Umbilical cord around the neck

[sisica]

My husband was talking to his friend today about us having a homebirth. The friend said he was VERY glad that they had their baby in the hospital because, as the baby was crowning, the cord wrapped around her neck and she was in distress. They had to do an emergency c-section then and there.

What are the chances of this not being caught earlier on? What are the risks involved? Husband is worried about homebirthing now after hearing this story.

Please, offer any advice you have. I really want a homebirth but this frightens us!!

[Midwife Kris]

1 in 3 babies has the cord around its neck and any midwife out there knows exactly how to deal with it.

My guess is the baby was in distress long before crowning, they did a section and that is where the cord was seen around the neck... voila, section saves the baby's life. A baby crowning with its cord around the neck would be untangled from it and born (or if extremely tight, it is cut and born). It wouldn't be shoved back up and born by section.

My advice is to ask prospective midwives about this if it is your biggest fear. And get used to hearing every story in the world that includes the following, "Thank God our baby was born in the hospital because XXX happened and it would've died at home!" Just nod your head a lot and then ask why they feel compelled to scare you, LOL.

[mamaverdi]

I believe both my baby's life and my life were saved by being at home. And I know others for whom that was the case as well. I have posted about this before...in this forum and in other birth forums here. Too bad the search isn't working.

My baby was born wrapped in his cord...yet there was nothing wrong with his heart rate etc: Three times around his neck, and twice around his left leg. Wrapped. I had my cord twice around my neck, and still a vaginal birth...

The only thing I can say about my cord wrapped baby is that his birth took quite awhile. My midwife said it takes the cord awhile to stretch....but it will if you wait. I don't know if this is true...but again...it's yet another reason to attend to a birth, not manage one.

Have your dh read about what happens in hospitals...and talk with midwives about this particular or any fear.

Fears should not be a motivating factor in where you have your baby.

mv

[~Megan~]

That doesn't sound like he's got the whole story. ds' cord was wrapped around his neck and under his arm (good thing it was pretty long, eh?).
I think that most babies have cords around their neck, in fact I've heard it helps protect the cord from compression.

[NinaBruja]

google: nuchal cord somersault

i had a doctor who upon reading my birth records said 'oh a nuchal cord, good thing you had the cesarean' my god i could have smacked him.

i think people think of it like a rope instead of the stretchy thing it is.

[Kidzaplenty]

I have had seven babies that have had the cord around their neck.

One had the cord wrapped three times, Three had the cord wrapped twice, and the rest had it once. I have never had any problems with this, the cord has always been long enough to fully birth the baby and delay cord clamping.

A cord around the neck is nothing to get worried about. In most cases there is simply a long cord and it will cause no problems. If you are homebirthing, you have two cord clamps, just incase, and if the cord is so tight that the baby is blue and won't move further out, clamp it twice and cut between the clamps. Any midwife knows how to do this, and it is very easy. If you are UCing, it is still easy. Just don't forget to clamp it TWICE and cut between; otherwise you or baby will bleed out.

[sisica]

I'm going to have to say, AGAIN, that I LOVE this board!!

THANK YOU so much for sharing your stories!! People have been treating me as if I'm a "bad" mother for wanting to homebirth. My family has been supportive, but other people think I'm nuts. It's so great to have a place to have my questions answered by supportive, encouraging, and experienced women. I just wish I'd found this board earlier in my pregnancy!

I will share this thread with my husband. Thank you so much.

[Maggi315]

A cord around the neck is not really a big deal. About 1 in 3-4 of the babies I delivery have it sometimes multiple times. Only once did I have to cut it and it was probably due more to inexperience than anything else. We do a somersault maneuver which works like magic. Plus we don't cut the cord right away which is even more important in babies with the cord around the neck because we want to make sure they get lots of oxygen and blood.

Don't let this deter you from a homebirth, you probably have better chances of a better outcome if there is a cord problem at home than at the hospital!!!

[Full Heart]

My last birth the cord was wrapped around the baby's neck. Which actually was a good thing. We unwrapped the cord and noticed it was limp, not pulsing...which is bad. It was a sign to get the baby out NOW. Cord was limp because the placenta had detached. I think if I was at the hospital with my slow labor I would have been given pitocin which could have seperated the placenta before pushing causing distress and emergency c/s. I know at the hospital I wouldn't have had skin to skin contact immediatly after birth either if the same thing had happened.

Labors are generally slower with a cord around the neck and hospitals don't like long labors. They interfer and cause distress. Then they are creditited with fixing the problems that they created.

So ime, cord around the neck is safer at home than at the hospital.

[rad]

MY DD had her cord around her neck once. Mymidwife flipped it over and I pushed her out. No big deal at all.

[loraxc]

My baby had a double or triple nuchal cord (think it was triple but I can't recall) and a "true knot" in her cord. She was never in distress at any time--the midwife unwrapped the cord as she came out. I remember her calmly saying, "Let's get the cord off there" or something.

I have often thought about how if I had had a section someone would have said, "Oh, the c-section probably saved her life!" because of the nuchal cord and cord knot. I did have a very long labor.

[StacyL]

I just gave birth and my ten pound son had the cord around his neck, but he was not in distress and MW just unlooped it after his head was out. He had some shoulder dystocia which was a bigger deal than the cord.

[Emilie]

my dd born at home had a cord ariound her neck. it was quite tight- i noiticed a drop in heart rate on the last monitoring... during pushing... tho we did not speak about it- i just pushed her out- and she was blue and had a low apgar score.she was in distress. we wrapped her in a towel and i nursed her and she was fine within a few minutes.
. I am convinced that she would have not done as well in a hospital- because she would have been taken from me and layed in a cold plastic box for "monitoring"
It was scary. i will not lie. i feel that it would have been scarier to me in a hospital with a bunch of people freaking out. my mw simply suctioned her while i held her and then we rubbed her body a bit and it was fine. she is perfect. i would never birth in a hospital again.
homebirth is the way to go,
polease discuss your concerns with your mw. that is what she is there for.

[pamamidwife]

Cords around the neck are an issue totally created by us extrauterine beings.

Anything tight around the neck of a breathing human can cut off oxygen. However, babies in utero are not BREATHING.

We are totally equating our own extrauterine experience with what babies could be feeling. Nothing is farther from the truth.

The vessels in the cord have a protective caseing called Wharton's Jelly. Unless there are serious issues with the mother's health (or with baby), this Wharton's Jelly is a gelatinous substance that provides ample cushion to babies during compression, either before labor or during.

Nature has already created a plan for those busy little babies...early in pregnancy, really active babies create more pull on their cords. The cords naturally lengthen to accomodate these busy ones.

It's really quite a perfect design system. Low heart tones during pushing are often very normal - in fact, you'll see dips during the contractions because of head compression.

The only time cord wraps - around the legs, arms, trunk or neck - cause issues is when the cord is so super short that it impedes actual descent. This is not as common as people think. If your baby has a cord long enough that it allows them to be on your low abdomen after birth, it was long enough for them to be birthed without much problem.

I don't even check for cords around the neck at births. Mostly because I'm not always catching, but it's REALLY painful for the mom. Does it matter if I loop the cord over the head before the body is born? Not really. In fact, the more the cord is handled before birth, the higher the risk of it starting to clamp down. I'd rather leave it where it is and not cause issues in case of a shoulder dystocia, etc.

I think it's so interesting that we've created such an idea of danger and drama around something that is so normal - and designed to work pretty darn well without our help.

[RockStarMom]

What about a knot in the cord- can those be more serious?

Sorry to butt in- I've been wondering about this and kept forgetting to ask about it.

[JenMidwife]

Well said, pamamidwife!

[amygoforth]

Ditto what other moms have posted. Home waterbirth, cord around his neck, midwife took care of it (slipped it over his head, or unwrapped it... I can't remember), and all was well. This is neither an uncommon nor scary event.

[bradleybirth2mom]

First of all, the cord is a very tough and flexible material, and it is generally routine for a midwife to watch for it, tell a mom to stop pushing momentarily and unwrap the cord. Having a C-section for this tells me two things about the doctor: He/she was too inexperienced to unwrap the cord skillfully and he/she would rather take the higher fee offered for performing a C-section. Keep in mind that research shows only 3% of women actually need a C-section for their babies to survive---THE RATE IN U.S. HOSPITALS IS 33% OF WOMEN. What you should really fear is the unneccessary intervention and the harm that hospitals cause. Read Ina May's Guide to Childbirth---starting around pg. 133, after the positive natural birth stories, you will see her research on these issues, including C-section. You will also see her birth statistics in the back of the book---in 30 years, her birthing organization, The Farm, had never lost a mother and out of 2,028 babies, only 8 were lost. Those statistics are much better than a hospital----send me a private message with your email and I will be happy to send you some compiled statistics on the safety of homebirth for your and your DH. Hope this helps!

[pamamidwife]

True knots are generally NOT a problem at all. They're given as reasons for stillbirths, but whether it's a valid reason, I don't think so (I think that "umbilical cord accidents" account for the majority of stillbirths with unknown etiology). I've seen two true knots in my short years of attending births, neither had any sort of heart rate variation.

Again, I think the body accomodates things like true knots. It would be reasonable to think that a baby could end up knotting the cord - wouldn't it be just as reasonable to think that the body will help prevent a crisis in such an event?

I really feel like providers need to stop checking for cords and looping them over the baby's heads. Babies are easily unwrapped after the birth - and the less handling of the cord prior to the birth of the baby the better.

[mama in the forest]

panama midwife - do you think that Wharton's Jelly is protective for the cord also in the case of a vaginal breech birth? I've been researching breech birth & cord compression, and some birth attendants seem so concerned about cord compression.......but my instints tell me that in a spontaneous breech birth with no interventions, combined with the natural protective mechanisms of the wharton's jelly, cord compression would not be such a worry. What do you think?