Decisions, mind-bending decisons

The ABCs of Biotech for Christians - Twenty-second in a series - U is for Umbilical Cord Blood

In this biotech age many healthcare decisions must be made simply because knowledge has increased. (Dan 12:4) And though the professional guide whom you trust can fully explain your condition or that of your loved one and the available therapies, the heavy burden of decision-making is on you.

For example, the obstetrician who describes and refers for tests that a pregnant woman can take to determine whether her pre-born baby has Down Syndrome (DS), cannot advise the parents to select to abort the baby if anomalies are discovered— at least not in the USA. (In some other nations, DS children are weeded out before birth. Nearly 100% of unborn DS babies are aborted in Iceland, and Denmark is a close second with 96%.)

For most Christians this would not be an impossible decision. God would give grace to choose life and to love and enjoy the special child.

But what about choosing whether to reserve umbilical cord blood at the birth of a child? And, why would this be a hard decision? Cord blood has no embryonic stem cells.

The purpose of saving cord blood is to freeze it for future use:

“Cord blood is a rich source of blood stem cells. Stem cells are the building blocks of the blood and immune system. They have the ability to develop into other types of cells, so they can help repair tissues, organs, and blood vessels and can be used to treat a host of diseases. … Unlike the stem cells in bone marrow or peripheral blood, stem cells in cord blood are immature and haven't yet learned how to attack foreign substances. It's easier to match transplant patients with cord blood than with other sources of stem cells because the cord blood stem cells are less likely to reject the transfusion… Cord blood stem cells have been used successfully to treat more than 80 different diseases, including some cancers, blood disorders, and immune deficiencies. Among these are leukemia, aplastic anemia, Hodgkin's disease, and non-Hodgkin's lymphoma.
Cord blood transplants are also accepted as treatment for thalassemia and sickle cell anemia … and to treat rare metabolic disorders that would otherwise be fatal for infants, such as Krabbe disease and Sanfilippo syndrome … Children in clinical trials are being treated with their own cord blood for cerebral palsy …and for autism…” (ref)

The procedure is not hard. After clamping and cutting the cord, a needle is inserted into the umbilical vein on the part of the cord that is still attached to the placenta, and the blood drains into a collection bag in less than 10 minutes. The blood is then shipped to a cord blood bank where it is tested, processed and cryopreserved for long-term storage if it meets quality standards. (ibid) It can be reserved as a family resource or for the public good. Learn more about cord blood here.

Why would any Christian not do this, if not for personal use, for public donation? A simple answer is that not all hospitals or midwives offer this option. Cord blood collection services are only available in certain places. Realize, too, that an altruistic gift of cord blood will trade internationally for between $23,000 and $31,000/unit. 1

But if it is an option, a parent could still have concern whether it would be the best and right thing for the health of their baby.

The American College of Obstetrics and Gynecology (ACOG) recommends a delay of 30 to 60 seconds between delivery and cord clamping for healthy, full-term babies. It's believed that delayed clamping may be beneficial for newborns. Delayed clamping may affect the volume and quality of cells collected for donating or storing cord blood, however. (ibid, The Baby Center)

More thoroughly—

“Although clamping within a minute or less of delivery has become widely accepted as part of active management of the final stage of labor, there’s increasing concern among obstetricians that it deprives the baby of up to 60 percent of red blood cells and 30 percent of blood volume. For a full-term infant, allowing full placental flow gives the baby an additional 80 to 100 milliliters of blood. A series of clinical trials found that delayed clamping could reduce the risk of anemia, chronic lung disease, brain hemorrhage, sepsis, and eye disease in later life. While early clamping slams the brakes on hard and fast, ‘leaving the umbilical cord unclamped allows a period of transition between the fetal and adult circulations… thereby easing the newborn into extrauterine life.’” 2

But, to reiterate, if clamped too late, not enough stem cells are residual in the cord blood to make it valuable.

Thus, we see the dilemma that a parent must confront, desiring to do the right thing and to trust the professionals, yet having enough knowledge to doubt whether it is advisable, and not being sure.

As with all deep needs for wisdom, we pray for discernment and, if at all possible, to avoid last-minute decisions that may later haunt ones conscience and emotions. Expectant parents need our prayers.

It will help to memorize James 1:5 for those who need help with decision making.

1. Donna Dickenson, ME Medicine vs. WE Medicine, (Columbia University Press, 2013), 101.
2. Ibid, 99.

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Flesh and Bone and The Protestant Conscience is an e-book on Amazon.com. It is 99¢ and in the Amazon lending library as well. The book description follows.

Would you let your conscience be your guide?

Does God care if the skin and bone of the dead are passed along to the living for medical uses? Is organ donation OK with God? Should you sign a Living Will?

Did you know that dead organ donors are often anesthetized before their organs are removed? Do you know the current definition of death? The conscience cannot function without facts.

As we ponder the ethics of in vitro fertilization, stem cell research and man-made chimeras, our thoughts trail off. How then should we live? (Ez 33:10)

How should a Christian think about euthanasia by starvation when doctors and the state attorney general all agree it is time to withhold feeding from a brain injured patient? Some things are family matters, but someday it may be our family.

Here is a small book to help you think about whether you want to sign your driver's license, donate a kidney, cremate your loved one, and many other practical questions that may arise in the course of your healthcare decisions or watch over others.

It offers a special focus on the doctrine of the Resurrection that is related to such decisions. Sunday School classes and Bible Study groups could use this book to facilitate discussion about the issues covered.