Cord around the neck? - Page 2

[CryPixie83]

DD's cord was wrapped around her neck (twice I think?) but t was easily unwrapped while I rested a bit between birthing her head and the rest of her body.

I remember reading one UC birth story where the baby's cord was wrapped tightly and keeping the baby from descending as it normally would, but in the end mama let the baby guide himself out and he did a little flip as he moved from the vagina (I believe that's how it went). The only adverse affects that I remember reading about was that the babe needed an adjustment from the chiropractor.

The only problem that comes to mind with the cord is prolapse (when the cord comes before the baby, and can cut off the oxygen supply).

[SaveTheWild]

Originally Posted by TechnoGranola

Okay, I know this is a dumb question, but if the head is out, why wouldn't the baby have oxygen? Can't the baby begin to breathe the oustide air?

ETA: Okay, I thought about and think I answered my own question! I am guessing the baby's head is out, but since the cord is around its neck, it can't breathe the outside air because the cord is choking it. Thus, NOT cutting the cord should ensure the babe gets oxygen from the cord. Am I correct here?

I am hoping a midwife comes in here with the correct answer, but I am assuming babies can't breath until they are out ebcause they cannot inflate their lungs while they are still in the vag. canal. Way too much squeezing pressure for them to fight against. this is just a guess, though.

[alegna]

My dd had her cord around her neck twice and shoulders once. She was born at home with no problems. LONG labor (31 hours) LONG pushing stage (~6 hours) but everything was fine because no one messed with anything. Her water didn't break until moments before she was born so she had a nice cushion the whole time.

-Angela

[LoveChild421]

ds's cord was wrapped 3 times around his neck- fairly loosely as he had a really long cord. No problems- his apgars were 9/10. I think most of the time the midwife or the mother herself can easily just unwrap it, but sometimes it needs to be cut before the baby can be born (if it's wrapped extremely tight around the neck or the cord is very short- which is rare)

[Emilie]

OMG- I just wrote this long post and dd erased it all!
She had a tight cord around her neck that we did not catch until I brought her up- she was born in water. I had a midwife. Dh got the cord off cause midwifes hands were wet. She had a low apgar at 1 minute and a 8 apgar at 5 minutes. She is FINE.
I think cutting the cord is not a good idea- at all that is the babies oxygen supply- and as long as the cord is attatched she/he is getting vital oxygen.
I also think taking the baby away from the mom is a HUGE mistake in these circumstances. DD being white and quite unresponsive nursed right away-....
I think that made a HUGE difference.

I can go into more detail for you if you wish- if you are planning a homebirth.
I also suggest you read Birhthing From Within along with the birth stories on here.
Midwifes are REALLY trained for these circumstances. I knew she would probally have a cord from MW's last fetal monitoring.... I heard a hiccup in her heartrate. I do not think a cord is a reason to decide a hospital birth.

Emilie

[~*~MamaJava~*~]

Just thought I'd share. Luke was born in hospital vaginally and it's a miracle he's alive and totally undamaged. I now believe I could have had him at home too, probably, except there might not have been as many hands there to help.

What happened: once I pushed his head out, it became evident that he had major cording around his neck. 6 loops, in fact, drawn very tight. I pushed his shoulders out and was asked not to push anymore (easy because all that was left was body). They cut and clamped 4 times, all while two of the nurses held him just so that the blood wouldn't run back out of him via the cord, since we couldn't get his whole body out. Not enough cord. It was also under his neck twice.
Once he was untangled and free, we discovered there were also two knots in the cord. One was pulled tight. We think that's why he was small and skinny.

Anyways, the moral of the story is: what happened to him is incredibly rare. The crazy thing is, I had stress test after stress test with him because I was way over, and an ultrasound 2 days before he was born, and no knowledge this was happening. He had to have been like that for months. Every now and then on the stress test his heartrate would drop a bit, but never below 90. They said to me that they thought he might be putting a little pressure on his cord. I think they suspected a nuchal cord, but didn't tell me. And they didn't do a section! If we would have known I know I would definitely have opted for one, because he was on the razor's edge of survival in there. My water even broke before labor started, so no cushion or anything. He did need a chiropractic adjustment.
However, we made it vaginally. So, no, it isn't always necessary! The thing is, there's no way to know. U/s can't see a cord, apparently. I don't know if those 3-D ones are able to show you one. The only way to know, in my experience, is by the heart rate dropping. If it doesn't, no one knows.

[Quagmire]

This is a very informative thread!

I went a-Googling to see what I could find too Here's a good link:

http://www.storknet.com/complications/salafia/cord.htm

What I got from this is that death resulting from nuchal cord is usually due to other problems with the baby/ placenta/ pregnancy. I'm curious what everyone's thoughts are on this one.


Here's a good "how to handle it" article:

http://www.gentlebirth.org/Midwife/nuchlcrd.html

I did have a question about this bit of the article:

I noticed that when midwives talk about waterbirth, they sort of ignore the whole "checking for cord" step, which I couldn't figure out until I realized that the baby's just kind of unwind themselves if the cord is impeding their exit.

We are planning a water birth so this interested me. Is this because (similar to Angela's comment above) the water provides natural cushioning for the baby and cord to move around freely? Does that mean a water birth can be safer where cords are concerned?

[Emilie]

Hmmm I am not sure.
I think maybe since they can not see as well it is not as good to be under water?
I will be interested to hear the answers.

[MamaHippo]

Originally Posted by Tummy

I have five (5) children. My first born was an E-C/S at 10 cm due to fetal destress. His cord was around his neck. I never one time pushed (was 10cm for 2 hours). Day after my E-C/S the Dr came and told me that I was lucky, that had I pushed even one time that they would not have been able to save my son. He was a blue baby at birth. The Dr said they had to put the clamps into my uterus and cut his cord just so they could pull him out. His cord was 3X around his neck.

Same type of thing happened to me when i had my DS. I labored for 9 hours with him, until he started having lots of heart decellerations, into the 20's. I got to 7 cm before his heart rate went to 25 and stayed down, so i had an emercency c-section. Turns out the cord was wrapped twice around his neck and was pulling tightly with each contraction, and thats why he never engaged in my pelvis at all thru all my labor. He was also born blue and needed oxygen. the doc told my Dh in the operating room that he would have lost us both within another hour of labor - DS from lack of oxygen, and me from uterine rupture. But of course any midwife with a doppler could have seen that coming, since DS had multiple decell's before they did the csection, and gotten us to a hospital.

[ashleyhaugh]

mine was 2x around my neck, and my mom delivered me vaginally

[boobybunny]

Originally Posted by MagentaMom

Oddly enough though she LOVES having things around her neck. I'm always having to watch that she isn't going to choke herself.

My oldest is that way, triple looped around his neck, vaginal birth, two weeks under observation.

Now at age nine, he loves to wrap stuff around his neck. Scarves, stuffed snakes, sweatshirts, you name it will try to wrap it around his neck. He does it when he is stressed out or trying to sleep.

[Jane]

Originally Posted by Quagmire

We are planning a water birth so this interested me. Is this because (similar to Angela's comment above) the water provides natural cushioning for the baby and cord to move around freely? Does that mean a water birth can be safer where cords are concerned?

With a water birth, if the baby crowned, but didn't arrive in a contraction or two, the midwife would just dive in and look for a cause. I've seen a mom have to get out of the tub because the delivery was complicated. That's worst-case, as getting out with a baby head between your legs is not fun. In a water birth, the baby gets first chance to resolve the cord and be born through it.

[afishwithabike]

Ds cord was around his neck then down around his shoulder and across his abdomen. When I pushed him out my MW looked as though she was unwrapping a ball of yarn she caught him and stated "It's.....a.....Boy" As she finally unwrapped our sweet package. He didn't even show any signs of a problem. Why? Because there wasn't one.

[Shiloh]

not having a doctor present was the only thing I believe that saved my son.
He was born cord 3 times, and a good lenght of the cord came cord first. Because the nurse delievered and there were no interventions and a very short labour (no breaking the waters, no drugs, no pitocin) the bag of waters didn't break until I actually delivered (like push 2-3 out of 4 total)

He was born with piticeal (sp) hemoraging on his face, blood shot eyes.
But if the doctor had broken my water (which in the last 2 deliveries they were always gung ho to do quite early on to speed things up) I have no doubt in my mind that my baby would have gone into severe distress with the pressure on the cord, that because it was before his head, and wrapped.....

basically I can't think about it it makes me very afraid and I don't think I'd ever go into the hospital again without a midwife period. I realised that those convience things (drugs, pitocin, epidural, breaking the water) could have cost my ds some brain cells....and even with an emergency section those still take a few minutes to set up and the doctor was in another section (an emergency..) my ds's brain couldn't have waited any longer.

The nurse was very skilled, and tried to get me to not push too hard, got her hands right in there, clamped, cut, unwrapped as best she could and was kind enough not to tell me (*although I could feel the cord I didn't even ask dh about the experience until the next day)

[Lovinmy2babies+1]

My SIL just had a baby 3 days ago. The cord was wrapped around his neck and everytime she pushed, his heartrate went waaaay down and soon started going into fetal distress and his heartbeat wasn't coming back up. She refused a c-section and they are saying the baby is "traumatized." He's got a very delayed latch and doesn't latch well, and his eyes are bloodshot, along with bruises around his neck and face. But I don't know how much of what the Dr.'s say is actually true...

[Jane]

Lisa - I hope you sister's baby is okay. Did they do blood gases after delivery? That's a measure of how well the baby was doing, right before birth A baby can have bruises and be neurologically fine or have not a scratch and have suffered a large loss of oxygen. I wouldn't be really concerned with his appearance.
Can you get her a pump and syringe? - he may just be a sleepy, lazy baby, I hope.

[jgale]

Hi, I'm a midwife. I thought I'd just give my 2 cents on the subject. Having a cord around the neck is very very common and almost always no big deal.

Usually it is loose enough that you can just unwind it from the baby's head while the body is still inside. Another alternative is to just pull a little bit of slack in the cord and then deliver the baby through it (like the baby was diving through a hoop). If it is a little too tight for either of those things, you can "somersault" the baby out, where you just hold the head really close to the perineum as the rest of the baby is born, so the baby does a bit of a somersault without putting too much traction on the cord.

Having to clamp and cut the cord before the body is born is pretty unusual. I've attended about 100 births as a midwife and only done that once. In the 300 or so births that I've observed, I've never seen it done. All the stories that people have shared here with blue babies with really tight cords--those are memorable because they're so scary, but also memorable because that really is a pretty unusual thing.

The only times it would be necessary or appropriate to do a c-section for a cord around the neck is if the cord were so tight and so short that the baby couldn't descend. But you wouldn't know that ahead of time--you would just see a really abnormal labor pattern. Sometimes you see a pattern of changes in the baby's heart rate that are indicative of some kind of pressure on the cord--it might be around the kids neck or it might be somewhere else, but it gets pinched. It sounds like that's what happened with Lisa's sisters baby. If the baby's heart rate is bad enough, then someone might need a c-section.

In answer to the other questions about blood flow and breathing: the baby can't breathe when its head is out and its body is inside because it can't inflate it's lungs. Remember that when the babe is in the womb, it's lungs are full of fluid. It takes a really big breath of air to get all those alveoli (air sacks) in the lungs to pop open and force the fluid out. Occasionally you'll see a baby who gives it's first cry before it is fully born, but that's pretty rare.

Of course when the head is out and there is a tight tight cord, there is minimal blood flow through that cord anyway. If you have to clamp and cut, of course you want to get the baby delivered as fast as possible--the combination of a tight nuchal and a shoulder dystocia is a total nightmare--but even if you hadn't clamped and cut, it's not like the baby is getting a lot of blood flow anyway at that point.

Well that's quite a long post. I would sum it up as: cords around the neck are something that every reasonably well prepared birth attendant knows how to deal with. For UC'ers, I wouldn't worry too much about it--nature made a pretty good system. Hope that cleared things up rather than confusing them more.

Jessi

[Emilie]

thanks jessie!!!!

[Lovinmy2babies+1]

Originally Posted by Apricot

Lisa - I hope you sister's baby is okay. Did they do blood gases after delivery? That's a measure of how well the baby was doing, right before birth A baby can have bruises and be neurologically fine or have not a scratch and have suffered a large loss of oxygen. I wouldn't be really concerned with his appearance.
Can you get her a pump and syringe? - he may just be a sleepy, lazy baby, I hope.

The night he was born, he was having alot of difficulty breathing, so they kept him on oxygen for the night and on heart monitors. They said his heartbeat was very irregular all night long. He still has episodes every 15 minutes of so where he seems to be "gasping for breath." We are all very worried, but SIL doesn't seem all that concerned. She already said BFing is too hard and not for her, so there's no convincing her now.

[Emilie]

aawww.... that is too bad... i have a keagan to! is yours a ds or dd? can you nurse the baby? kinda kidding- kinda not! lol