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Cord accidents

post #1 of 77
Thread Starter 
It was my understanding that, a cord wrapped around a baby's neck was "no big deal", and generally, easy to deal with during labor.

And yet, more than once here on MDC I have read about a mama that lost her baby to a cord accident- a twist in the cord, or the cord wrapped around the baby's neck.

How big a deal is it really, and why do some babies die, or have problems from cord issues, and others it just involves "pulling it over their head" and they are fine?

Is there anything that can be done to prevent cord accidents? I've never put any stock in the old wive's tales regarding cords, but perhaps, is there some truth to them?
post #2 of 77
Having had a wonderful pregnancy thusfar without any complications or worries about the baby (thank God) .. this is the last of my big worries...

I am hoping some experienced people can shed some light... or is it something that just *happens*...?
post #3 of 77
I think it does depend, somewhat, on the overall length of the cord. I don't know. To put some fears to rest (hopefully!), my dd was born with a nuchal cord that was easily handled. Ds was born with the cord around his neck TWICE and it was easily handled. No problems whatsoever with either of them. (In fact, ds was crying when it was just his head out!) Dd's cord was normal length, and the midwife commented that ds' cord was 'really long.' Other than that, I don't know what could make the difference (except, of course, possibly management of the issue?)
post #4 of 77
Breathless, I was wondering that too. I think we must have read coleslaws very tragic and sad news about her baby this morning.

I will have to say that *I* personally in the last 15-16 years that I have been literally "obsessed" with obstetrics, births, and women's birthstories, I've heard more stories about babies being born with cord injuries than anything else. Yet, I read time and time again that some babies are easily born with the cord wrapped around their necks and with knots and are perfectly fine. Is it the luck of the draw? I don't know. I know that when I was really militant natural birth supporter, that this was the one issue that didn't seem to bother me when people had medicated births or cesareans -- I just knew to many, read about too many who had lost their babies that way (some before they were ever born).

Two babies, one of them being my husband's youngest brother, in my husbands family have died from cord injury -- prolapse cord and then one had it wrapped tightly around the neck twice and around the arm tightly. Recently a friend of mines cousin lost her baby to cord injury. Baby was breech, cord was really long, and some how strangled herself on the cord. It was wrapped weirdly all around her body and constricting her neck. My neighbor's MIL was/is a mountain woman and worked with a midwife for years (she is also a LPN) and said they had more complications with babies with cord issues than anything else, including breeches.

I have to say that cord injury scares the bejezus out of me, especially since I carry my babies breech or transverse, because it just seems to be the luck of the draw. At the OB office I go too, they now do ultrasounds at 35-36 weeks to check position of baby and to look at where the cord is. They have the new GE Volusion machine that actually color codes the cord that shows how many vessels it has and where the cord is. I know some probably think this is awful and just another intervention to interfere with normal birth -- and to some extent I agree, but I have to say I am interested in seeing how things look with my breech baby in 3-4 weeks and her cord.

One of the reasons I personally am against ECV is risk of cord injury, but I am firmly in the belief that if a baby is breech and they can't be turned by low intervention techniques like Websters, tilts, or accupuncture, then there is a reason they are that way.
post #5 of 77
Thread Starter 
The thing is, 3 of my children have had cords around their necks at birth.

Only one was in distress, and I attributed it later to the doctor's interventions (AROM, Pitocin, Narcotic pain relief, IFM, lithotomy position, no food, etc.). The baby was "saved" by the episiotomy they cut, and the fact that they had me stop pushing once the head was out, and cut the cord.

Was I just lucky?
post #6 of 77
Another issue is that many unknown stillbirths are called cord accident for lack if a better explanation. Some parents feel better to have an explanation, some doctors feel it might protect them from liability. But it is sort of a catch-all description for deaths that might be a variety of causes.
post #7 of 77
Some cord accidents happen in utero when the baby grows with the cord a certain way, like around the whole torso or neck, and the cord strangles the baby as they get bigger. Its very rare. Most of these no big deal cord things are just the way the baby comes out, there`s probably plenty of room with certain cords and they are not cutting off air at all, they just come down with a cord around the neck that slips off easily. Its like shoulder dystocia, many babies have a sticky shoulder moment and are fine, but some get stuck very badly and die.
post #8 of 77
I don't know what causes the difference.My ds was born with the cord around his neck, but it was easily slipped off. My dd had the cord wrapped 3 times around her neck, and the midwife said she'd never seen a nuchal cord that tight. Lauren's heartrate was in the 40s and not recovering, and she needed oxygen after birth for a few minutes.
post #9 of 77
Quote:
Originally Posted by Clarity
Another issue is that many unknown stillbirths are called cord accident for lack if a better explanation. Some parents feel better to have an explanation, some doctors feel it might protect them from liability. But it is sort of a catch-all description for deaths that might be a variety of causes.
I was going to say that. I wonder in how many of these deaths the cord wrapping around the neck, or having a knot, is coincidental and not actually the cause of death?

Correlation does not guarantee causation.
post #10 of 77
I agree with Clarity and Kristin. Many times we have no solid explanation for stillbirths. Yet, everyone needs a reason, so sometimes there are guesses.

Some babies have very little wharton's jelly (the white gel that surrounds the vessels) and this can cause issues with knots or really short cords. This is very, very rare. There is no way to determine by u/s (despite a new trend wanting to do so) which babies are more at risk.

Ultimately, we cannot control all injuries and/or deaths. Whether it's before birth, during birth, or afterwards - or even with our eight year olds. We are not in control of our fates - yet there seems to be a drive to believe so.
post #11 of 77
oh, and nuchal cords are very common. I wish providers would stop looking for them with the birth of the head. This is not only very uncomfortable, but it puts the baby at risk by handling the cord and exposing it to air. If the cord is so short that it needs to be cut (again, very rare, but many providers think that if they cannot loop it over the head it should be cut), the baby is suddenly being suffocated without an oxygen source until it is born and hopefully breathes on its own.

I read one story where a midwife thought it was a short nuchal cord that was holding the head up, so she cut the cord before the head was completely born. The baby actually had a shoulder dystocia and it took an additional five minutes for the baby to be born. It had severe brain damage from the insult.

I just think that we need to leave things be more often. Nuchal cords are not an issue the vast majority of the time. If they were, you'd hear it during labor with heart tones and even then, those babies stay high and seem to dive right down at the right time to birth rather quickly.
post #12 of 77
My second DD was born with the cord wrapped around her neck, twice, very tightly. Midwife didn't unwrap it until after her entire body came out. She was not in distress and had great apgar scores.

I was told, after DD1 was delivered via cesarean, that her decels were probably caused by the cord being wrapped around her shoulder, or maybe she was grabbing hold of it too tightly. Because there were absolutely no signs of distress and she had PERFECT apgar scores! I believed this story, too, until I got a copy of my records and did a little more research, and now I think it was because of the Cytotec they gave me (without my informed consent). Of course, no doctor is going to tell you that the problems you had during childbirth were caused by things he did!
post #13 of 77
Quote:
Originally Posted by OnTheFence



I have to say that cord injury scares the bejezus out of me, especially since I carry my babies breech or transverse, because it just seems to be the luck of the draw. At the OB office I go too, they now do ultrasounds at 35-36 weeks to check position of baby and to look at where the cord is. They have the new GE Volusion machine that actually color codes the cord that shows how many vessels it has and where the cord is. I know some probably think this is awful and just another intervention to interfere with normal birth -- and to some extent I agree, but I have to say I am interested in seeing how things look with my breech baby in 3-4 weeks and her cord.
Maybe I am missing something here... but the cord is floating in water. How would seeing it on an u/s 3 weeks before birth tell you much about the position of the cord before the birth (or the next day, even). Doesn't the cord move around and change position as the baby changes position?
post #14 of 77
Quote:
Originally Posted by reader
Maybe I am missing something here... but the cord is floating in water. How would seeing it on an u/s 3 weeks before birth tell you much about the position of the cord before the birth (or the next day, even). Doesn't the cord move around and change position as the baby changes position?

I wouldn't say anything is floating in water that late. It's pretty tight in there at the end. kwim?

But I agree w/ you 100%. If there are no signs of distress then, how does looking at it 3 weeks ahead of time, when there's plenty of time for the baby to roll a few more times, show that there will be distress later? Makes no sense to me.

My brother was born w/ the cord around his neck a few times. I think 3. He was fine. There is an old wive's tale that babies born that way can't die from drowning. My brother drowned in a bucket of water (the phone rang and my mom put the bucket in the bathtub before answering it!) but my mom knew cpr and he was perfectly fine.
post #15 of 77
Yeah, it's definitely tight in there, but there is still generally a layer of fluid cushioning the baby. And the cord will still be at least be partially floating, as there is always the insertion point into the placenta itself that would be sticking out. Even if baby was laying on it, one roll and it would be in a totally different position.

Theoretically, a baby could be fine during an u/s, and have a cord accident later that day. I agree with Pam that we just can't control these things. They're not meant for us to control. If we were meant to control the baby's cord, there would be something we could do about it.
post #16 of 77
My DH had his cord wrapped around his legs, well, it had actually grown into his legs, and it had to be cut out. The doc told his mom that he would never walk because of it. But my dh started walking at 18 months. He still has the scars in his legs from where the cord was, though.
My ds had his cord wrapped around his arm a couple of times, but he was fine.
post #17 of 77
Hi ladies, it's me. I sincerely want to thank BW for starting this thread. As you can imagine (since I think I'm the reason this thread got started), I have many questions about this myself. I have learned a lot from all of your comments, particularly pamamidwife. I have dabbled in the angry phase of grief today and was ready to march into my midwives' pratice and demand some answers on how they could have missed this and what else they could have done. I do have questions, but they have become more rationale and focused thanks to some of the information I have read here. Like some of you said, it may not have been the cord. We thought it was because of what my dh saw when Grace was born - it appeared to him like it played a role, but hasn't given me details and I haven't asked. The doctor (long story why it wasn't a midwife) said that it may be the case too. I didn't see anything until they put her in my arms wrapped up in blankets (which was fine with me). They are doing tests on her placenta and her and did bloodwork on me. Maybe we will find something out then.

Please continue the discussion if there is more to be said and know that you are helping a greiving mom get through one of the hardest moments of her life. I thank you for that with all my heart.
post #18 of 77
This is a very interesting topic. My first child Amanda died because the placenta abrupted, but, there were also several hemerages in the cord.

My son was born with the cord around his neck and shoulder. The cord again, had several hemerages and the placenta was torn. He came out screaming and healthy. The doctor later said he was amazed that ds was so healthy.

In the 10 years since my daughter was stillborn, I've done a lot of searching for answers. One thing I've come to believe is that life and pregnancy are a very delicate balance. Most stillbirths do seem to be from cord or placenta accidents, but there is little that can be done to detect a problum.

Coleslaw, I am so very sorry for your loss - I wish I had some answers for you - all I have are cyber hugs Please know your in my thoughts as yoj move through this.
post #19 of 77
Quote:
Originally Posted by reader
Maybe I am missing something here... but the cord is floating in water. How would seeing it on an u/s 3 weeks before birth tell you much about the position of the cord before the birth (or the next day, even). Doesn't the cord move around and change position as the baby changes position?
I have no idea but I will be sure to ask. My babies don't really move after a certain time period. I've had a breech baby now for sometime and she can't move due to the septum. (she seems quite ticked at times too because of this)
post #20 of 77
My daughter had her cord wrapped around her neck FOUR times and she was still born vaginally, albeit with assistance from forcepts. The nurses were amazed as none of them had ever seen a cord x 4 and this is a fairly large hospital with 2500 + births a year. My doctor (a wonderful woman) did everything she could to get my daugher to come out, since due to repeated decels I had only one or two more pushes left until a c section. While she spent 3 days in the NICU, more due to the fact that no one knew if she should be closely monitored or not, in the end I was grateful to have a beautifil healthy baby to take home. A skillful Dr. or midwife, I believe, can handle most situations without problem, but it is the rare occurrence that will take a baby's life that skill or experience can do nothing to prevent that is so frightening!
Take care Mama and don't worry!
Colleen
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