Ah, the joys of pregnancy. Along with dealing with a changing body, wild mood swings, and all types of morning sickness, there are a slew of logistical decisions to make about the delivery of your child. Natural water birth at home or the epidural at the hospital? Breastfeeding or formula? Should you bank your baby’s cord blood in a private or public bank? Or is collecting umbilical cord blood even something you need to consider?
There’s been a lot of promising talk about umbilical cord blood and the stem cells found in the cord and the placenta. Cord blood banking has come a long way since the first successful cord blood transplant back in 1988. It wasn’t until around 2005 that the procedure moved from experimental territory into public practice. In 2005, roughly 6,000 cord blood stem cell transplants were performed worldwide. By 2018, that number rose 30,000+ cord blood transplants.
Advocates of cord blood banking tout it as a potential miracle cure, one that can be used in medical treatments should your child or someone in your immediate family need it. But what is cord blood banking exactly, and what are the benefits? Let’s break it down.
What is the collection and storage of cord blood?
Cord blood banking is the collection and storage of the blood that stays in the placenta and in the attached umbilical cord post-birth. Blood is taken after the umbilical cord is clamped and cut, a simple and painless procedure compared to the whole bringing-a-child-into-the-world aspect of it all.
The blood is collected because it contains various types of stem and progenitor cells, namely hematopoietic stem cells. So what makes this type of stem cell so damn special? Most cells are only able to make copies of themselves. Hematopoietic cells, on the other hand, can mature into different types of blood cells in the body, and it is this versatility that makes them such a promising component in treatments for everything from autoimmune disorders to some forms of cancer, including leukemia and lymphoma.
Stem cells from an umbilical cord have also been used in an experimental treatment of HIV that doesn’t just treat the virus, it apparently cures the patient of HIV. The experimental procedure using umbilical cord blood has successfully stomped out the virus in three people, the most recent being a woman of mixed race 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,” Dr. Steven Deeks, an AIDS expert at the University of California, told The New York Times after the exciting news broke. “There’s something magical about these cells and something magical perhaps about the cord blood in general that provides an extra benefit.”
It’s not just the fact that stem cells from umbilical cord blood might be a way to cure HIV that makes them seem so magical, though. Stem cells from umbilical cord blood are much less likely to carry any infectious diseases than adult stem cells. Cord blood cells are also much less likely to be rejected from transplant recipients than adult stem cells.
The extraction process of 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 upsides and speculative treatments for diseases previously deemed incurable, it is easy to see why researchers are extra excited about the future of umbilical cord blood treatments.
Given all of the potential uses of umbilical cord blood, why is collecting and storing it so controversial?
Umbilical cord blood has sparked interest in 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 safer and easier to collect than bone marrow.
Still, the practice of cord blood banking has been criticized, and often it’s 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 lab-made, often in fertility clinics, but America’s penchant for controlling women’s bodies has detractors labeling the practice as murder.
There are some valid criticisms of cord blood banking, but they have to do moreso with the privatization of storing cord blood. More on that later.
What is the cost of cord blood banking? Is there a difference between public and private cord blood banking?
Anyone who deals with America’s health care system knows how prohibitively expensive obtaining critical care or medication can be. The cost of cord blood banking varies, mostly dependent on whether or not you opt to store 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 can be free, or it might cost a nominal fee. Public cord blood banks store your donation for free, but the donation is not saved for you — anyone can use it as deemed medically necessary.
A private bank carries a price tag for both the collection and storage of umbilical cord blood while keeping your donation stored just for you. Most private cord blood bank websites don’t list prices but have “helpful” calculators to determine the ballpark of your cost. People who opt for private banks can except to part with $1,000-$2,500 as a starting fee, and then an additional fee between $100-200 a year for storage costs.
Most doctors and experts agree that public cord blood banking is preferred. Not everyone who needs a life-saving stem cell transplant can afford to preemptively collect and store cord blood in a private bank, which can cost upwards of mid-four figures after a few years of storage. Storing your baby’s cord blood in a public bank gives it to anyone waiting on a stem cell transplant that’s a match.
Storing umbilical cord blood in a private blood bank isn’t worth it for many families, at least statistically speaking. The odds that you will need your baby’s umbilical cord blood to treat a disease later on in life is roughly the same as the probability of your baby or someone in your immediate family having a disease that can be treated with umbilical cord blood.
That is to say, unless your family has a history of a disease or illness that can be treated with cord blood, chances of your child needing a stem cell transplant by the age of 20 is 3 in 5,000, or .06%. So, unless your family has that type of medical history, it’s probably not worth shelling out the exorbitant amount of cash to privately store cord blood.
The American Academy of Pediatrics and the American Medical Association agrees. “Private storage of cord blood as biological insurance is ‘unwise’ — families may be vulnerable to emotional marketing at the time of birth of a child,” the organization concluded.
This is where the criticisms of cord blood banking, specifically banking with a private bank, come into play. We all know how insidiously effective targeted advertising can be. The U.S. is the world’s largest pharmaceutical market, accounting for over nearly half of global revenues. In 2019, health and pharmaceutical companies spent $1 billion on Facebook mobile advertising alone, according to TheMarkup, a nonprofit newsroom that investigates how technology is used by powerful institutions.
So, if you feel like you are getting bombarded with ads for cord blood banking, don’t assume it’s a sign from the universe to save your baby’s blood. Take a moment, talk over the decision with your doctor and family, and more forward accordingly.
Does insurance cover cord blood banking?
If it is deemed medically necessary, insurance may cover some of the procedure. It’s best to check with your individual insurance provider, as different carriers have different stipulations. For example, some might only cover procedures that include cord blood collection, like allogeneic stem cell transplants, but not cover cord blood banking services. Others might cover cord blood banking for leukemia and blood disorders, but not autoimmune diseases.
There are some insurance programs that can help pay for cord blood banking, including Flexible Spending Accounts (FSAs), Health Spending Accounts (HSAs), and Health Reimbursement Arrangements (HRA). Still, always check with your individual insurance provider.
There are also instances in which cord blood banking is tax deductible as a qualified medical expense. A New Jersey Senate Bill just introduced potential legislation that would “extend gross income tax medical expense deduction to certain cord blood banking services.”