ABSTRACT
This chapter provides the history of optimal cord clamping and focuses on the midwife’s role and the decision-making within this practice. All midwives must understand of the physiology of transition of all aspects of third stage of labour and the short- and long-term impacts for both the mother and baby of prematurely interrupting placental blood flow. Natural physiology allows a baby to receive a placental transfusion of approximately 30% of their blood volume following birth. In relation to optimal cord clamping, the dilemma for all midwives is how one upholds her professional accountability while following institutional protocols and guidelines, which may not reflect the latest evidence. Midwifery decision-making around active and physiological third stage management of labour and the timing of administration of an oxytocic drug has been a contentious issue for many years. Historically blood gases were taken in order to assess the condition of the baby after a complicated birth or when the baby was born compromised.
