Yes, you can do delayed cord clamping during a cesarean section. Both the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization recommend delaying cord clamping for 30 to 60 seconds after birth in healthy term infants, regardless of delivery method. While it’s more commonly associated with vaginal births, delayed cord clamping is increasingly practiced during scheduled and unplanned C-sections alike.
How It Works During a C-Section
The logistics differ slightly from a vaginal birth. After the baby is delivered through the uterine incision, the surgeon or an assistant holds the baby at roughly the level of the incision site, or the baby is placed on your abdomen or legs while the cord continues to pulse. The goal is to allow blood to flow from the placenta to the baby for at least 30 to 60 seconds before the cord is cut.
There’s been some debate about whether holding the baby higher (like lifting them over the surgical drape so you can see them) reduces the amount of blood transferred compared to keeping the baby lower. A NICE evidence review looked at several studies comparing baby positioning and found only a small difference in infant hemoglobin levels at 3 to 4 months. The committee ultimately concluded there wasn’t enough evidence to recommend one specific position over another. So if your surgical team lifts the baby briefly for you to see before placing them back down, that’s a common and generally accepted practice.
Benefits for the Baby
The main advantage of delayed cord clamping is better iron status. Allowing that extra blood to flow from the placenta boosts the baby’s blood volume and red blood cell count, which translates to improved iron stores for up to six months after birth. This matters because iron is essential for brain development in the first year of life, and iron deficiency is one of the most common nutritional gaps in infancy.
For preterm babies delivered by C-section, the benefits are even more pronounced. Delayed clamping is associated with better circulation during the transition to breathing air, a higher red blood cell volume, fewer blood transfusions, and lower rates of two serious complications: bleeding in the brain (intraventricular hemorrhage) and a dangerous intestinal condition called necrotizing enterocolitis.
Is It Safe for the Mother?
One of the main concerns with delayed clamping during a C-section is that the uterus is open and actively bleeding while the surgical team waits. A randomized clinical trial of 113 women undergoing scheduled term cesarean deliveries directly tested this. While subjective estimates of blood loss suggested slightly more bleeding in the delayed clamping group, the objective measures told a different story: there was no significant difference in postoperative hemoglobin levels, need for additional medications to contract the uterus, or blood transfusion rates. The hemoglobin drop was nearly identical between groups (1.90 g/dL with delayed clamping versus 1.78 g/dL with immediate clamping).
In practical terms, waiting 30 to 60 seconds does not appear to meaningfully increase maternal blood loss during a cesarean delivery.
The Jaundice Question
Because the baby receives more blood, there’s a slightly higher chance of jaundice requiring phototherapy (the blue light treatment). For most healthy term infants, this increase is small, around 2 percentage points. However, one specific group showed a larger effect: babies with ABO blood type incompatibility with their mother. In a retrospective study, phototherapy rates in these infants rose from 22.4% to 36.8% after a hospital adopted delayed cord clamping. If your blood type is O and your baby’s father has type A or B blood, this is worth discussing with your care team.
For the vast majority of babies, the slight bump in jaundice risk is manageable and treatable. Phototherapy, when needed, typically lasts one to two days.
Keeping the Baby Warm
Operating rooms are cold, and a wet newborn loses heat quickly. This raises a reasonable concern about hypothermia during the 30 to 60 second wait. However, systematic reviews of randomized data have not found an association between delayed cord clamping and hypothermia. The Canadian Paediatric Society recommends wrapping term babies in warm towels or placing them on your abdomen during the delay. For preterm infants, medical-grade plastic bags or wraps are used to maintain body temperature. Most surgical teams have a protocol in place for this.
When Delayed Clamping May Not Be Possible
There are situations during a C-section where the cord needs to be clamped right away. If the baby isn’t breathing or needs immediate resuscitation, the surgical team will prioritize getting the baby to the warming table. Placental abruption (where the placenta separates from the uterine wall), significant maternal hemorrhage, or a compromised cord can also make delayed clamping unsafe. These are judgment calls your obstetrician makes in the moment.
Cord Milking as an Alternative
When delayed clamping isn’t feasible, cord milking offers a faster way to transfer placental blood. The technique involves gently squeezing blood along the cord toward the baby several times before cutting, and it takes only 10 to 15 seconds. Some research suggests cord milking may actually be more effective than a 30-second delay during cesarean deliveries specifically, because C-sections can reduce natural placental blood flow due to lower uterine tone and potential drops in maternal blood pressure.
One study comparing the two techniques during elective C-sections found that cord milking produced higher hemoglobin and hematocrit levels in newborns than 30 seconds of delayed clamping, with no significant difference in bilirubin (the compound that causes jaundice). For emergency C-sections or situations where every second at the incision site matters, cord milking gives the baby a meaningful blood transfusion in a fraction of the time.
How to Include It in Your Birth Plan
If you’re planning a cesarean delivery, bring up delayed cord clamping with your obstetrician during a prenatal visit rather than on the day of surgery. Most hospitals now accommodate the request routinely, but confirming ahead of time lets the surgical team plan for it. Ask whether they typically do delayed clamping or cord milking during C-sections, and under what circumstances they would skip it. Having that conversation early means your preferences are documented and your team knows what to expect.