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Originally Posted by jazzybaby9  Thing is, with all the females in my family who have given birth all had babies with the umbilical cord wrapped around the neck and doctors had to twist the babies around so they wouldn't be strangled...it's happened around 5 times in my family...my aunts, my mother, my cousins.....
So that's what I'm really worried about.......
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A nuchal cord (or more than one!) is very, very common, and contrary to popular belief, is
almost never a "complication". (The only real risk - and this can happen with or without the cord being around the neck - is cord prolapse, or compression of the cord that stops blood flow. But that is detectable via intermittently monitoring the fetal heart rate, which midwives are entirely capable of doing. It's also VERY rare!)
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Originally Posted by Vicitoria I had a birth center birth with midwives. My son was born with the chord arond his neck. His first apgar wasn't great but the second was. They cut the chord right away (obviously) and gave me a shot of pitocin to deliver the plecenta faster to make sure everything was OK with it. They had oxygen standing by but it wasn't necessary. Midwives can do the same thing a doctor would in that case. And, since you didn't have the baby in the hospital, the baby will stay with you. I'd imagine, in the hospital they would take the baby for observation just because even if all was well with the second apgar.
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Cutting the cord early is usually unnecessary even with a nuchal cord, and will increase the risk of a low first Apgar score. Babies count on and deserve the continued blood flow (and oxygenation!) that comes with an intact cord!
Looking seriously at all the major complications - the biggest, scariest is probably postpartum hemorrhage. First, it's LESS likely to happen at home than in the hospital! (Pitocin, epidurals, forced pushing, IVs and stress all increase the risk of PPH, as will early cutting of the cord and all the standard interference with early motherbaby contact and breastfeeding that hospitals are famous for.) Second, most midwives have a huge bag of tricks for dealing with PPH, from monitoring and supporting your health and nutrition during pregnancy (and there are conditions that place one in a higher risk for PPH - midwives screen for those prenatally, and either refer you to another practitioner or help you treat those conditions and lower your risk) to encouraging a physiological second and third stage to visualization (remarkably effective!), herbs, and usually Pitocin or methergine should a PPH problem actually arise. Some midwives carry IVs also, and most know how to perform bimanual compression in case of a real blood loss emergency (not only very,
very rare, but again, something that is more likely to happen in a hospital), at which point paramedics would also be called.
So in a hospital, how would this situation be handled differently? It would be more likely to not be prevented (very little attention paid to nutrition and wellbeing prenatally), it would be more likely to be caused (higher risk of labor induction or augmentation with Pitocin, less chance of a physiologic second and third stage), they would have FEWER tools in their toolkit (visualization, herbs, and baby skin-to-skin and at the breast aren't usually considered in the hospital as PPH prevention or treatment), but they would have blood available, which very, very few cases of PPH (which itself is very, very rare) actually need.
This is just one example of the types of complication of labor and birth, and how midwifery care and hospital care differ in their approach. There surely are very real complications of labor and birth - your best bet, if you are worried about them, is education! You will learn that (as with a cord around the neck) they aren't actually problems at all, or (as with PPH) they are complications well predicted, prevented, and treated at home.
No big deal. Really.
The doctors made it seem like a huge deal. Thank you for clearing that up!
Otherwise we'd all know how overpaid and full of themselves they are.... 
Arwyn, your answer rocks!
Shoulder dystocia is another of the Big Scaries, but again, it's something less likely to happen at home, and midwives are more capable of dealing with it.
