, immediate cord clamping can cause a loss of up to 50% of blood volume (www.waitforwhite.com). Optimal cord clamping for preterm babies reduces risks including intraventricular haemorrhage and sepsis. In fact, for preterm neonates, immediate cord clamping has been shown to increase the risk of neonatal mortality by 28% (Fogarty et al, 2018).

References

  • Fogarty, M., Osborn, D. A., Askie, L., Seidler, A. L., Hunter, K., Lui, K., ... & Tarnow-Mordi, W. (2018). Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-anaysis. American journal of obstetrics and gynecology, 218(1), 1-18.
  • Katheria, A., Lee, H. C., Knol, R., Irvine, L., & Thomas, S. (2021). A review of different resuscitation platforms during delayed cord clamping. Journal of Perinatology, 41(7), 1540-1548.
  • Rabe, H., Gyte, G. M., Díaz‐Rossello, J. L., & Duley, L. (2019). Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database of Systematic Reviews, (9).
  • Robledo, K. P., Tarnow-Mordi, W. O., Rieger, I., Suresh, P., Martin, A., Yeung, C., ... & Bowen, J. (2022).
  • Effects of delayed versus immediate umbilical cord clamping in reducing death or major disability at 2 years corrected age among very preterm infants (APTS): a multicentre, randomised clinical trial. The Lancet Child & Adolescent Health, 6(3), 150-157.
  • Tizard, H (2018) Collecting cord gases with an intact cord , accessed online www.bloodtobaby.com/post/collecting-cord-gasses-with-an-intact-cord


We hope that this page is of interest, especially to our colleagues in the maternity services improvement community.

The AIMS Campaigns Team relies on Volunteers to carry out its work. If you would like to collaborate with us, are looking for further information about our work, or would like to join our team, please email campaigns@aims.org.uk.

Please consider supporting us by becoming an AIMS member or making a donation. We are a small charity that accepts no commercial sponsorship, in order to preserve our reputation for providing impartial, evidence-based information.

JOIN AIMS

MAKE A DONATION

Buy AIMS a Coffee with Ko-Fi

AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.

Latest Content

Journal

« »

What has the AIMS Campaigns Team be…

AIMS Journal, 2026, Vol 38, No 1 By The AIMS Campaigns Team Published written outputs: 8th November: AIMS Response to the NHS 10 Year Workforce Plan Consultation 11th Nov…

Read more

Antenatal Education in Imaginary Hi…

AIMS Journal, 2026, Vol 38, No 1 An Editorial foreword: As an antenatal educator I would often invite the expectant parents to imagine that their baby had safely arrived…

Read more

Editorial: What is there to learn?…

AIMS Journal, 2026, Vol 38, No 1 By Alex Smith Welcome to the March edition of the AIMS journal. This issue explores the question of antenatal education. Antenatal educat…

Read more

Events

« »

AIMS Workshop: Focusing on Inductio…

Join us for one of our series of interactive online AIMS workshops, " Focusing on Induction of Labour ". Nadia Higson (principal author of "The AIMS Guide to Induction of…

Read more

AIMS Workshop: Wellbeing

AIMS is delighted to be hosting a Wellbeing workshop delivered by Ruth Weston , veteran birth activist, AIMS volunteer and author of 'Born Stroppy Make Change Happen'. Th…

Read more

AIMS Workshop: Focusing on Rights i…

Join us for one of our series of interactive online AIMS workshops, " Focusing on Rights in Pregnancy and Birth ". Emma Ashworth (principal author of "The AIMS Guide to Y…

Read more

Latest Campaigns

« »

Continuity of Carer - Speaking note…

London, Wednesday 4th March 2026 A key component of ensuring maternity service provision that is safe, personalised and equitable, is the provision of a robust and sustai…

Read more

Rebirth Festival, Athens, April 202…

Background: AIMS is a member of ENCA - the European Network of Childbirth Associations 1 . Each year, one of the member associations hosts a two day gathering of birth ac…

Read more

AIMS responds to Woman’s Hour Cover…

The National Maternity and Neonatal Investigation, led by Valerie Amos, published an interim report on February 26, 2026. This was covered on the BBC’s Woman’s Hour progr…

Read more