Ah, the joys of pregnancy. Along with coping with a changing body, wild mood swings, and all types of morning sickness, there are a host of logistical decisions to make regarding the delivery of your child. Natural birth at home or epidural in the hospital? Breastfeeding or formula? Should you store your baby’s cord blood in a private or public bank? Or is collecting umbilical cord blood something you need to consider?
There has been a lot of promising talk about umbilical cord blood and the stem cells found in the cord and placenta. Cord blood banking has come a long way since the first successful cord blood transplant in 1988. It wasn’t until around 2005 that the procedure moved from experimental territory into public practice. In 2005, approximately 6,000 cord blood stem cell transplants were performed worldwide. In 2018, this number increased by more than 30,000 cord blood transplants.
Proponents of cord blood banking tout it as a potential miracle cure, which can be used in medical treatments if your child or an immediate family member needs it. But what exactly is cord blood banking and what are its benefits? Let’s break it down.
What is cord blood collection and storage?
Cord blood banking is the collection and storage of blood that remains in the placenta and in the attached umbilical cord after birth. Blood is drawn after the umbilical cord has been clamped and cut, a simple and painless procedure compared to the whole aspect of delivering a child.
Blood is collected because it contains different types of stem and progenitor cells, namely hematopoietic stem cells. So what makes this type of stem cell so special? Most cells can only make copies of themselves. Hematopoietic cells, on the other hand, can transform into different types of blood cells in the body, and it’s this versatility that makes them such a promising component in treatments for everything from autoimmune diseases to certain forms of cancer, including leukemia and lymphoma.
Stem cells from an umbilical cord have also been used in an experimental treatment for HIV that not only treats the virus, it apparently cures the patient of HIV. The experimental procedure using umbilical cord blood successfully eradicated the virus in three people, the most recent being a mixed-race woman known as the ‘New York patient’, who has not experienced any resurgence of the virus since her transplant 14 months ago. .
“Umbilical stem cells are attractive,” said Dr. Steven Deeks, an AIDS expert at the University of California. The New York Times after the exciting news broke. “There is something magical about these cells and something magical perhaps about cord blood in general that provides an added benefit.”
It’s not just the fact that umbilical cord blood stem cells could be a cure for HIV that makes them so magical. Umbilical cord blood stem cells are much less likely to carry infectious diseases than adult stem cells. Cord blood cells are also much less likely to be rejected by transplant recipients than adult stem cells.
The process of extracting umbilical cord blood is much less invasive than that of adult bone marrow, making it both more readily available and safer to extract. With all of these speculative benefits and treatments for diseases previously thought to be incurable, it’s easy to see why researchers are extremely excited about the future of umbilical cord blood treatments.
Given all the potential uses for umbilical cord blood, why is its collection and storage so controversial?
Umbilical cord blood has captured the interest of the medical community not only because of its potential to cure everything under the sun – at least 80 conditions, according to cord blood bank Viacord – but because it is often more safer and easier to collect than bone marrow.
Yet the practice of cord blood banking has been criticized, and this is often due to a misunderstanding of the process. Some critics might automatically associate cord blood banking with the collection of embryonic stem cells, an extraction that destroys the human embryo in the process. These embryos are made in labs, often in fertility clinics, but the American penchant for controlling women’s bodies has critics calling the practice murderous.
There are valid criticisms of cord blood banks, but they are more related to the privatization of cord blood storage. More on that later.
What is the cost of a cord blood bank? Is there a difference between public and private cord blood banks?
Anyone who deals with the American healthcare system knows how expensive getting intensive care or medication can be. The cost of the cord blood bank varies, mainly depending on whether or not you choose to store the cord blood in a public or private cord blood bank.
Public cord blood banks collect and store cord blood, and depending on the hospital, the collection portion may be free or may cost a small fee. Public cord blood banks store your donation for free, but the donation is not registered for you – anyone can use it if deemed medically necessary.
A private bank applies a price tag for collecting and storing umbilical cord blood while keeping your donation stored just for you. Most private cord blood banking websites do not list prices, but have “helpful” calculators to work out the approximate price of your cost. People who opt for private banks can save parting with $1,000 to $2,500 as a start-up fee and then an additional $100 to $200 per year for storage fees.
Most doctors and experts agree that public cord blood banks are preferable. Not everyone in need of a lifesaving stem cell transplant can afford to collect and preemptively store cord blood in a private bank, which can cost up to four figures after a few years of storage. Storing your baby’s cord blood in a public bank gives it to anyone waiting for a matching stem cell transplant.
Storing umbilical cord blood in a private blood bank is not worth it for many families, at least statistically speaking. The likelihood that you will need your baby’s umbilical cord blood to treat an illness later in life is about the same as the likelihood that your baby or someone in your immediate family has an illness that can be treated with umbilical cord blood.
That is, unless your family has a history of an illness or disease that can be treated with cord blood, the chances of your child needing a stem cell transplant before the age of 20 are 3 in 5,000, or 0.06%. So unless your family has this type of medical history, it’s probably not worth shelling out the exorbitant amount of money to store cord blood privately.
The American Academy of Pediatrics and the American Medical Association agree. “The private storage of cord blood as biological insurance is ‘unwise’ – families may be vulnerable to emotional marketing at the time of childbirth,” the organization concluded.
This is where criticism of cord blood banking, especially from a private bank, comes in. We all know how insidiously effective targeted advertising can be. The United States is the largest pharmaceutical market in the world, accounting for nearly half of global revenue. In 2019, healthcare and pharmaceutical companies spent $1 billion on Facebook mobile advertising alone, according to markup, a nonprofit newsroom that studies how technology is used by powerful institutions.
So if you feel like you’re being bombarded with advertisements for cord blood banks, don’t assume it’s a sign from the universe to save your baby’s blood. Take a moment, discuss the decision with your doctor and family, and move forward accordingly.
Does the insurance cover the cord blood bank?
If deemed medically necessary, insurance may cover part of the procedure. It is best to check with your individual insurance provider, as different insurers have different stipulations. For example, some might only cover procedures that include cord blood collection, such as allogeneic stem cell transplants, but do not cover cord blood banking. Others might cover cord blood banking for leukemia and blood disorders, but not autoimmune diseases.
Certain insurance programs can help pay for cord blood banking, including Flexible Spending Accounts (FSA), Health Spending Accounts (HSA), and Health Reimbursement Arrangements (HRA). Nevertheless, always check with your individual insurance provider.
There are also instances where cord blood banking is tax deductible as a qualified medical expense. A New Jersey Senate bill has just introduced potential legislation that would “extend the medical expense deduction from gross income tax to certain cord blood banking services.”