Nurse-Midwifery M.S.

Year Approved


First Advisor

Missal, Bernita


Background: Currently in the United States, after a baby is born, the umbilical cord is immediately clamped; this is a routine obstetric procedure despite lack of evidence supporting this practice (Elchenbaum-Pikser, 2009). The practice of cord clamping varies with each provider from immediate cord clamping, to delayed cord clamping (which can vary from 1 to 5 minutes) to cord clamping after pulsation of the cord ceases. The procedure of cord clamping is a practice choice made by each medical provider and is based largely on personal preference, not evidence. Purpose: The purpose of this review and synthesis of literature is to examine studies focused on the impact of delayed cord clamping versus immediate cord clamping, both with full-term and preterm infants: Does delayed cord clamping impact transitional outcomes of the newborn? Results: While utilizing Imogene King’s Theory on Goal Attainment, twenty articles were found for appraisal and review using the John Hopkins Research Evidence Appraisal Tool. The key findings of the appraised research include the following: benefits of delayed cord clamping, effects of delayed cord clamping on third stage of labor, and practice differences. Conclusion: Delayed cord clamping requires only a small change in practice and is free while offering significant benefits to the newborn and maternal outcomes. Nurse-Midwives have the capability to change immediate cord clamping practice by educating other providers, staff, and parents. Implications for Research and Practice: Implications for research include more studies on preterm babies and keeping the cord intact during resuscitation, delayed cord clamping with Cesarean deliveries, as well as delayed cord clamping with high-risk pregnancy and/or high-risk infants. Even though there is more research that needs to be conducted on delayed cord clamping, current practice needs to be changed. The conclusions of this review support delayed cord clamping by all providers. Nurse-Midwives have the power to promote change in provider practices by providing education on the advantages of delayed cord clamping. Nurse-Midwives can provide evidence-based research to recommend and implement change in personal preferences on delayed cord clamping by implementing protocols to unite all providers’ practices.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis