Cord Wrapped Around Neck? Just Curious - Mothering Forums

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#1 of 22 Old 01-26-2009, 10:35 PM - Thread Starter
 
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Hey, I'm curious, because well, I don't really know why I've been thinking about this a lot lately. I'm not pregnant right now or anything, but I was wondering what you usually/would do. (to birth profesionals)

In my family, it seems like the umbilical cord being wrapped around babies neck runs in the family. Lots of cesarians because of it. Me, my cousin.... my other cousin apparently has cerebral palsy from lack of oxygen because of the cord? Anyways, I was wondering, how do you know when the cord is wrapped around the babies neck? What do you do? particularly in homebirths? Is there an option besides c-section? I want to be a midwife someday, so I suppose I'll learn this at some point, but I'm curious now, lol. thanks.

Caroline, partner to J, post partum doula, kitchen manager, aspiring midwife, soon to be nursing student, mama to my furbaby, someday a mama to not so furry munchkins, G-d willing
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#2 of 22 Old 01-26-2009, 11:21 PM
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The cord is around the neck in about 25% of births, usually there is no issue.
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#3 of 22 Old 01-27-2009, 12:00 AM
 
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Not a professional.

Dd's cord was around her neck twice and shoulder once.

Ds's cord was around his neck 5 times.

Both were normal, healthy, vaginal births at home.

-Angela
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#4 of 22 Old 01-27-2009, 12:50 AM
 
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I've read that about 30% of all babies are born with cord around the neck. Someone on here has suggested (maybe pamamidwife) that a nuchal cord is helpful in preventing cord prolapse, which can be a real emergency.

As for me, I've had four kids, one with a cord around the neck, so that's 25%. She was my home waterbirth. The midwife unwrapped her cord after she was born. I didn't even notice.

I just looked this up about a nuchal cord causing CP, and I couldn't find a correlation. It specifically says
Quote:
In other words, the chances of a child developing CP were nearly the same whether the child was born with a cord wrapped around her neck or not.

treehugger.gif Erika
mom of twins.gif (8)  blahblah.gif(5) thumbsuck.gif (3) and baby.gif born at home on Christmas day! 
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#5 of 22 Old 01-27-2009, 02:22 AM
 
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I have read from 25% to 30%, from what I have seen personally, It is much higher than that. Most people are not even aware of it. It is unwrapped as the baby is born, most obs unwrap it immediatly after the head emerges, that isnt usually even needed, as in many cases it can just be manuvered around as the rest of the body is delivered.

Usually if there is going to be a problem it is due to an unusually short cord that makes it difficult for baby to fully decend without it being moved. I havnt actually seen this myself, but it happens occationally i guess.

I would not make that oneof the things I worried about during pregnancy. And I can not see a link that would cause it to be hereditary in anyway. If you think about the physical properties of it, baby moves and flips all around in the womb, Im surprised all babies arent born with the cord around one part of the baby or another.
The baby is not being strangled by it as many think, as long as it isnt getting completely pnched off the blood is still flowing providing the oxegen needed.

Lisa~Was Aspiring Midwife~Now-AAMI Midwifery Student #2020~Mama to Zackery 3/29/96, Drake 9/22/01, and Selina 10/26/03...and here was the link to my new blog
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#6 of 22 Old 01-27-2009, 03:48 AM - Thread Starter
 
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thank you so much. that was what I had the feeling, was that there really wasn't this huge pressing need to have a c-section because the cord was wrapped around the neck. Of course, we were all ~2 weeks late, and I'm learning that a lot of hpc, particularly obs won't let pregnancy go beyond that either.

Caroline, partner to J, post partum doula, kitchen manager, aspiring midwife, soon to be nursing student, mama to my furbaby, someday a mama to not so furry munchkins, G-d willing
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#7 of 22 Old 01-27-2009, 04:34 AM
 
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Originally Posted by Magelet View Post
thank you so much. that was what I had the feeling, was that there really wasn't this huge pressing need to have a c-section because the cord was wrapped around the neck. Of course, we were all ~2 weeks late, and I'm learning that a lot of hpc, particularly obs won't let pregnancy go beyond that either.
Definantly not reason for a c/s. The only way to know before birth would be to do an ultra-sound on every pregnant woman when she goes into labor and really look for that cord. Not one bit logical, otherwise you're not even going to know until birth has happened--too late for a section then

Lisa~Was Aspiring Midwife~Now-AAMI Midwifery Student #2020~Mama to Zackery 3/29/96, Drake 9/22/01, and Selina 10/26/03...and here was the link to my new blog
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#8 of 22 Old 01-27-2009, 08:16 AM
 
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ITA w/Mamato3cherubs

that ol 'had to have a csec because of cord' thing is SO silly IMO. I firmly believe that in at least 99% of cases where a doc says that to a mom, it has absolutely NO basis in reality. I even doubt that the remaining 1% has much merit...tho it's possible. To me, mainly it's a ready-made excuse for the doc who doesn't really know why he's doing a csec (other than personal convenience or a basic lack of understanding about what is 'normal birth', that is). When he extracts the baby and sees a nuchal cord, voila! instant csec excuse! And people tend to buy it, having little knowlege on the subject.
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#9 of 22 Old 01-27-2009, 11:51 AM
 
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Originally Posted by Magelet View Post
thank you so much. that was what I had the feeling, was that there really wasn't this huge pressing need to have a c-section because the cord was wrapped around the neck. Of course, we were all ~2 weeks late, and I'm learning that a lot of hpc, particularly obs won't let pregnancy go beyond that either.
Going 2 weeks past your due date is not a reason for a c-section either or induction for that matter. I see a lot of babies go one or two weeks past their due date. If you have a family history of babies being born late then that should not be a concern either, the women in your family just cook their babies longer. As far as OB's not "letting" a woman go that far past her due date, an OB they can not force you to do anything. Don't show up for a scheduled induction or c-section, show up at the hospital in labor. And if you want to avoid all of that stress please get a midwife and just stay at home.

Lisa
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#10 of 22 Old 01-27-2009, 11:59 AM
 
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Originally Posted by Magelet View Post
Of course, we were all ~2 weeks late, and I'm learning that a lot of hpc, particularly obs won't let pregnancy go beyond that either.
Good reason to choose a midwife

Ds (mr. cord 5 times) was 43 weeks 5 days.

-Angela
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#11 of 22 Old 01-27-2009, 04:03 PM
 
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This has some good information about umbilical cords

Midwifery Student and Mama to 2 daughters and 3 sons.     
ribboncesarean.gif vbac.gifhomebirth.jpg I have given birth a variety of ways and I am thankful for what each one has taught me.

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#12 of 22 Old 01-28-2009, 04:45 AM - Thread Starter
 
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When the time comes, I most certainly will find a way to afford having a midwife, and do a homebirth unless I absolutely must transfer to the hospital. And I'll definitely try to find one whos willing to help me try to take my pregnancy post-term if that's the way its going. I'm aspiring to become a midwife myself some day. I was just curious at the moment, since it seemed to me that there had to be some other solution rather than c-section, and it just didn't seem like it was quite right.

Caroline, partner to J, post partum doula, kitchen manager, aspiring midwife, soon to be nursing student, mama to my furbaby, someday a mama to not so furry munchkins, G-d willing
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#13 of 22 Old 01-28-2009, 05:58 PM
 
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Its good to ask these questions now. I had a recent homebirth, head came out, MW told me to pant, cord TIGHT around neck, had to be cut before I could birth the rest of baby (turns our this baby had what seemed to be even shorter cord than DD). No big deal, and I was glad that I had knowledge about cords being around the neck, that it, in most cases in not only NOT an emergency, but something easily handled. I looked down, saw her clamping, and said, oh ok, I know what she's doing, felt no fear. But the mainstream media, and the stories that women tell, create a lot of fear around it. So, good for your for asking, and when your time comes, if the cord is around the neck you can know the truth about it!

mom to Reaghan born underwater into midwife's hands 1/17/07 & Myra born surrounded by doulas and midwife at home 1/12/09. Birth Educator, and Photographer, Baby #3 Coming May 2013!

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#14 of 22 Old 01-28-2009, 06:08 PM
 
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Originally Posted by Magelet View Post
When the time comes, I most certainly will find a way to afford having a midwife, and do a homebirth unless I absolutely must transfer to the hospital.
Well, even if you can't afford or find a HB MW, you can still have a MW for a hospital birth. No matter who your health care provider (MW, OB, family practioner, etc.) Just make sure they are friendly to natural birth, understand what it's all about, practice evidence-based care & intervene only when the benefits of intervention outwight risks. But you know the drill!!

DS' cord was around his neck 2X. Actually, his HR was dropping as I pushed to the 70's/ 80's, but my MW just had me lay down on my left side (I had been on hands & knees) & they gave me oxygen. Once his head was out, MW unwrapped the cord, then with the next push, his body was out & DH was able to catch him & put him on my chest. He was fine.
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#15 of 22 Old 01-29-2009, 02:56 PM
 
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IMO, the cord should never be clamped while the head is on the perineum, because you are cutting off the baby's oxygen source, and while *most* babies will be born with seconds or so, you can never know ahead of time which ones will end up stuck and need help being born. I have heard from very experienced midwives that even with the tightest cord around the neck, the baby can still be somersaulted out with the next contx by holding the baby's head close to the mother's thigh.

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#16 of 22 Old 01-29-2009, 04:15 PM
 
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IMO, the cord should never be clamped while the head is on the perineum, because you are cutting off the baby's oxygen source, and while *most* babies will be born with seconds or so, you can never know ahead of time which ones will end up stuck and need help being born. I have heard from very experienced midwives that even with the tightest cord around the neck, the baby can still be somersaulted out with the next contx by holding the baby's head close to the mother's thigh.
Somersaulting works amazingly well. I have gotten the opportunity to do it with some pretty tight cords that took what seemed like forever to unloop after the baby was born. There wouldn't have been enough cord for the baby to come straight out, but tucking the head to the thigh allowed the baby's body to tumble out while the head and neck stayed in the same location and didn't put anymore stress on the cord.

My fear with cutting the cord on the perineum is that what if you swear it is the cord that is holding that baby up, you cut it, only to discover the cord had nothing to do with it and now you have a stuck baby with no oxygen.

Erika, mama to three beautiful kids (plus one gestating), and wife to one fantastic man.

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#17 of 22 Old 01-30-2009, 11:23 PM
 
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I'm not sure why my MW made the choice she did, perhaps she knew my daughter was about to fly out the moment I gave the nxt push. Her cord was the shortest she'd seen. and there wasnt much to negotiate with in extra length, but all is well.

mom to Reaghan born underwater into midwife's hands 1/17/07 & Myra born surrounded by doulas and midwife at home 1/12/09. Birth Educator, and Photographer, Baby #3 Coming May 2013!

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#18 of 22 Old 02-02-2009, 03:40 AM
 
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From AJOG (American Journal of Obstetrics & Gynecology)

CONCLUSIONS: Nuchal cord loops and tight cord do not cause significant peripartum morbidity.

http://pt.wkhealth.com/pt/re/ajog/us...195629!8091!-1


From Perinatal Journal:

Conclusion: There is no significant correlation between nuchal cord entanglement and adverse perinatal outcomes.

http://www.perinatology.org.tr/journ...ext/txt_05.asp


From NEJM (New England Journal of Medicine)

CONCLUSION: Nuchal cords do not influence clinical management at delivery, and neonatal primary adaption is not impaired.

http://content.nejm.org/cgi/medline/...urcetype=HWCIT


From AIUM (American Institute of Ultrasound in Medicine):

Conclusions. A sonographically detected nuchal cord is not associated with important perinatal complications.

http://www.jultrasoundmed.org/cgi/co...stract/23/1/43


another study:

CONCLUSION: Nuchal cord is not associated with adverse perinatal outcome.

http://www.ncbi.nlm.nih.gov/pubmed/18604054


and yet another study with the same conclusion as above:

CONCLUSIONS: Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary.

http://www.ncbi.nlm.nih.gov/pubmed/16374604
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#19 of 22 Old 02-03-2009, 01:28 AM
 
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Originally Posted by Magelet View Post
thank you so much. that was what I had the feeling, was that there really wasn't this huge pressing need to have a c-section because the cord was wrapped around the neck. Of course, we were all ~2 weeks late, and I'm learning that a lot of hpc, particularly obs won't let pregnancy go beyond that either.
A u/s tech told me once that it's not possible to tell if a cord is wrapped around the baby unless it's wrapped many many times, because you can't see the back of the baby to know where it is. So they can tell that the cord is crossing the front of baby's chest, say, but they can't tell where it goes once it gets behind the baby. So even a late u/s is not useful information in terms of delivery decisions based on cord positioning.
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#20 of 22 Old 04-14-2009, 06:35 PM
 
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We figured it out via ultrasound...I'm 10 days late and she doesn't seem to keep her head in my pelvis, and so the ultrasound, which confirmed everything else, amnio is good, HR is good etc. She does have a cord around her neck.

Now the concern is if it is 'tight' enough to get restricted when she actually gets pushed into the birthing canal...if she'll get the oxygen supply she needs.

My midwife isn't too concerned yet, just wants to closely monitor everything once labor does begin.

I blog about all I say here and more at KristinBennett.com. Mom of Kenzie 9/2005, Hazel 4/2009, and Baby (?) EDD 6/2011.
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#21 of 22 Old 04-14-2009, 08:33 PM
 
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Anyways, I was wondering, how do you know when the cord is wrapped around the babies neck? What do you do? particularly in homebirths? Is there an option besides c-section? I want to be a midwife someday, so I suppose I'll learn this at some point, but I'm curious now, lol. thanks.[/QUOTE]



I want to help you understand how to "know" if the cord is a problem around the neck. When you go to your prenatal, have your midwife listen to the baby with either a doppler, or you could use the fetascope. Either one is just fine. For the ease of this conversation, I will say doppler, but again, you can use either. While she/he is using the doppler, take the bottom of the baby, which should be up in the fundus, and push the bottom toward the head. If there is a problem with the cord that might hinder the decent of the baby, you will hear a marked decrease in the baby's heart rate.

If you are a mom who has had babies before, many times when the 2nd stage is quick, a cord around the neck will not be a pblm, d/t the fact that the 2nd stage is short. But, if you have a long 2nd stage, this could present as a lowered heart rate pattern, which might necessitate immediate transfer to hospital for further evaluation.

yalad
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#22 of 22 Old 04-14-2009, 09:56 PM - Thread Starter
 
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hmmm. interesting. thanks yalad.

Caroline, partner to J, post partum doula, kitchen manager, aspiring midwife, soon to be nursing student, mama to my furbaby, someday a mama to not so furry munchkins, G-d willing
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