Which condition must the infant be in before you cut the umbilical cord?

• A. The infant must be crying loudly.
• B. The placenta must be delivered.
• C. The infant must be breathing on his own.
• D. The mother must be stable.

Answer: (C)

The important idea is the newborn’s transition from placental to lung-based oxygenation. While in utero, the baby receives oxygen through the placenta via the umbilical cord. If you cut the cord before the baby is breathing on his own, the infant loses that placental oxygen supply before the lungs are taking over, increasing the risk of hypoxia. Therefore, you wait for the infant to establish spontaneous breathing (or have adequate respiratory effort) before clamping and cutting the cord. If the baby isn’t breathing yet, focus on providing ventilation and stimulation and reassess, rather than cutting the cord.