When it comes to making decisions surrounding your birth, you need to think about the immediate after birth, too!
Often, we think that’s just for newborn care procedures, but today, I thought we could talk in-depth about cord blood banking, placenta donation, and placenta encapsulation.
In this article you’ll learn:
- The pros and cons of cord blood banking, and why the American Academy of Pediatrics recommends against it
- What placenta encapsulation is and the potential benefits and drawbacks
- How to go about donating your placenta, and the benefits of placenta donation for medical use
As always, this article is meant to inform you to make the right decision for your birth and family. I encourage you to take this information, do your own research, and discuss this decision with your OBGYN or midwife before giving birth.
Without further ado, let’s get into it!
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Cord blood banking
Cord blood banking is a buzzword we are hearing more and more often surrounding birth. The blood found in your baby’s umbilical cord is full of stem cells that could possibly be used to cure your baby or family member of a disease one day.
However, the vast majority of babies won’t end up ever needing their cord blood, and current technology greatly limits how useful it really is. Choosing to bank your baby’s cord blood may come at an initial cost to baby’s well-being as they adjust to life outside the womb with a significantly lower blood volume than they would have without banking blood.
Often the decision to bank your baby’s cord blood isn’t made with a complete understanding of:
- How it’s done
- How useful (or not) it really is
- What the cons are to banking the blood instead of doing delayed cord clamping
What is cord blood banking?
Cord blood is the blood found in the umbilical cord and placenta at birth. This blood is rich in hematopoietic stem cells, which can be used to treat some diseases, in transplants, or to strengthen the immune system.
The stem cells present in cord blood are unique because they are rarely rejected during transplants, they present more possibilities for matches than bone marrow, there are 10 times more stem cells present than in bone marrow, and they can be frozen for an indefinite amount of time before being used.
Cord blood banking is the act of collecting this blood from the umbilical cord directly after the cord is clamped. Your provider will insert a needle into the cord and collect any remaining blood into a bag that will be sent to a storage facility.
When it comes to storing cord blood, there are two main options:
Public cord blood banks
Public cord blood banks are free to donate to. Upon receiving the cord blood, the public bank will run tests on the blood and catalog it into a registry that doctors can access for use in patients in need.
Public cord blood banks contribute to furthering research on the potential benefits of cord blood and their use can provide life-saving cells to people in need across the country.
To donate to a public cord blood bank:
- Your blood will need to be prescreened to ensure it is free of genetic disorders and infectious disease
- You need to give birth at a certified cord blood collection site (which many hospitals are!)
- The blood to be donated also must be at least 40 mL, which means delayed cord clamping is likely not an option because delayed clamping won’t allow enough blood to stay in the cord (though you should discuss this with your provider!)
Private family cord blood banks
The other storage option is in a private family bank. In this scenario, your baby’s cord blood will be stored for baby’s use or for direct family donation. Private storage banks charge a fee for collection and a monthly or yearly storage fee after. Private storage banks market their services as “biological insurance for your child and family”.
But I want to be transparent in telling you that this claim is rejected by the American Family of Pediatrics and the organization strongly cautions parents against their use.
Benefits to banking cord blood
Benefits of donating cord blood to a public bank:
- Your baby’s cord blood will be cataloged into a registry available to all doctors looking for stem cells to save their patients’ lives
- The stem cells in your baby’s cord blood might be used to advance medical research or in life saving clinical trials
- Donation is completely free
- Donating cord blood to a public bank is contributing to the advancement of this field of research and to the “good of science” and “greater good” if you will
- For those interested in cord blood banking, this is the method most often recommended by the AAP and ACOG
Benefits of storing cord blood privately:
- Privately stored cord blood is stored just for your baby and your family’s use
- The cord blood may be used to treat a sick family member or in the event of a family member needing a stem cell transplant
- If you have a sick family member that needs, or may one day need a stem cell transplant, you may be making a lifesaving choice by storing cord blood privately
- There is an ever-changing and evolving understanding of how stem cells and cord blood can be used, in the future it may benefit your baby in a way not currently known
- Private cord blood storage is only recommended by ACOG and the AAP if you have a family member with a known disease that will benefit. Otherwise, it is not recommended. The idea of “biological insurance” is rejected and seen as a marketing tactic
Drawbacks to cord blood banking
- You can’t do delayed cord clamping: As I mentioned earlier, you often cannot do delayed cord clamping if you are donating to a public bank because not enough blood can be collected. If you’re donating to a private bank you can do DCC but the amount of blood collected in that case will be limited in its potential benefits especially considering the storage cost
- Private cord blood storage is costly: This varies from facility to facility, but fees average around $2000 for initial processing and have an annual fee between $100-$300
- Private cord blood storage is not recommended by the AAP unless medically necessary: For a variety of reasons, the American Academy of Pediatrics does not routinely recommend private cord blood storage (read more here). The same claims are supported by ACOG (read here)
- Cord blood can currently be stored for 20 years: For this reason, it really makes sense to contribute to a public bank. Blood stored in a private bank will only give your child that “biological insurance” for 20 years
- Most privately banked cord blood is never used: According to the Cord Blood Association, the chances of your baby ever needing their own cord blood is very low and WebMD cites a study that says the likelihood is between 1 in 400 and 1 in 200,000. One reason for this is that in the event of blood cancer, like leukemia, a baby’s own cord blood cells cannot be used to fight the disease. The likelihood of a family member using your child’s stored cord blood is also very low. This is because the amount of stem cells in a single cord blood collection is not enough to support a transplant in most adult patients
When is private cord blood banking recommended?
Two scenarios most often discussed as warranting private cord blood storage and eventual use of the cord blood are:
- You have another child in your family who has a blood cancer (like leukemia) or another inherited blood disease
- When a mother is at risk of conceiving a child with certain genetic disorders like sickle cell disease, which could be treated with cord blood
(source)
What is delayed cord clamping
A few times above I mentioned delayed cord clamping, but I realize that some of you may not know what that is or why it’s so beneficial.
With delayed cord clamping, instead of clamping and cutting the cord right away, you can choose to wait for the cord to be clamped and cut. Standard practice is to wait 60 seconds before clamping the cord.
Most hospitals do this for every baby that is born (unless baby needs immediate medical attention, in which case we would clamp and cut the cord immediately). Some people choose to wait even longer before the cord is cut.
Benefits of delayed cord clamping
Allowing this extra time before clamping the cord can increase the blood volume in your baby by up to one-third!
This extra blood volume provides your baby with:
- Iron reserves for their first 6-8 months of life
- Improved developmental outcomes in the future
- Increased hemoglobin and hematocrit levels at birth
- Increased brain myelination.
What’s more, in preterm babies the benefits of delayed cord clamping are even greater!
Additional benefits for preemies include:
- Improved transitional circulation
- Better establishment of red blood cell volume
- Decreased need for blood transfusion
- Lowered incidence of necrotizing enterocolitis and intraventricular hemorrhage
ACOG notes that there is a small increase in the incidence of jaundice in term babies who delay cord clamping.
There’s a lot to consider here
As you can see, there is a lot to consider when it comes to cord blood banking! I personally chose to do delayed cord clamping and not donate my children’s cord blood – but I recognize that every family’s situation is unique.
Again, I encourage you to discuss this more in-depth with your provider to help you make a decision!
Placenta Donation and Encapsulation
Okay, so moving along from the cord…let’s talk about what you’ll do with your placenta! Standard protocol after you deliver your placenta is disposal by the hospital.
However, there are actually some options here:
- You can choose to take your placenta and have it professionally encapsulated for consumption
- Donate your placenta for research
- Bring your placenta home for raw consumption (not recommended)
- Take your placenta home to plant it, have it made into jewelry, or create art with it
In this article, I am going to talk a bit more about placenta encapsulation and placenta donation.
Placenta Encapsulation
For centuries and across many different cultures, women have been consuming their placenta to benefit themselves postpartum. However, in today’s day and age, it is very controversial because it doesn’t come without risk.
It’s important to note that 70-80% of moms who choose to consume their placentas choose encapsulation. However, it can also be eaten raw (not recommended!), cooked, dehydrated, or roasted.
Placenta encapsulation involves steaming the placenta, drying it out, and then grinding it up into a powder and placing it in capsules. Typically, this is done by a professional service.
Potential benefits of consuming your placenta
- Increase in milk production
- Restoration of blood iron levels
- Increased release of oxytocin, which can help the uterus return to normal size and encourages bonding with baby
- A decrease in postpartum depression
- Increase in CRH (corticotropin-releasing hormone), a stress-reducing hormone
Potential risks of placenta encapsulation
- Improperly encapsulated placentas can harbor bacteria that can make you sick – and baby if you are breastfeeding
- Exposure to environmental toxins, like heavy metals, that accumulate in the placenta during pregnancy (this is because the placenta acts as a filter for baby while they’re in the uterus)
- Lower milk supply – the placenta contains progesterone, which inhibits the production of prolactin
- Increases risk of developing blood clots – the placenta contains estrogen, which increases the levels of clotting factors in the blood
- Can cause jitteriness/dizziness
I want to note that the pros and cons listed out here are largely based on anecdotal evidence! But there have been few studies done on the risks/benefits of placenta encapsulation.
One randomized, double-blind, placebo-controlled study found that taking placenta capsules had no impact on a woman’s iron levels, and there has been no scientific evidence to show that it helped prevent or treat postpartum depression
If you do choose to have your placenta encapsulated
Please make sure the placenta is handled safely. It should be packed in ice right after delivery, be stored correctly, and cooked thoroughly before consuming.
There are no laws governing the practice of placenta encapsulation, so it’s important to do adequate research and choose a company that will handle the placenta safely.
Donating your placenta and/or umbilical cord
In my experience, placenta donation (aka birth tissue donation) is talked about a bit less than some of the other topics in this article. It is the act of donating your placenta and/or umbilical cord for research or medical use.
Placenta donation is something that you’ll be asked about once admitted to the hospital. You will need to:
- Give consent
- Complete a medical history form
- Have your blood screened for any diseases that could be passed to a receiving patient through your birth tissue
As I mentioned above, routinely, your placenta is discarded after birth (unless you opt to take it home with you for another use), and placenta donation doesn’t impact your birth in any way.
It isn’t taken until after baby has been delivered safely and doesn’t affect your ability to opt into delayed cord clamping or cord blood banking.
What are the benefits of donating your placenta?
In short, donating your placenta truly doesn’t affect you or baby at all! The tissue from your placenta and cord, referred to as birth tissue, is currently used to:
- Heal traumatic wounds
- Aid in skin grafting for severe burn victims
- Assist in the treatment of diabetic ulcers
Doctors and researchers are finding more and more benefits and uses for birth tissue too. This includes helping patients with eye injuries and diseases, spinal and dental procedures, and sports injuries as well.
You can learn more about the process, benefits, and how to sign up at Birth Tissue Recovery, and/or ask your provider for information at your next prenatal visit.
What are your thoughts on cord blood banking, and your placenta after birth?
Now that you understand the potential pros and cons of the options discussed in this article, you can make more informed choices on your birth plan and discuss these decisions with your provider!
Keep getting educated by checking out these articles:
- A Complete Guide to the Placenta and Umbilical Cord
- How to Make a Birth Plan: An L&D Nurse’s Guide
- Stillbirth Prevention: Actionable Things You Can do To Reduce the Risk of Stillbirth
