The most recent was my godmother's story--she had the fetal monitor around her belly, every time she'd have a contraction his heartbeat would "stop", so the doc cut her a full episiotomy, reached in and pulled the baby out. This was all due to the cord being tightly wrapped around his neck and cutting off oxygen. Apparently had the doctor not intervened and cut and pulled the babe out, he would've been stillborn. This is what my godmother was told and what she believes 30y later.
The story before that was that the momma was laboring for about 60-70 minutes. The fetal monitor showed that the heart rate dropped during contractions. Mom received an emergency cesarean, and the babe was born "with the cord tightly around his neck". This was "a close call" and if they hadn't had a cesarean, I am told the babe would have died. FWIW this mom had a very "medical" OB attending her.
Can we talk about this?
It's my understanding that the cord is around the neck in 1/4 or 1/5 births. Can the cord around the neck really cut of oxygen and cause stillbirth? Would the babe be born, cord unwrapped, and isn't it still receiving oxygen from the placenta even if the cord is wrapped?
What about the heart tones slowing or "stopping"? Is this caused by the nuchal cord? Even if the heart rate slows during ctx, could that birth work out ok w/out interventions?
Without the fetal monitor, would these births have simply progressed naturally with the babies pinking up after birth? Or would they really have been stillborn because the cord was too tight? At that point, isn't birth pretty much imminent?
I hated the fetal monitor and only let them put it on my for a minute, and I don't want one in this next birth I'm preparing for either.
I'd like to understand what's really going on here and dispel the "horror cord" myth. Can you all help me out, here?
Mama to Umberto 12, Camille, 9, Piper 7, Rowena 2, and Jude Therese Prenatal DS diagnosis due December 23.
I do know someone whose baby was stillborn because of a cord around his neck-- but I think (I'm fuzzy on the details) that the baby died before labor. In any case, the baby was delivered in a hospital, and that didn't make a difference for him.
The vast majority of babies who have nuchal cords are just fine.
Especially with the births that happened so many years ago, I would question the quality of the EFM.
So thankful for our healthy baby boy, born Easter morning, 2010!
both of my children had the cord around their neck, ds also had a true knot.
one reason it's so common because as the baby is descending into the birth canal, often he/she will go through a "loop" of cord and by the time baby is out it's been caught around their neck.
it's typically a non-emergent occurrence, and as the research bears out, the more monitoring/interventions, the more likely that something happening during labor/birth that is non-emergent will *become* emergent directly due to interference.
and i agree with MPP: i would be wary of any results from efm that was going on 30 years ago.
eta: the very nature and construction of umbilical cords make them nearly impervious to *most* compression during labor/birth. they are designed to withstand intervals of great pressure, while still delivering oxygen to baby. all babies will experience heart tone variation during labor. it is completely normal for the heart rate to slow some during a contraction, and then pick up again when the ctx ends. mama is working hard, but so is baby. it's not like baby is just chillin' and hangin' out. baby puts out energy and physical force to make birth happen.
what makes a difference is the rate of decel and recovery: how baby is handling ctx's.
A true Knot might reduce blood flow thus oxygen rich blood, to the baby.
Because the blood flow is changed via cord compression, any cord compression is going to show up via EFM, especially continuous EFM. The key is to understand that when cord compression from a cord around the neck is likely to be most severe is when birth is imminent because the cord is being stretched to the maximum. In the case of the massive episiotomy and vacuum extraction, it sounds like birth was pretty close anyway and someone who trusted the mother's ability to birth a baby could have encouraged her to push with everything she has and get the baby out just as quickly, with less tissue trauma. In the case of c-sections for cord compression, I find that they are often the result of a fetal distress call made because baby isn't tolerating contractions well, is having deep, late decels and isn't recovering quickly after a contraction. That is considered a non reassuring FHT, and I guess in those cases the only logical choice is a c-section, although I always wonder...if we weren't obsessively listening to those babies, how many would be born vaginally and recover just fine? It's a purely hypothetical question, of course, because no one is going to see a non-reassuring FHT and say, "well, let's just wait and see what effect this is really going to have on the baby."
There are cases where the cord compression could be severe enough to stop blood flow through the cord altogether (which is what happens when a baby dies in utero due to a "cord accident"), but those cases are rare and every study of EFM ever done says that the only thing continuous EFM does is increase the rate of surgical delivery, NOT decrease the rate of fetal demise.
The most recent was my godmother's story--she had the fetal monitor around her belly, every time she'd have a contraction his heartbeat would "stop",
Frankly I don't believe this. Although I'm prepared to believe that this is what she was *told*. It takes a serious insult for anyone's heart to stop beating and, when it does, it requires some considerable effort to get it started again.
What is more likely is that contact was lost between the monitor and the foetal heart during contractions. This is a very common problem with EFM.
It is also fairly common for the heartrate to drop during contractions. This is due to the pressure on the babe's head and is called an early deceleration. It is a normal response and not a sign foetal distress.
A quick review of the literature seems to suggest that a nuchal cord may be responsible for foetal death during labour in some circumstances. However those circumstances - cord wrapped multiple times tightly around neck and/or an unusually short cord which is pulled tighter than a cord of average length would be - are very rare.
Mother of two spectacular girls, born mid-2010 and late 2012
Appalachian mountain woman, radical homemaker, homeschooler, childbirth educator, and doula loving her DH and three powerful little femmes. Deladis 8-4-05, Ivy 4-28-08, and Gweneth 7-21-12 HBA2C! -
She's 2.5 and totally fine.
This is nature's way of preventing the cord from falling out when the doctor decides to prematurely rupture the membranes.
As for decels in the baby's heart tones, the baby is gently getting ready to live outside the womb and will have some stress as the birthing process takes place, but the baby needs to be ready to breathe.
There's a large number of babies whose moms don't even know they had the cord around the neck because the dr just loops it over the head as the baby delivers. Most of the time it's no big deal.
Doula mama, medic daddy and Tenley Harper born naturally 11/29/11
Charmie981, thank you for your very thorough explanation.
I'm understanding this subject a lot better now and am feeling much reassured about "cord horror" lol.
|I'm understanding this subject a lot better now and am feeling much reassured about "cord horror" lol.|
|Umbilical cord accidents are the stuff of which nightmares are made. Occurring in otherwise textbook pregnancies, they result in the deaths of one in every thousand babies. The mortality rate is noteworthy enough -- twice as many babies die from cord accidents as from SIDS -- but it only tells part of the story. Another three in every thousand babies are left severely disabled as a result of cord accidents.|
It did prevent him from descending or moving and he had major meconium aspiration, so she did have a c-section, and then he was in the NICU for 2 weeks recovering. But he is fine today!
every study of EFM ever done says that the only thing continuous EFM does is increase the rate of surgical delivery, NOT decrease the rate of fetal demise.
I think that's important to note!
My daughter had her cord wrapped around her neck once and again around her shoulder. The midwife was monitoring her heartrate during pushing contractions intermittently, and noticed some decels. She had me roll onto my side (from my back), and DD's heartrate evened out.
His HR recovered, so the MW said I could get back on my hands & knees (side-lying was more painful AND felt less productive), but when his HR dropped again, she said, "Meg, you may like that position, but baby doesn't."
Cord was wrapped 2X around his neck & once his head was born, MW unwrapped it. With the next push, I birthed his body & DH caught him.
He was fine - great shape after about 45 min total of pushing.
I would just encourage you to not doubt all of the stories you hear because, first, you weren't there and aren't a medical expert so you can't be sure, and second, because I'm sure there are plenty of cases where it does save a life versus the cases where it may have been an unnecessary intervention. Give that mother the benefit of the doubt - she doesn't need her birth second guessed because the listener believes they know more about birth than the care providers she trusted.
|However, that mother should give the original poster the benefit of not fear-mongering! Telling horror stories & scaring Mamas away from home birth isn't right.|
No one should fear monger and having had three children I've heard plenty of horrible birth stories while pregnant and have one of my own. I do not share it with pregnant women IRL - I hardly share it at all, who wants to hear about babies dying? I do feel my son had a small chance because he was born in a hospital with a NICU team readily available. If I had given birth at home he would have had no chance (he needed immediate blood transfusions, he lost most of his in a matter of heartbeats due to a cord rupture).
Women need information to make informed decisions. Women need to know that good and bad outcomes happen no matter where you give birth. Women need to be free to make decisions that they will be able to live with no matter the outcomes of those decisions.
I agree that mom's shouldn't try to scare pregnant moms towards any decision (there are plenty homebirthers that make every single hospital and hospital birth seem awful - it goes both ways). Learning to offer support without judgment would be utopian - it has to start somewhere so why not with us?
And, as every pregnant woman quickly learns, you can listen to those stories or not, you can choose to surround yourself with people who won't try and scare you either direction but support your pregnancy journey no matter what decision you make.
My daughter was stillborn last April due to the cord around her neck (5 times) and a true knot. She was delivered in a hospital and had been dead for at least a day or two before I went into labor. I honestly had no idea until the hospital was unable to find her heartbeat with the monitors. Had she been born at home it would have made no difference as she was already deceased before labor even began. So while a little different than your situation, my point is that YES babies can be stillborn becasue of "cord accidents" BUT it can happen just as easily in a hospital. For me, it wasn't labor that killed her.
FWIW, I was told that cords around the neck 1, 2 or even 3 times is fairly common and generally not a big deal.
Congrats on your pregnancy and Good Luck on your delivery...everyone has a horror story about everything...don't let em get to you! Do what YOU feel is best for you and your babe
I'm sorry for your loss. And you're right - it DOES happen, so we should "Give the mother the benefit of the doubt" & not doubt her story. However, that mother should give the original poster the benefit of not fear-mongering! Telling horror stories & scaring Mamas away from home birth isn't right.
SAHM to two boys and a baby girl born at home on Valentines Day
First dd was wrapped 3 times, she was perfectly fine at birth.
Ds was wrapped twice with an incredibly short cord, my m/w did cut his cord as he crowned because of the shortness and tight wrap he was not going to come easlily. His first moments were tense for all of us but it was nothing my m/w couldnt' handle and he was safe, thank God.
DD was a requested induction on my part following decreased fetal movement and very very low fluid (after req. u/s nst and bpp found these to be true just as I sensed). Her cord was incredibly long and her body was wrapped so tightly that even though she was engaged she had stoppped moving. WE have pictures immed following birth where her vernix is clumped/lined in spots where her cord lay so tightly against her body. She had 2 true knots, pulled tightly, one under an arm, 1 between her legs, around her neck 3 times, and around her body like spider girl. My m/w was amazed with her birth, the cord was the longest she's ever seen and couldn't believe it. She had no decels during labor or birth as I was on the ext monitor becasue of a nagging fear and worry I had about her cord throughout her pg. I thank God everyday she is here safe and sound, but at no time during her labor and birth did she decel or stress. My m/w did somersault her out because it was clear she had a nuchal cord. Thta said, had my mw even given me 'the look' I would have been in a c/s before she could even suggest it at that point, I went in there with a feeling her birth would be very diffrerent, and very alert to that.
I'm sorry the people in your life feel its appropriate to scare you when you are preparing for the birth of your baby . The most impt undertaking is your confidence in your mw and peace with your decision, your instinctual feelings. A hb mw, like other pps have said, will know how to handle what arises.
Congrats on your impending birth!
Cheshire and Mom to E & A ~ I am so sorry for the loss of your Babies, I cannot imagine the pain and heaviness of heart their loss brings.
I know things with my dd2 (and even the others) could have ended very differently, I take nothing for granted.
I was allowed to try and birth naturally, right up until the *hit hit the fan. It was understood that, above all, i wanted to birth this child naturally. Yet, in the end, i am so thankful for my live child.
Even though I'm an extremley alternative parent and person, if I had another baby I would have it at the hospital for this very reason. My childs life isn't anything to take chances with.
|I was allowed to try and birth naturally, right up until the *hit hit the fan.|
|Even though I'm an extremley alternative parent and person, if I had another baby I would have it at the hospital for this very reason. My childs life isn't anything to take chances with.|
Lisa, lucky mama of Kelly (3/93) , Emma (5/03) , Evan (7/05) , & Jenna (6/09)
Loving my amazing dh, James & forever missing Aaron Ambrose (11/07)
Well, I wouldn't believe it, because if true cord emergencies were as common as OBs and their patients make them out to be, the human race would have been extinct a long time ago.
That doesn't mean that people can't homebirth if they want to, because as it's been said, babies can and do die in the hospital. There are no guarantees, but a modern hospital or a skilled midwife today is probably more adept at handling those emergencies compared to previous centuries.
It is not universal hospitalization that saves women in childbirth today; it is antibiotics for infections and blood transfusions for excessive bleeding, neither of which needs to be in a hospital.
In the 1940s-70s, women would be recuperating in a hospital for a week after the birth. Today, most women are shown the door after three days.