"heart rate dropping from cord around neck" - Mothering Forums
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#1 of 12 Old 10-12-2008, 06:32 PM - Thread Starter
 
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Um, I don't understand this. Someone on another board said that she labored at home for 5 hours, then went to the hospital and had an emergency c-section b/c the baby's heart rate dropped "because the cord was wrapped around it's neck".

How would this cause the heartrate to drop? The baby isn't breathing through it's mouth in the womb. Is this just misinformation? Seems like having the cord around the neck/body is a relatively safe thing, to prevent cord prolapse?

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#2 of 12 Old 10-12-2008, 06:59 PM
 
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Right before delivery, when the baby's head is near delivery, if the cord is wrapped around the neck, it's in the narrow birth canal. Contractions constrict that area, and squish the cord, making all the life-bringing supplies that flow through it stop through the contraction. So, it's not that the baby's windpipe is being constricted, but the cord itself. I had that, but was able to deliver dd in 3 contractions so it wasn't a problem requiring a c-section.

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#3 of 12 Old 10-12-2008, 08:08 PM
 
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yeah, oxygen is brought to the baby via the cord, and if the cord is kinked or wrapped so tightly that it's constricted, the baby can't get enough oxygen and hence the heartrate drops. i have to admit, i have a small fear that this could happen during my homebirth because i hear of it happening so often. in some birth videos i've seen, the cord is all twisted up when the baby is born, and i know the cord is extremely tough, but it still makes me wonder why it is relatively common for the cord to become kinked.
oh well, good thoughts, good affirmations....
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#4 of 12 Old 10-12-2008, 08:09 PM
 
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what goldfinches said is basically true...except that a cord wrapped around the neck is not getting nearly as constricted as you might think because the head and chest, both larger than the neck, are taking the greatest amt of pressure in the birth canal. Now, if it were wrapped a few times so that there was little or no slack left in it, and the cord was getting pulled really tight during pushing, that could cause some circulation/oxygenation issues. Having the cord around the neck is fairly common--but true problems from it are very unusual.

I have heard so many of these stories "good thing I got a csec because the cord was around the baby's neck!"--and I'd have to say that most often this is just pure malarkey spouted by docs to cover up unnecessary csecs. It is also pretty common for babies' heartrates to drop some during later labor as baby is descending. This is another malarkey factor I hear about a lot--but as long as HR doesn't drop below 100 for too long, and continues to recover between contrax, it is just rarely a problem.
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#5 of 12 Old 10-12-2008, 08:56 PM - Thread Starter
 
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Quote:
Originally Posted by MsBlack View Post
what goldfinches said is basically true...except that a cord wrapped around the neck is not getting nearly as constricted as you might think because the head and chest, both larger than the neck, are taking the greatest amt of pressure in the birth canal. Now, if it were wrapped a few times so that there was little or no slack left in it, and the cord was getting pulled really tight during pushing, that could cause some circulation/oxygenation issues. Having the cord around the neck is fairly common--but true problems from it are very unusual.

I have heard so many of these stories "good thing I got a csec because the cord was around the baby's neck!"--and I'd have to say that most often this is just pure malarkey spouted by docs to cover up unnecessary csecs. It is also pretty common for babies' heartrates to drop some during later labor as baby is descending. This is another malarkey factor I hear about a lot--but as long as HR doesn't drop below 100 for too long, and continues to recover between contrax, it is just rarely a problem.
Your whole post makes very good sense... it's sort of my feelings on it, but I didn't have much for affirmations.

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#6 of 12 Old 10-12-2008, 09:02 PM
 
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This happened with me. My ds had the cord wrapped 4 times (a hospital record) and couldn't even descend all the way so the contractions caused the cord to tighten and thus ds's heart rate to drop and i had to have an emergency c-section too. It all depends on how the cord is wrapped and how tightly. nonetheless oxygen deprivation is a serious matter to keep in mind.
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#7 of 12 Old 10-13-2008, 11:12 AM
 
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ds 2 had the cord wrapped around his neck. His HR kept dropping but none of the LDR nurses seemed to be concerned. When my CNM was done with work at her office for the day and came up to see how the labor was progressing she decided that it was time to get things moving bc she said the cord was wrapped around his neck. After I delivered him he was fine, but they took him to the NICU just in case.

That was one of my concerns with this homebirth and I have brought it up to my midwife. SHe said it is quite common and she knows how to handle it. I still worry though, especially after reading this post.

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#8 of 12 Old 10-13-2008, 02:35 PM
 
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It is estimated that about 1/3 of all babies have cord around the neck. It is very rarely a problem though. A short cord in addition to it being around the neck can be one of the problems. We have only had a transport that ended in a C-section for this once. The baby had the cord wrapped around the neck, again around the shoulders, once under the arm, and around the abdomen. Besides dips in heart tones, the baby never descended far enough and she was dilated to 8 for many hours.

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#9 of 12 Old 10-13-2008, 02:50 PM
 
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My DD's cord was wrapped 3 times. Her heart rate did drop significantly at one point, but I changed positions (to my hands and knees) and she was fine after that.
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#10 of 12 Old 10-13-2008, 11:48 PM
 
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My baby brother died three days after an emergency c-section that wasn't done quickly enough. He had severe cord compression, wrapped around his entire body (he was breech, turned to vertex before labor) and he could not descend. Cord compression can be a very serious thing and sometimes you can't tell how serious until it's over.
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#11 of 12 Old 10-14-2008, 04:01 PM
 
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ds must be destined for good fashion sense bc he wore his cord like a feather boa, several times around his neck and then down and around one leg. his cord might have been a problem if it had been shorter and cord complications can cause serious risk, but for the most part, babies often have their cords wrapped around them one or more times and have no ill effect. ds didn't like it when i was on my left side during labor, but with good monitoring (handheld doppler not those awful c/s inducing straps and their terrible machine) he responded well to labor and had no problems during delivery. of course at home i was doing self directed pushing and he waited a long time after full dialation to actually drop so that when he finally did it was a very fast, easy birth. the medical model of care definitely complicates often harmless situations.

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#12 of 12 Old 10-15-2008, 10:23 AM
 
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Like pp said, having the cord wrapped around the head is pretty normal, and it's relatively rare for it to cause a problem. The mws here say they see more like 40% of babies having the cord around their necks.

With DS, we think that the cord may have kept him posterior...but it wasn't very short. He did have it wrapped 2x around his neck relatively tightly. But, he never had any indication of it in his heartbeat, though he was born in the caul, and perhaps that gave him some cushioning.

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