Here is my opinion and experience, hope it helps.
I didn't really have any urge to bank DD's cord blood but my mom was really gung ho about it. Not for any particular reason, but "just in case." For my part, I was adamant that DD get all of her blood. Mom and I agreed that we would not prematurely clamp and cut, but after DD had balanced all her blood with the placenta and the cord stopped pulsing, sure, we could see if there was any left to store. Mom paid the initial collection though we would be on the hook for the annual payment (much smaller). Honestly I was not really happy about that but I was a different person then. (Today I'd just say no way, end of conversation).
So we did it as we agreed. There was absolutely no blood left to collect after we clamped and cut. My midwife tried, the assistant tried, and my mom (and RN) tried. My mom was satisfied that we did our best. I was supersatisfied that DD had all the blood she needed.
Anecdotally, it seems that the majority of the time, if you "delay" clamping and cutting until the baby's blood is all settled and the cord stops pulsating, you probably will get some blood but not enough. Sometimes, however, you can.
You would need to check with the banking facility but the two I talked to, including the one we went with, would refund the fee minus about a hundred bucks to cover the collection materials and such. Totally fair, in my opinion. So mom got most of her $1000 back, and was just out about $100 for the venture. In our case, getting the refund was smooth, we didn't have to jump through hoops and they didn't play any games with it.
- I strongly believe that the cord should be left to pulse until it stops. I believe that premature clamping (and it's the clamping that matters, after it clamps it doesn't matter if it's cut or not - I point this out because some medical professionals "agree" to delay cutting but still clamp immediately. That's total BS.) carries real consequences for the baby. You know how it's a big deal that rice cereal and formula is fortified with iron? Why would babies all become deficient in iron at a few months of age? Doesn't make any sense, does it? Unless you see that the loss of the baby's iron-rich blood on his or her birthday naturally leads to reserves running out long before the baby is ready to eat solids.
The amount of blood lost to the baby due to premature clamping can be significant. I'm all for blood donations, but I believe donations should be made by healthy adults, not babies on their first, delicate day of life. They need every advantage to survive and thrive.
- Cord blood is indeed an amazing thing, but I believe private banking is a real waste of resources. I don't know what the chances are that your family could use the blood in the next 20 years, but they are pretty low. (The blood lasts only a max of 20 years, often less, that's why the time frame). Extra blood should, in my opinion, be donated to public banks. Blood must be matched for compatibility, but your baby's blood is not a guaranteed match either, believe it or not.
- This is a continuation of the above thought, but kind of a separate point... anyway, you might be assuming you are banking the baby's blood for the baby's possible use. Well, that blood of course is a perfect match, yes. However, the chances of your baby needing the blood and being able to use it are low. Why? Because if there are genetic issues or diseases, the blood contains those markers already. Not good to use.
- The blood is most likely to be useful to the baby's siblings (if any). That's useful to consider when making your decision. But please know that the chances of a match at a public bank are reasonable (exact numbers depend on factors like your race - unfortunately there are fewer donations and thus matches for Hispanics and African Amercians, but there are more for white Americans, I don't remember about Asian Americans).
So, there's my completely opinionated point of view. To sum, I think baby needs the blood first and foremost in his or her body. Next, if extra blood can be gathered (if a professional clamps without your permission, or if you don't really believe premature clamping is a big deal, or if there is just extra blood left over after the cord stops pulsating) I believe a public bank is a better and more ethical use of resources than a private bank.
Homeschooling mama to 6 year old DD.