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'short' cord ??

post #1 of 10
Thread Starter 
Update: I'm bumping to ask for more info on short cords.... I keep finding examples where a mother was told the problem was because of a 'short cord' and I really need some concrete information. Now I'm not feeling as concerned about a water birth as I am just about how a short cord can effect the normal progression of birth.... Thanks.



I hope this is the right place to post this. I finally requested ds's birth records from the hospital and reviewed them briefly. One of the questions that comes up for me is that he did seem to have a short cord- it was noted in the midwives notes. I do remember it prevented him from being put up to my breast while I was delivering the placenta, having epi-tear repaired ( ), etc. He actually did the elbow crawl-- which I noticed, but they didn't tell me that he couldn't move up and then took him away for their stupid routine stuff. The cord may have also been wrapped around his leg, which would restrict him too, I suppose. My dh told me this weeks later and I sobbed because nobody told me this was why I hadn't gotten to hold him at that time. Again, I cried when we went over this with my midwives at the 6 weeks review.

I was out of it, and though every instinct screamed give me back my baby, all I could muster was to try to explain the things we did/didn't want done to ds at the time. It was very upsetting not to have him closer-- to let him nurse, especially since he was rooting and crawling-- he was probably more alert at that moment than he was the rest of the week (sleepy baby, I was induced and had epidural - another long story).

So, yes planning on avoiding the negatives of that birth and avoiding the many things that led to much frustration and insecurity.... but what do I need to know about short cords???

My MIL had 2 boys- and both of them had short cords. My dh, it didn't seem to be a big deal, but she seems to remember with her youngest, they had birthing complications because the cord was so short-- she had a difficult time getting him all the way out- from the sound of this. He had some breathing difficulties-- but I'm not really sure of the details. Last time it came up (when I breathed something about homebirth) the she said well thank goodness she was in the hospital that the cord was wrapped around bil's neck, yadda yadda, and he almost died, untill she had a chance to think about it more and realized that was really not at all what happened- he had a short cord and it was NOT wrapped around his neck.: Hows that for over reacting? (It was all very uncharacteristic of MIL, who is normally very supportive and calm).


So... that was probably too much info.... but what's the deal of the 'short cord'? Is it something I need to worry about?

And what about a water birth-- something I'm considring for the next time around... but I would want the baby out of the water, ASAP-- and being restricted by the cord and having to get out of the water myself also seems a bit frightening (but I guess, in that situation, I'd surely manage and with speed, too if urged)?

Thanks,

Jessica
post #2 of 10
If you wanted to have a WB next time you could just keep his body underwater head out of water and wait until the cord stops pulsing and cut it and then put him on your chest or get out of the water.
post #3 of 10
Thread Starter 
That's probably what we would do... we let the cord pulsate at the hospital too... I guess my worry is that it could be hard to get his/her head out of the water... I mean with Josh, his head barely was at my belly button, so wouldn't that be well below water level???

I guess I could just float on top of the water??

I'm sure there are a million creative ways to solve this challenge, I'm just trying to figure out how it would work, because I'm 'stuck' on it a little.

Jessica
post #4 of 10
My birth pool was only something like 2 feet deep. When I stood up my butt was above the water line. If you are unsure of what to do with the baby if he/she has a short cord just stand up!

I sat back on my husband's lap after DD was passed between my legs to me. It raised me up out of the water a bit.
post #5 of 10
Thread Starter 
I'm bumping to ask for more info on short cords.... I'm just happening to find a few more cases where a mother was told the problem was because of a 'short cord' and I really need some concrete information.

Its not like it has been covered by any of the birth books I have.

thanks,

Jessica
post #6 of 10
so she commented short cord and yet it was long enough to wrap around your baby's leg---did someone put a measurement down for the cord? 40-70 cm 15.75-27.5 inches average range with 55-60 cm being typical length.We do not know what all goes into determining cord length- it is believed by some researchers that cord length has to do with movement - the analogy I have read is that the cord just like a phone cord will stretch out-- umbilical cords are coiled even if it isn't obvious--the more movement in pregnancy the longer the cord, and things that change movement like--
less amniotic fluid (oligohydramnios), drug and alcohol exposure, genetic things like Down's syndrome, uterine abnormalities(like bicornet uterus) have been shown to cause shorter cords in animals or in people so they may be guessing correctly.
so if you take a tape measure and you hold the average length up to your breast while you are lying back and a baby is down on your tummy placenta at the top of the fundus still- the length may reach your breast but then think about it wrapped around a leg- shortens it up- kido may not be able to reach and if it was on the shorter end of average- even less likely to be able to reach--
if you are afraid that it will be too short for your baby to reach the surface to breathe then use a bath tub it is much shallower- or use less water in your blow up kiddy pool or have a plan to stand up-- you are not going to be frozen to the spot once the baby comes out- you will be able to move---
I have had babies born with relatively short cords be fine in water births-- remember there is the distance from the belly to the head to take into consideration- and mom is more upright in a tub- not completely reclining so she can usually hold a baby in that position- with her arms extended--
post #7 of 10
Thread Starter 
I'm not so worried about the baby not being able to be out of the water. I understand the placenta is stretchy and coiled and typically the right length... I just don't know what is relevant when taking about 'short cord'-- or if there truly are genetic tendencies.

The accounts I've read that concern me were where the baby got stuck or slowed in the birth canal because the cord was too short (this is what my mother law is suggesting that happened during her birth).

Does this really happen??? Does this mean that the cord can pull on the placenta... .. I imagine this is the risk (if this causes bleeding), along with the baby being 'stuck'.

Obviously, I just have no clue... I had discounted my MIL's situation (as one probably created by the medical environment) but I'm not even sure how to search for this info.

Obviously, my son's cord was long enough to wrap around his leg.... but possibly not long enough to wrap around his leg and then be still long enough to come up to breast level.

I'm no longer concerned about issues in water birth-- the cord would still supply oxygen and I could get my body in position so baby was above water.... so I understand that much better after understanding the mechanics of breathing and waterbirth.

I'll have to look at the actual length to see if it was 'truly' short or not.

Jessica
post #8 of 10
ok did another search and found a few abstracts-- still not much research--

this is an epidemiology study

Am J Obstet Gynecol. 2005 Jan;192(1):191-8.
Placental abruption in the United States, 1979 through 2001: temporal trends and potential determinants.
Ananth CV, Oyelese Y, Yeo L, Pradhan A, Vintzileos AM.
----- most of this abstract is trimmed-------------
"The determinants that were associated with trends in abruption
included anemia, gestational diabetes mellitus, preterm labor, short umbilical cord, and velamentous cord insertion, although their effects varied substantially by maternal race. CONCLUSION: The temporal increase in rates of abruption may reflect a true increase in risk or may be the result of improved diagnosis of both abruption and its determinants. Although the cause of abruption is still speculative, the trend is of concern and deserves scrutiny."

-------------------------------------------------
Obstet Gynecol. 2004 Jan;103(1):119-27.

Risk factors and outcomes associated with a short umbilical cord.

Krakowiak P, Smith EN, de Bruyn G, Lydon-Rochelle MT.

Department of Epidemiology, School of Public Health and Community Medicine,
Molecular and Cellular Biology Program, University of Washington, Seattle,
Washington 98195-7762, USA.

OBJECTIVE: To identify risk factors and outcomes associated with a short umbilical cord. METHODS: We conducted a population-based case-control study using linked Washington State birth certificate-hospital discharge data for singleton live births from 1987 to 1998 to assess the association between maternal, pregnancy, delivery, and infant characteristics and short umbilical
cord. Cases (n = 3565) were infants diagnosed with a short umbilical cord. Controls (n = 14260) were randomly selected from among births without a diagnosis of short umbilical cord. RESULTS: Case mothers were less likely to be overweight (body mass index 25 or more, odds ratio [OR] 0.7; 95% confidence interval [CI] 0.6, 0.8) and more likely to be primiparous (OR 1.4; 95% CI 1.3,1.6). Case infants were more likely to be female (OR 1.3; 95% CI 1.2, 1.4), have a congenital malformation (OR 1.6; 95% CI 1.4, 1.8), and be small for their gestational age (risk ratio [RR] 1.6; 95% CI 1.4, 1.9). A short cord was associated with increased risk for maternal labor and delivery complications, including retained placenta (RR 1.6; 95% CI 1.2, 2.3) and operative vaginal delivery (RR 1.4; 95% CI 1.3, 1.5). Adverse fetal and infant outcomes in cases included fetal distress (RR 1.8; 95% CI 1.6, 2.1) and death within the first year of life among term infants (RR 2.4; 95% CI 1.2, 4.6). CONCLUSION: Modifiable risk factors associated with the development of a short cord were not identified. Case mothers and infants are more likely to experience labor and delivery complications. Term case infants had a 2-fold increased risk of death, which suggests closer postpartum monitoring of these infants.

PMID: 14704255 [PubMed - indexed for MEDLINE]
--------------------------------------------------------------
I am adding this one because they mention short cord as not being a cause of longer pushing stage---
J Reprod Med. 1990 Mar;35(3):229-31.

Perinatal outcome after a prolonged second stage of labor.

Moon JM, Smith CV, Rayburn WF.

Department of Obstetrics and Gynecology, University of Nebraska College of
Medicine, Omaha.

It is commonly held that the second stage of labor should last no more than two hours because of an apparently increased risk of morbidity. The purpose of this investigation was to determine whether this commonly held notion is true in this era of close fetal monitoring and umbilical blood gas determination. Between May
1987 and October 1988, 50 (3.5%) of 1,432 uncomplicated term pregnancies ended in delivery after a second stage of labor lasting greater than 120 minutes. A prolonged second stage was associated more commonly with nulliparity, occiput posterior positioning, epidural anesthesia and a need for operative delivery but not birth weight greater than 4,000 g or a short umbilical cord. Infants born after a prolonged second stage did not have an increased incidence of umbilical artery pH less than 7.20 or of five-minute Apgar scores less than 7, nor did they need intensive care nursery admission. A prolonged second stage of labor
appears not to impose an increased hazard on the fetus but does require close fetal monitoring and increases the possibility of operative delivery.

PMID: 2325032 [PubMed - indexed for MEDLINE]
------------------------------------------
and another one that relates to restricted movement as being something that increases the likelihood of a short cord-
Pediatrics. 1981 May;67(5):618-21.

Short umbilical cord: its origin and relevance.

Miller ME, Higginbottom M, Smith DW.

A short umbilical cord was found in newborns for whom there was evidence of early intrauterine constraint and in those with gross structural or functional limb defects that limited intrauterine movement. These findings were interpreted as showing that umbilical cord growth occurs in response to tensile forces
relating to intrauterine space availability and fetal movement during early development. Thus, the finding of a short umbilical cord may indicate diminished fetal movement from either early intrauterine constraint or fetal limb dysfunction.

PMID: 7254991 [PubMed - indexed for MEDLINE]
post #9 of 10
I have researched this as well. There is no good research that I have found so I wanted to share my own expereinces.

I gorw short cords! I have a short body too none of my cord have been long enough to raise baby off my crotch until the placenta is released and it meant nothing other then I had to bend in half if I wanted to nurse right away. Thank goodness for gigantic FF_GG boobies or it wouldn't have happened, the Creator knows what He is doing and each baby and mother fit together well. For me, it was great to have short cords because my babies love to tumble and stay breech until about 33-35weeks. Cord prolapse was never a concern, cords getting tied around parts was never a concern etc. They were all about a ft or less. My first had the longest and because he was breech at 38weeks, then turned and his cord was around his neck (not really a problem, except that it couldn't be removed and had to be cut)

goodluck in your research. My babies had none of the risks or problems cited in the studies, all normal and all about 9lbs.
post #10 of 10
Thread Starter 
Thanks, I will have to look at the links later.

I also looked at the records and the midwife just said 'noted short cord at delivery' but did not take a measurement.

Jessica
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