"he had the cord wrapped around his neck and WOULD HAVE DIED!!" - Page 3

[Hannah32]

Originally Posted by miriam

The reason that so many women died in childbirth 100-200 years ago is because doctors refused to wash their hands in their rounds between the morgue and the maternity ward. It was called puerperal fever and doctors blamed it on the mothers and told them it was a mental condition - "it is all in your mind". If you do not believe me, google Dr. Ignaz Semmelweis and see how his colleagues treated him when he confronted them with the truth and with a remedy - handwashing with chlorinated lime solutions to kill the germs.

It is not universal hospitalization that saves women in childbirth today; it is antibiotics for infections and blood transfusions for excessive bleeding, neither of which needs to be in a hospital.

In the 1940s-70s, women would be recuperating in a hospital for a week after the birth. Today, most women are shown the door after three days.

So why do more babies survive very early childhood today, at least in very industrialized countries? Infant death used to be far more common and I did think that's what we were primarily talking about.

It's quite easy to find human population graphs online. You can study the line for yourselves. Flat flat flat flat, then this dramatic curve upward around the year 1800. That's pretty good evidence, IMO, regarding all sorts of issues...from childbirth to disease survival in general.

None of this means that homebirth is a not a good choice. Midwives also have better tools today, as others have mentioned.

I think homebirth is a totally cool choice for those who want to. I don't think the OP should be afraid. I think she should go for it if that's what makes her feel right.

[member234098]

I was responding to a PPs statement as to why women died 100+ years ago. It was not the women's fault.

There is better nutrition and sanitation today and women are having fewer children per woman. Women are able to recuperate and recover from childbirth more easily. More dependable birth control has lowered the number of children per woman.

Women averaged six children each to about 1750, losing most in early childhood to disease or exposure. This is also shown on historical population charts. Women also died earlier than their husbands, so many men had two families.

[Storm Bride]

Originally Posted by Hannah32

So why do more babies survive very early childhood today, at least in very industrialized countries? Infant death used to be far more common and I did think that's what we were primarily talking about.

It's quite easy to find human population graphs online. You can study the line for yourselves. Flat flat flat flat, then this dramatic curve upward around the year 1800. That's pretty good evidence, IMO, regarding all sorts of issues...from childbirth to disease survival in general.

None of this means that homebirth is a not a good choice. Midwives also have better tools today, as others have mentioned.

I think homebirth is a totally cool choice for those who want to. I don't think the OP should be afraid. I think she should go for it if that's what makes her feel right.

I think you and I are talking about two different things. I'm not looking at 17th, 18th & 19th century vs. 20th & 21st century numbers. We don't have good data on populations that were reasonably well nourished (eg. moms who didn't have pelvis deformations from childhood rickets), supported by their communities, breastfed and breastfeeding, etc. etc.

Infant death, outside the neonatal period, is a whole other issue, as it can be completely unrelated to anything the midwife/doctor/taxi driver/mother/father/older child/other did at the birth (or even during the pregnancy). Hospital birth isn't going to do anything about the deaths of babies who don't have enough food, or clean water, or anything else we consider basic.

Human population graphs, likewise, prove very little about childbirth, in and of themselves. We're surviving infancy in greater numbers. We're surviving childhood in greater numbers. We're surviving adolescence in greater numbers. None of those things address childbirth.

And, I maintain that if true cord emergencies (or any other obstetrical emergencies) happened at the rates OBs state, or strongly imply, the race would have died out. Mothers wouldn't have attempted more pregnancies, because we'd have been dropping like flies, too.

[calmom]

i want to share my story without getting involved in the debate. my son DID die because of a nuchal cord but i also do realize that having a nuchal cord is very common and most babies are just fine. his cord was wrapped very tightly 3 times around his neck. the ob said the point at which it was wrapped played a part in his death. the cord was pulled tightly from his navel directly to his neck and then wrapped around. she said it might have been different if it had been loose from his navel to his neck and then wrapped 3 times. that makes sense to me.

i am a big homebirth supporter (my Matthew was a planned homebirth and I have had 3 successful homebirths) but i no longer think that all homebirths are safe and all hospital births are dangerous like i did before.

[GuildJenn]

Originally Posted by craft_media_hero

So it seems like whenever I mention homebirth, I get one of these cord horror stories in response. Instinctually, I don't believe it, but I'm not a birth professional and don't really know enough to understand what's really happening here....

The story before that was that the momma was laboring for about 60-70 minutes. The fetal monitor showed that the heart rate dropped during contractions. Mom received an emergency cesarean, and the babe was born "with the cord tightly around his neck". This was "a close call" and if they hadn't had a cesarean, I am told the babe would have died. FWIW this mom had a very "medical" OB attending her.

Can we talk about this?

It's my understanding that the cord is around the neck in 1/4 or 1/5 births. Can the cord around the neck really cut of oxygen and cause stillbirth? Would the babe be born, cord unwrapped, and isn't it still receiving oxygen from the placenta even if the cord is wrapped?

What about the heart tones slowing or "stopping"? Is this caused by the nuchal cord? Even if the heart rate slows during ctx, could that birth work out ok w/out interventions?

Without the fetal monitor, would these births have simply progressed naturally with the babies pinking up after birth? Or would they really have been stillborn because the cord was too tight? At that point, isn't birth pretty much imminent?

I hated the fetal monitor and only let them put it on my for a minute, and I don't want one in this next birth I'm preparing for either.

I'd like to understand what's really going on here and dispel the "horror cord" myth. Can you all help me out, here?

I'll talk about my experience, but as a warning, it's not a happy one.

I went for a hospital birth in a hospital with a low intervention rate and a pretty natural approach to labour. Midwives were available but because of other issues I had opted for an OB, and ended up with the OB on rotation that day.

Labour progressed pretty well until the pushing phase. At that point I pushed for 2.5 hrs; there was an unusual series of emergencies in the L&D ward and the ob was in emergency surgery for much of that time. There was an inexperienced nurse attending and she missed the decel pattern on the monitor, until my daughter's heart stopped (2x nuchal cord). She was revived, but died 4 days later. I pretty much blame the hospital.

To answer your questions - my umbilical cord was WHITE when it came out; the 2x nuchal combined with the pushing resulted in a total failure of oxygen to the baby. Regardless of what interventions should or should not have taken place there was no question that it was the nuchal cord that caused the problem. It may be rare and it may not be something you choose to worry about but I've experienced it personally and yes, it can cause death. Sorry for everyone who thinks that you can will a good birth or that cord accidents are a myth.

The monitoring did indicate a problem but the pattern (not coming up fast enough) was missed. It's not just how long the heartrate drops but how it comes back up. (We didn't know this prior to delivery.)

I probably would have done better with an experienced midwife than I did at the hospital, so I don't really consider it an argument against homebirth.

That said, a c-section would have saved my daughter's life and actually the revival effort could have worked had the period of oxygen deprivation not been so long. The things I learned were:

- when things go wrong, they can go wrong pretty quickly. Whatever your plan is, be sure you have a sense of what will happen at that point.
- your team seriously matters
- you cannot plan for everything and a certain point you have to just accept there are risks

Good luck with your decision. FYI I had my son in a hospital afterwards and it was an uneventful and respectful delivery.

[MegBoz]

Originally Posted by Hannah32

So why do more babies survive very early childhood today, at least in very industrialized countries? Infant death used to be far more common and I did think that's what we were primarily talking about.

Well, I think you're both right.
I just don't like when people use the point that, "Women used to die in CB all the time centuries ago." They often use this as an argument against HB or even against low-tech birth (i.e. 'expectant' vs. 'active' management.)

But the fact of the matter is that birth is not that dangerous, most of the time! Yes, we should have a skilled MW there (or be very well educated & prepared if we're going to UC), and yes, sometimes we will need medical technology and that technology can, and does, save lives. But that doesn't mean that birth is inherently dangerous! it's just not! Most of the time, mamas just need emotional support & a little monitoring to confirm mama & babe are fine. That's it!

I think personally, I just classify the statement of "But women & babies used to die in CB all the time!" as a, generally, ignorant statement made by uneducated people who assume that hospitals, OBs, drugs & intervention lead to the best outcomes. & we all know that's wrong! In that regard, it reminds me of the phrase, "Natural birth makes as much sense as natural dentistry."

While technically it is true, it still irks me due to the context in which it's most often used.

[thefragile7393]

No one has mentioned how many years ago the OP's godmother's incident was. 30 years ago birth was very different for a lot of patients. Doctors were trained very differently back then and the extent of the interventions she had shows. I'm not pooh-poohing the possible dangers at all...but it's quite possible the situation wasn't what the doctor made it out to be---doctors still do this now, why wouldn't it have been any different back then? Heck, my own mom was told she was too "old" for a homebirth and "had" to have me in a hospital 30 years ago. Now we know that isn't true....she was a very healthy 41 year old person back then, but she didn't think to question the doctor.

I would take this person's experience with a grain of salt, given the circumstances (I'm sure she believes it's true, and maybe it is, but since there's no way to know for sure, take it for what it is...an experience) and do research, ask the midwife what to do. Sadly unforseen things happen whether at home or at a hospital...but that does not mean that it happens as many times as people think. Since they do happen, educate yourself on the real possibilities, look at the stats, get reassurance from your midwife on what to do in situations...and go from there.

[Storm Bride]

Originally Posted by GuildJenn

- you cannot plan for everything and a certain point you have to just accept there are risks

This.
There are risks, no matter where we give birth. I don't subscribe to the belief that homebirth is some kind of guarantee of a good outcome. I just don't subscribe to the belief that hospital birth is such a guarantee, either. There is no guarantee.

Good luck with your decision. FYI I had my son in a hospital afterwards and it was an uneventful and respectful delivery.

Yeah. I've had a total of one respectful delivery. Mine was also after my stillbirth. If hospital treated all mothers-to-be the way they treat those of us who have had a loss, I'm guessing their "patient" satisfaction rates would be a lot higher. It was kind of refreshing being on the maternity ward and being treated like I had a brain and deserved some kind of respect and consideration. I think I was actually out of the hospital before it sank in that I'd actually been treated well.

[annekh23]

On a list I'm on, someone summed it up rather nicely, "some babies die because they are born at home, some babies die because they are born in the hospital, right now, the rates are similar".

Which means there is scope for improval in both areas and having read many many case studies, my overall impression is that there may well be more scope for reducing the in hospital rate, because a lot of the hospital ones you can pick up details like lack of continuity of care, poor communication etc which can be improved on. But there is also plenty of scope for improvements in care of homebirths, like good coordination of care, delays between a problem being noticed at home and getting intervention because you have to go through the ER, or the hospital treats you as a newly arrived labour patient, not a transfer from a compentent professional.

However, when you look at the death rates at home for midwives that have developed reputations for outstanding care and have good relationships with doctors. In most scenarios, I'd rather have Mary Cronk, Ina May Gaskin, Gloria Lemay etc, than an OB resident, but ideally they'd work together, so when one of those fantastic midwives says help is needed, help is given, fast.

Sadly, some of these fantastic midwives are forced to only attend births at home or in freestanding birth centers, when there are some situations and individual preferences that would indicate hospital birth, so that back up is available quickly.

The WHO ideal is continuous care from a midwife, with obstetric back up and they put an awful lot of research into that.

[Pumpkin_Pie]

Just wanted to add one more nuchal cord story to the thread. My son was born only a few days after his due date, but about 55 hours after my water broke. His cord was around his neck three times, and was so short that it prevented him from descending. I also had an episiotomy and a vacuum extraction and the midwife delivering ended up cutting the loops off his neck before his body was delivered in order for him to fully descend. He was blue and had to be resuscitated with a rub down and oxygen, but was pretty much fine after that.

It was a very scary start (the very first words I heard after he was born were, "Don't worry, he's not dead"), but I feel extremely confident that if I had birthed him at home he would have been just fine with a competant midwife. They only real interventions needed were the episiotomy and vacuum and a bit of oxygen and a towel to rub him down with to stimulate him a bit. Could he have died? Yes, easily. Would I do it again at home? Definitely. Just because there is a cord issue, does not mean being in a hospital will make the outcome different in all cases.

Good luck with your upcoming birth mama. May you have no cord issues!

[dannic]

My mom had a stillborn son after me who died a few days before labor from the cord being wrapped around his neck. they didn't know til birth. It would be a very difficult thing to lose a child in any instance, and naturally, any family who does lose a child is going to be fearful of it happening again, no matter the cause. (Whether from cancer, cords, or a car accident). When I planned my first homebirth, one of my first questions was about cord issues and how they would be handled at home. My midwife gave the stats and then proceeded to show me with a teddy bear how she would unwrap baby. My dd born at home did have one loop around her neck and the midwife just sort of somersaulted her as she came out.

For those of you as mothers who have lost a child, my heart goes out to you! I am planning my second hb now. We all have to make our decisions with the knowledge we have and we all have to deal with the consequences of those decisions. They must be our own.

[2sweetboysmom]

Another personal experience. Mine has nothing to do with nuchal cord but a true knot coupled with a short cord.
My third son Elijah was all set to be born at home, we all needed a really quiet, low key birth. He was breach so I went for an ultrasound to see if we could see why. He turned around, but measured small and I was diagnosed IUGR. Through a series of perinatal visits and a naging intuition we decided to induce. (remember I was planning a quiet home birth) So way ramped up on pit my water was broken. 2.5 hours of intense labor later he was born with a single involuntary push. His cord was white between the tight knot and his belly, and the length of the cord was so short that his feet were still in me but the cord was pulled tight.
If I had a more "normal" deliverey at the hospital or home we would have lost him in pushing. Period.
Mothers are given good sense and an intuition for a reason. The choice of place and method of delivery are very personal and even change over a lifetime of experience.
As much as I long for a quiet home birth and fully suppport any woman's right to choose such, after that experience and the mid term loss of Michael and Providence, I am choosing the hospital this time.

[craft_media_hero]

Wow, I am so sorry to hear about everyone's difficult births and those of you who have shared the stories of your losses.

[AllofGrace]

The midwife who delivered DD2 tells an amazing story of a baby who was fine (developed normally and had great apgars) with a cord wrapped SEVEN (7!!) times around his neck. The mom was a first-timer with a very normal labor at the birth center. When pushing started, the baby had major decels, but always recovered well. Mom couldn't make any progress pushing, and MW could feel the head not budging at all during pushing.

MW says she normally doesn't transport so quickly for a c/s, but something told her she needed to in this case. The operating OBs were stunned with the number of wraps---the most they had seen in their 30-yr careers. All agreed it was a miracle the little boy not only survived labor so well, but that he had developed normally too.

[mamabearsoblessed]

Originally Posted by 2sweetboysmom

Another personal experience. Mine has nothing to do with nuchal cord but a true knot coupled with a short cord.
My third son Elijah was all set to be born at home, we all needed a really quiet, low key birth. He was breach so I went for an ultrasound to see if we could see why. He turned around, but measured small and I was diagnosed IUGR. Through a series of perinatal visits and a naging intuition we decided to induce. (remember I was planning a quiet home birth) So way ramped up on pit my water was broken. 2.5 hours of intense labor later he was born with a single involuntary push. His cord was white between the tight knot and his belly, and the length of the cord was so short that his feet were still in me but the cord was pulled tight.
If I had a more "normal" deliverey at the hospital or home we would have lost him in pushing. Period.
Mothers are given good sense and an intuition for a reason. The choice of place and method of delivery are very personal and even change over a lifetime of experience. As much as I long for a quiet home birth and fully suppport any woman's right to choose such, after that experience and the mid term loss of Michael and Providence, I am choosing the hospital this time.

bolded ~ Yes.

[erin_brycesmom]

After having a baby with a tight double nuchal cord suffer an unnecessary traumatic entry into the world because of my choice to birth in the hospital, I feel way more confident birthing at home in the event of nuchal cords.

A nuchal cord is just a variation of normal. It is not dangerous in and of itself:

From AJOG (American Journal of Obstetrics & Gynecology)

CONCLUSIONS: Nuchal cord loops and tight cord do not cause significant peripartum morbidity.

http://pt.wkhealth.com/pt/re/ajog/us...195629!8091!-1


From Perinatal Journal:

Conclusion: There is no significant correlation between nuchal cord entanglement and adverse perinatal outcomes. Therefore nuchal cord entanglement alone is not an indication for cesarean section.

http://www.perinatology.org.tr/journ...ext/txt_05.asp


From NEJM (New England Journal of Medicine)

CONCLUSION: Nuchal cords do not influence clinical management at delivery, and neonatal primary adaption is not impaired.

http://content.nejm.org/cgi/medline/...urcetype=HWCIT


From AIUM (American Institute of Ultrasound in Medicine):

Conclusions. A sonographically detected nuchal cord is not associated with important perinatal complications.

http://www.jultrasoundmed.org/cgi/co...stract/23/1/43


another study:

CONCLUSION: Nuchal cord is not associated with adverse perinatal outcome.

http://www.ncbi.nlm.nih.gov/pubmed/18604054


and yet another study with the same conclusion as above:

CONCLUSIONS: Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary.

http://www.ncbi.nlm.nih.gov/pubmed/16374604

[JessicaS]

Originally Posted by 2sweetboysmom

Another personal experience. Mine has nothing to do with nuchal cord but a true knot coupled with a short cord.

Hey! I had a short cord with a true knot baby too

[baileyandmikey]

My ds1 was born with his around his neck three times, very tight, he was purple, and i mean purple, but he was fine. his heart rate was wacky during the delivery, but it all ended well.

my friends ds was in a dire situation at birth, cord was knotted and around his neck multiple times, delivered via csection 4 weeks early due to ultrasounds and fetal monitoring said the baby wasn't doing well. He was on a breathing machine for three weeks due to his lungs not working properly, but I don't think this happens as often as people say.

[mmaramba]

I think the thing that's tough about these stories-- and again, not doubting anyone-- is that (especially in the case of second-and-third-hand retellings) it's very hard to distinguish babies who died because of a cord around the neck from babies who died with a cord around the neck.

AFAIK, when there is no apparent cause of death, but there is a cord around the baby's neck, this is the official "reason" given for the stillbirth, for "the record" and malpractice purposes.

And of course, we have sampling error here. Anyone who lost a baby for known (or even suspected) cord issues-- or who knows someone who did-- will comment that this is why her baby died. Ask this question on a mainstream board and you would get even more such answers.

[pinchbeck]

I think home birthing is great! So many women I know have easy births including a mom who had twins and just plopped them out! However, my experience with childbirth has proven difficult. During my second birth (8 years after the first) my son's heartbeat went down to half what is considered normal. His heartrate did not recover. A c-section was performed immediately since they couldn't get in there to loosen the cord. I was told that the cord had been wrapped around my son's shoulders and that my contractions were causing a decel in heart beat. It was sad because I was almost fully dilated and I could have pushed him out (about 40 minutes later). I am thankful he is here.