First--sorry this is so long, but I was off forum all day and many responses came in. I am addressing various people all at once now, instead of one at a time. Feel free to scan for the point that interests you most. Not that I usually have an excuse for being verbose
Yes, Katelove, it's AVA--artery, vein, artery in the cord. But in an umbilical cord, arteries act like veins and veins act like arteries....well, in a manner of speaking. It took me quite awhile to keep that straight (thanks to my nurse friend Ehtan for "AVA") ; the confusion comes about (for me anyway) because in anyone already born, all of your blood vessels are inside your skin, where arteries act exactly like arteries (carrying blood from heart to lungs and body) and veins act exactly like veins (carrying blood back toward the heart). But with pregnancy we have that 2-in-1 circulatory system that includes some 'external' circulation via the cord and placenta...and the placenta acts somewhat like a heart.... that is how 'arteries act like veins' and so forth. Now that I've made it all so much more confusing
I'll move on.
YES, absolutely, I should not have said 'pitocin' as if I knew for a fact that it was a pitocin induction. My bad. I guessed pitocin, given various elements of the story and my knowledge of induction. However, it doesn't matter if it was pit, cytotec or cervadil....chemical inductions frequently cause longer, stronger contrax with less rest in between--less resting time overall, and less complete/effective rest for mom/baby. This is very hard to control with inductions. We don't know, of course, but I still think it is *probably* accurate to name induction as a factor influencing the speed of a labor. I do however carefully add that we *don't* really know this for a fact--and I am sorry if I imply that I am absolutely certain that induction caused a faster and 'rougher' (on baby) labor. I just think that this is an important thing to consider when deciding anything about a birth. Few docs really admit that induction itself plays a part in birth problems; most would prefer to believe that a fast labor was *necessarily* a good thing in a case like this but in fact, a fast labor *may well* have contributed to a stressful birth for that baby.
And I *really* need to go buy a new power cord for my old laptop....which isn't working due to a bad power cord...and which also has all my great links! Not so long back, someone posted an article written by a doc about umbilical cords, wharton's jelly, all that--and I want to post the link but I can't at the moment.
In any event, first the construction of the cord and it's safety features are explained (wharton's jelly, etc). But this doc goes on to say that in cases where it APPEARS that a true knot....or, say, cord compression in the presence of low amniotic fluid....where it APPEARS that some form of 'cord accident' has caused death, that it is actually much more likely that there was some other, underlying issue that prevented sufficient development of wharton's jelly...or other 'cord development' problems that prevented a baby's cord from acting as it should to protect baby in utero from cord accidents.
To lose a baby is so very sad, to birth a baby with CP or any issue that seems to be related to hypoxia/brain damage--these things are so terrible to bear. In no way do I want to minimize that or seem to be careless of anyone's feelings. And yet we really don't know if 'cord knot' or other 'cord accident' is really the true cause of such sad things. Things are simply NOT what they appear to be in so many cases in this life....few places is this so true as with birth, where most of what occurs is, well, hidden from view (as someone pointed out, even w/ultrasound we don't always find cord knots, just to name one small thing that is 'invisible'). And-- despite what 'med science' would have us to believe--pregnancy and birth are still far from well-understood scientifically.
But we do love our certainties, and certain professions (mm, medicine??? for one) definitely like their certainties quite a bit--well, their livelihoods and the amount of power/influence docs have in this world IS after all, dependent upon our believing their certainties! Just remember that Modern Obstetrics has gone through quite a few periods of various 'certainties' that have proven damaging or deadly to moms and babies. And yes, in each and every one of those periods of false certainty, the docs were every bit as certain that they had 'science' on their side, and every bit as given to pronouncing their certainty to clients.
In any event, it needs to be understood that (as mwherbs so wisely has said in the past) 'cord accident' is a wastebasket diagnosis. In fact, upwards of 70% of stillbirths show no verifiable cause--and most of those 70% of deaths are put down to 'cord accident' (knot, prolapse, tight wrap), with or without any solid evidence to back that up--sometimes without even a visually discernable issue (you can see a knot....you might not see a prolapse at all, ever, which means you can guess 'occult prolapse' as a COD without even needing any evidence). You can SEE a knot, you can SEE that it looks tight, that perhaps there is less blood flow on baby's side of the knot than there should be--and so we say 'cord accident', naming the knot. Well, maybe there was an accident--but it was not the knot--it was events well prior to the knot's formation that prevented the cord from being able to withstand a knot, as most do.
And look people--sure, this is a sensitive topic and I am taking an unpopular stand with perhaps less diplomacy than some might wish for. But still--don't put words in my mouth. I never said that a cord knot was NEVER a problem--I'm not even saying that now in spite of all the elucidating I've tried to provide on why knots and nuchal cords usually can't be blamed for adverse outcomes (or for 'nearly adverse outcomes' such as the doc implied in the OP's story). But I *am* saying that I simply do not believe that doc's pronouncement. S/he DOES NOT KNOW--but does want patients to believe that h/she does know.
I mean seriously, what's an OB to do--take a look at that knot and say 'Sheesh, I'm awful sorry I induced you--looks like your body was taking this whole labor thing very slowly on purpose, to PREVENT issues related to a cord knot. And I'm just so glad that having induced you so unwisely, you and baby are fine now anyway!'
I think not.