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Card 7Clamp and cut the cord after cord pulsations have ceased or approximately 2-3 minutes after birth ofthe baby, whichever comes first.• Wait to clamp and cut the cord until the cord stops pulsating or 2–3 minutes after the baby’s birth, whichever comes first.NOTE: Refer to national protocols for cord cutting if the woman is infected with HIV.NOTE: Clamp and cut the cord immediately if the baby is not breathing.• Place one clamp or tie about 4 cm from the baby’s stomach.• Gently milk the cord towards the woman’s perineum and place a second clamp or tie on the cord approximately 1 cm from the firstclamp. Milking the cord towards the mother will reduce blood spurts when you cut the cord. Do NOT milk the cord towards the baby.Never milk the cord towards the baby!• Cut the cord using sterile scissors, covering the scissors with gauze to prevent blood spurts. Do NOT use the same scissors used forepisiotomy.• Tie the cord only after all steps of AMTSL are complete and initial care of the mother and baby has been provided.QUESTIONS1) Why is it important to wait until the cord stops pulsating, or 2-3 minutes after the baby’s birth, to tie and cut the cord?2) Why must you wait until after the placenta is delivered to tie and care for the cord?3) Why should you use a sterile, new scissors for cutting the cord instead of using the same scissors used on the mother?KEY MESSAGES• Delaying cord clamping can help to prevent anemia in babies and increase the duration of early breastfeeding.• If you take time to tie the cord instead of delivering the placenta, the placenta may sit in the vagina with blood behind it.• The mother may have any number of infections that are passed in the blood, including HIV and Hepatitis B. If you use the samescissors used on the mother for cutting the cord, you may introduce these infections into the baby.
Clamp and cut the cord after cord pulsations have ceased or approximately 2-3minutes after birth of the baby.•Card 7
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