Integrated review of the knowledge, attitudes, and practices of maternity health care professionals concerning umbilical cord clamping

Birth. 2022 Dec;49(4):595-615. doi: 10.1111/birt.12647. Epub 2022 May 18.


Background: Umbilical cord clamp timing has implications for newborn health, which include increased iron stores up to 6 months of age. National and International cord clamping guidelines differ as do health professionals' practices. The rationale for differences in cord clamping practice is unclear.

Aims and objective: Studies on the knowledge, attitudes, and practices of maternity health care professionals about cord clamp timing were synthesized. Similarities and differences between professional groups and understanding of the optimal timing of cord clamp timing for term newborns were compared.

Methods: An integrative review was undertaken. PubMed, Scopus, MIDIRS, CINAHL, and Google Scholar were searched. Publication date limits were set between January 2007 and December 2020. Quality appraisal was undertaken using the Critical Appraisal Skills Program (CASP) tools.

Results: Eighteen studies met inclusion criteria, as they included primary research studies that investigated maternity health care professionals' knowledge, attitudes, and practices about umbilical cord clamping, and were written in English. Four main subject areas were identified: a) knowledge of optimal cord clamp timing; b) attitudes and perceptions of early vs deferred cord clamping; c) cord clamping practice; and d) rationale for cord clamping practice.

Conclusions: Different attitudes and practices were identified between midwifery and medical professionals in relation to cord clamp timing together with health professional knowledge and practice gaps pertaining to optimal cord clamp timing. Contemporary evidence should inform guidelines for clinical practice and be embedded into maternity health professional curricula and professional development programs.

Keywords: cord clamping; integrative review; midwives; obstetricians; placental transfusion.

Publication types

  • Review

MeSH terms

  • Constriction
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Time Factors
  • Umbilical Cord Clamping*
  • Umbilical Cord*