Can you do delayed cord clamping with a C-section?
Yes, in many cases. Canada's pediatric and obstetric societies note delayed cord clamping can be done during a cesarean with the baby held at the level of the incision. UK charity Tommy's says it's possible in planned and emergency C-sections. What your team can offer depends on your hospital and how you and your baby are doing, so ask ahead.
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Yes, a cesarean doesn't rule it out
Many parents assume a C-section means the cord is cut straight away. It doesn't have to. Canada's pediatric and obstetric societies note that delayed clamping can be done with the baby held at the level of the incision while the cord is still attached. Tommy's, the UK baby charity, tells parents it's possible in both planned and emergency C-sections.
What happens at your birth depends on your hospital's practice, your surgeon and how you and your baby are doing on the day. That's why the most useful step is a conversation with your team weeks before, not a request shouted across the operating room.
Why it's worth asking for
The reason to wait is the same in any birth. While the cord stays attached, blood from the placenta keeps moving into your baby, and that blood carries iron. The brain uses iron to build myelin and make its chemical messengers, and babies need their stores to last until iron-rich foods start around 6 months.
A Cochrane review of 15 trials found that babies whose cords were clamped early were more than twice as likely to be iron deficient at 3 to 6 months. A few small trials hint at small developmental gains, with no difference in IQ. The full picture is on the benefits of delayed cord clamping page.
Even a modest wait counts for something. Classic measurements cited in Canada's national guidance found the blood transfer about a quarter done at 15 seconds, about half done at 60 seconds and nearly complete by 2 to 3 minutes. So if your surgeon can give you one or two minutes, that is a real share of the blood, not a token gesture.
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Cord milking: the fallback when time is short
Sometimes the cord has to be clamped quickly. Cord milking means squeezing blood along the cord toward the baby a few times before clamping. It's one way some teams move part of that blood across when they can't wait.
- The American College of Nurse-Midwives says it may help term babies, and preterm babies over 28 weeks, when the cord must be clamped quickly.
- It is not recommended under 28 weeks, because it may raise the risk of serious bleeding in the brain.
- Canada's guidance is stricter: no milking under 32 weeks.
For preterm babies, cord timing is a decision for your team, not your birth plan. For a term baby, it's a fair question to ask your surgeon: "If you can't wait, do you milk the cord?"
Skin-to-skin in the operating room
The cord is one part of the first hour. The other is where your baby spends it. Ask whether your hospital offers skin-to-skin in the operating room once the baby is checked, with the baby on your chest above the drape.
In the Cochrane trials, skin-to-skin after a C-section still went with more breastfeeding at 1 to 4 months and better first breastfeeds. If you can't hold your baby yet, your partner can do skin-to-skin until you're ready. Partners, here's how to do skin-to-skin safely.
When the team will clamp right away
Waiting is for babies who are doing well. If your baby needs help to breathe, the team should give it fast. Some hospitals can start breathing support with the cord intact; if yours can't, they clamp and help your baby straight away. The cord may also be clamped early if there's a problem with the cord or placenta, or if the mother is bleeding heavily.
Emergency C-sections happen because something needs to move quickly. If your plan bends, that's the plan working. A changed first hour is not a failed first hour. Skin-to-skin can start as soon as you and your baby are stable, and the golden hour can become the golden afternoon.
If your baby goes to the NICU, ask when you can start kangaroo care (skin-to-skin), and do it as much as you're allowed. Until you can hold your baby, touch them and talk to them. If you plan to breastfeed, ask for help to start expressing milk early.
Your partner's job in the operating room
You'll be lying down behind a drape, so your partner becomes your voice. Their jobs are simple. Hold the plan and say it once, calmly. If someone wants to weigh or bathe the baby, ask, "Can that wait until after the first feed?" Keep the baby's face visible during skin-to-skin. And talk: your baby has heard your partner's voice for months from inside the womb. Say hello. Hum something. Take one photo, then put the phone away.
What to ask your surgeon
Take these to a third-trimester visit, and write the answers on your birth plan:
- "If I have a cesarean, how long can you delay clamping?"
- "Can you hold the baby at the level of the incision while we wait?"
- "If you need to clamp quickly, do you milk the cord for a term baby?"
- "If our baby needs help breathing, can you start it with the cord intact here?"
- "Do you offer skin-to-skin in the operating room, and can my partner do it if I can't?"
- "How do you check for jaundice before discharge?"
Policies differ between hospitals, and some answers depend on equipment. Find out before the day, discuss it with your birth team, and give your partner a copy so they can speak for you while you're on the table.
Do this
- Ask your surgeon at a third-trimester visit how long they can delay clamping in a cesarean.
- Ask whether your hospital offers skin-to-skin in the operating room, above the drape.
- Name your partner as the backup for skin-to-skin if you can't hold the baby yet.
- Write the answers on your birth plan, including what happens in an emergency C-section.
When to ask your doctor
Check with your doctor or midwife first if…
- your baby is expected before 32 weeks, since cord milking has age limits
- you are expecting twins
- you have a known placenta problem
- your baby has a known health problem found before birth
Call your doctor now if…
- you soak through one or more pads in an hour, or pass clots bigger than an egg
- you have a fever of 100.4°F (38°C) or higher, chest pain or trouble breathing
- a leg or arm is badly swollen, red or painful
- your baby looks yellow in the first 24 hours, or their color turns pale, gray or blue
This page is general information, not medical advice. Every pregnancy and every child is different. Ask your doctor, midwife or pediatrician before changing supplements, diet or care.
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In the book: Chapter 15: The First Hour
Chapter 15 covers cesarean births, cord milking and what to do when the first hour looks different, with a printable list of questions for your surgeon and a backup plan for your partner.
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People also ask
Can you do delayed cord clamping in an emergency C-section?
Sometimes. Tommy's, the UK baby charity, says delayed clamping is possible in both planned and emergency C-sections. In an emergency, though, your baby's or your own condition may mean the team clamps quickly, and that is the right call. Ask ahead what your hospital can usually offer.
How long can they delay clamping in a C-section?
It depends on your hospital, your surgeon and how you and your baby are doing. Canada's pediatric and obstetric societies note it can be done with the baby held at the level of the incision. Ask your surgeon directly, "How long can you delay clamping?", and write the answer on your plan.
Is cord milking safe?
The American College of Nurse-Midwives says cord milking may help term babies and preterm babies over 28 weeks when the cord must be clamped quickly. It is not recommended under 28 weeks because it may raise the risk of serious bleeding in the brain, and Canada's guidance says no milking under 32 weeks. Your team decides for preterm babies.
Can I do skin-to-skin after a C-section?
Often, yes. Ask whether your hospital offers skin-to-skin in the operating room, with your baby on your chest above the drape once checked. In the Cochrane trials, skin-to-skin after a C-section still went with more breastfeeding at 1 to 4 months. Your partner can do it until you're ready.