**23. Cord-blood collection and new born care**

Umbilical cord blood is a rich source of haemopoietic stem cells that is used in the treatment of diseases such as leukemia. It can therefore be collected, pooled and stored in core blood bank to be dispensed when required, usually on commercial bases. Maternal consent to the collection of umbilical cord-blood is ethically required. Early clamping of the umbilical cord has been shown to be capable of reducing the new born circulating blood volume by 30% and tripping the newborn into circulatory disturbance. Enlisting maternal consent to cord blood collection should therefore be preceded by the assurance of the mother that the umbilical cord will not be clamped early, to prevent hazard to her new born.

Resuscitation and care of the new born requires that the physician considers the welfare of the individual new born within the context of the ethical principle of respect for persons albeit incapable of autonomy, who should therefore be protected. The parents who constitutes the rightful surrogate of the child should be adequately informed as to the diagnosis and prognosis of the child's condition, for example, the severely preterm infant to enable them make appropriate decision and consent to the treatment of the child.

Gender, religious, ethnic and financial considerations should not influence decisions on the treatment of the new born. The physicians counseling and advice to the parents on treatment decision for the newborn should be based on accurate knowledge of the facts and statistics on the prognosis following the treatment of the condition, and in most circumstances, after due consultations with other members of the health team including a senior obstetrician and gynaecologist. Where there is disagreement between the physician and the parents independent adjudication may be sought for and where necessary, the view of the health facility's ethical committee. Following the death of the infant, permission should be sought from the parents for the conduct of a post mortem examination on the deceased new born, to confirm the definitive cause of death and provide more information for further counseling of the parents particularly for future births.
