In the vast majority of births, hospitals dispose of the umbilical cord and placenta as regulated medical waste. About 96 percent of cord blood from the nearly four million annual U.S. births is discarded, according to data from the Save the Cord Foundation. But parents do have other options: donating cord blood to a public bank, paying to store it privately, or contributing it to medical research. What happens depends on whether the family made arrangements before delivery.
What Happens Right After Birth
Before anything else happens with the cord itself, the medical team focuses on clamping and cutting it. The American College of Obstetricians and Gynecologists recommends waiting at least 30 to 60 seconds after birth before clamping, a practice called delayed cord clamping. This pause allows extra blood to flow from the placenta to the baby, which benefits both full-term and preterm infants. Once the cord is clamped and cut (sometimes by a support person, if the parents choose), the hospital staff decides what to do with it based on the birth plan.
The Default: Medical Waste Disposal
If no special arrangements have been made, the cord and placenta are treated as regulated medical waste. Hospitals follow state-specific regulations that dictate how this tissue is handled, but the general process involves placing it in designated biohazard containers for treatment and disposal. Treatment methods typically include steam sterilization (autoclaving) or incineration. Hospitals with on-site incinerators can burn pathologic and anatomic waste directly, provided the equipment meets EPA emissions standards. For the overwhelming majority of families, this is what happens: the cord goes into a red biohazard bag and is processed alongside other surgical tissue.
Donating to a Public Cord Blood Bank
Public cord blood donation is free and works similarly to donating blood. The cord blood is collected, stored in a registry, and made available to any patient who needs a stem cell transplant. These stem cells can treat blood cancers, immune disorders, and other serious conditions affecting the blood-forming system.
The collection itself is straightforward and painless. After the cord is clamped, a nurse or technician drains blood from the umbilical cord and placenta into a sterile bag. A typical collection yields between one-third and just over one-half cup of blood (roughly 90 to 150 cc). The unit is assigned a tracking number and stored temporarily at the hospital. The day after delivery, the mother provides a blood sample for infectious disease testing. The cord blood unit is then shipped to the public bank for processing, testing, and long-term cryopreservation.
The catch is availability. Not all hospitals participate in public cord blood collection programs, so you need to confirm beforehand that your delivery hospital works with a public bank. If you’re planning to donate, let your nurse know when you arrive at the hospital. HRSA (the federal agency that oversees the national cord blood program) maintains a list of participating collection sites.
Private Cord Blood Banking
Private banking stores cord blood exclusively for your family’s potential future use. Unlike public donation, private banking costs money. Initial collection and processing fees start around $845 to $1,195 for cord blood alone, with annual storage fees of $199. If you also bank the cord tissue (the physical tissue of the cord, not just the blood inside it), first-year costs run between $1,595 and $1,945, with annual storage fees of $398 for both blood and tissue.
The collection process at the hospital is essentially the same as public donation. The difference is that you arrange everything with a private company beforehand, and they send a collection kit to bring to the hospital. The collected unit is then shipped to the private bank’s facility rather than a public registry.
Private banking is sometimes marketed as “biological insurance,” but it’s worth knowing that the odds of a family actually using their stored cord blood are very low. Most major medical organizations note that the likelihood of needing your own stored cord blood is small, and for many conditions, a patient’s own cells aren’t suitable for treatment anyway because they may carry the same genetic defect causing the disease.
Cord Blood vs. Cord Tissue: What’s the Difference
Cord blood and cord tissue contain different types of stem cells, which is why some banks offer to store both. The blood inside the umbilical cord is rich in blood-forming stem cells, the same type found in bone marrow. These are already used clinically to treat dozens of blood and immune disorders.
The cord tissue itself, the jelly-like substance surrounding the blood vessels, contains a different kind of stem cell with the ability to repair tissues and modulate the immune system. These cells are being studied in clinical trials for conditions like graft-versus-host disease (a serious complication after transplants). In one early trial, patients with steroid-resistant graft-versus-host disease who received cord-derived cells had a 70 percent overall response rate, with 90 percent surviving to 100 days. While promising, cord tissue applications are still largely investigational, and the FDA regulates their clinical use under strict research protocols.
Use in Medical Research
Some hospitals and research institutions collect umbilical cords (with parental consent) for scientific study. Cord-derived stem cells are being explored across a wide range of experimental therapies: immune cell treatments, tissue regeneration, drug delivery systems, and even 3D bioprinting of tissues. Because umbilical cord cells are young and adaptable, they’re considered especially useful for research compared to adult stem cells.
Research donation is typically arranged through specific programs at academic medical centers. If your hospital participates, you may be asked during pregnancy or at admission whether you’d like to contribute. There’s no cost to the family, and the donation doesn’t affect delivery or newborn care in any way.
How to Make Your Choice Before Delivery
The key detail for all of these options is timing. Cord blood collection has to happen in the minutes after birth, so any choice other than disposal needs to be arranged well before your due date. If you’re considering donation or banking, here’s what to plan for:
- Public donation: Confirm your hospital participates in a public cord blood program. Tell your nurse on arrival.
- Private banking: Choose a company, pay enrollment fees, and have the collection kit at the hospital before labor begins.
- Research donation: Ask your OB or the hospital’s research department whether a cord tissue research program is available.
The ACOG sample birth plan includes a checkbox for umbilical cord blood storage arrangements, so this is a routine part of pre-delivery planning. If you do nothing, the cord will be disposed of as medical waste, which is safe, standard, and what happens in the vast majority of births.