Umbilical cord stem cells have gotten so much hype as being a life-saving panacea for everything from cancer to blood diseases that you almost feel guilty if you don’t at least research how to bank it and how much it will cost.
There are two main types of cord blood banks: private banks (aka family banks) and public banks. A private bank means you’ve put the cord blood aside for your own family’s use, in the rare case one of you needs it in the future. Not to dissuade you, but the odds of this are pretty low— about 1 in 2,700 according to The American Congress of Obstetricians and Gynecologists.
The other option is a public bank. If you go this route, you won’t get your baby’s own cord blood back if it’s ever needed. Instead, your donation may help a patient needing a stem-cell transplant or be used for medical research. However, some public banks commit to helping donating families find a matching cord blood donation in the case it ever becomes necessary.
How much does it cost?
Costs for privately banking baby’s blood can be $1,500 to $2,000 during baby’s first year, with annual storage fees of around $100 or more, while publicly banking baby’s cord blood is free.
If you’re deciding between the two types of banking, cost can be a big factor. “Some look at private banking like an insurance policy,” says Anthony Gregg, MD, director of maternal-fetal medicine at University of Florida Department of Obstetrics and Gynecology in Gainesville, Florida, and chair of The American College of Obstetricians and Gynecologists Committee on Genetics. “This is an insurance policy you might never need. But if you can afford it, it’s nice to know it’s there.”
What else should I consider?
_Race. _If you’re a minority or your baby-to-be will be of mixed race, know there’s a shortage of bone marrow donations that are a match for minorities. Cord blood can be used as a substitute for bone marrow in many transplants.
_Genetic history. _If a genetic disease runs in your family, baby’s own blood can’t be used to treat it. It would have to be donor cord blood.
Helping others. “Some people like donating to a public bank because they like that they could be helping someone,” Gregg says. Just know that you need to be eligible — factors such as having had a tattoo or body piercing in the past year or having a history of some blood diseases or STDs could rule out donating.
Location. While private banks will collect umbilical cord blood from almost anywhere, public banks can’t accept donations in all locations. (Be The Match lists participating hospitals on its website.)
When do I need to decide?
Some banks require you to enroll and set up a payment plan at least six weeks before your due date, so get started as soon as you can. “I tell patients to look on websites of the different banks and make their own determination on which bank to go with,” Gregg says.
If you’re going private, look for a reputable company that you’re confident can safely transport and store your sample for years to come. In the end, it’s a personal decision. “There’s no data to say that one company gets a better sample or does a better job than the others,” Gregg says.
If you want to donate to a public bank, ask your OB which bank your hospital routinely works with to collect cord blood.
How do I inform my OB?
As your due date gets closer, tell your doctor about your banking plans, the way you’re communicating all your other birth plans. Ask your OB about her experience with collecting cord blood, suggests Mitchell S. Cairo, MD, chief of pediatric hematology, oncology and stem cell transplantation at Maria Fareri Children’s Hospital at Westchester Medical Center in Valhalla, New York, and spokesperson for the American Academy of Pediatrics. It’s important that she gets a large enough sample to be useful down the line.
“In some cases, you can’t get enough blood to easily flow to be considered an adequate specimen, and it’s not the doctor’s fault, or the mom’s fault, or the baby’s fault,” says Gregg. “Very rarely, there’s clotting in the bag that makes the blood unusable.” But at least 90 percent of the time, he says, things go according to plan.
Your bank will send you a kit to make it easy to correctly label containers and get them to the bank. Bring the kit with you when you head to the hospital and hand it over to your nurse or doctor when you get to the delivery room.
What is the procedure like?
After birth, baby’s umbilical cord will be clamped. The doctor will then clean it and insert a needle attached to a collection bag into the cord. (Nope, it doesn’t hurt.) She’ll lower the collection bag so the blood will flow into it using the force of gravity.
How does it get to the bank?
Once it’s ready, you or your partner may need to call a shipping service to let them know it’s ready for pickup, or a hospital rep may do that for you.
The blood will be stored in a cryogenic freezer at the bank. If you privately bank, you’ll be billed yearly for storing your sample and it’s up to you how long you want to keep it. Gregg notes that the sample pulled from an umbilical cord might not be large enough to treat an adult. “Some companies will tell you that they can expand the number of stem cells using the sample,” he adds. Plus, who knows what future technologies will hold — in 18 years, there may be even more ways to use the cord blood.
What if I need to, um, make a withdrawal?
If one day someone in your family needs stem-cell therapy, and their doctor decides that the cord blood deposit you’ve made can be used for it, you’ll give the doctor contact info for the company. Together, the bank and the physician will work out the details of getting the cord blood where it needs to go for the necessary medical treatment.
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