Cord around the neck? - Page 2 - Mothering Forums

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#31 of 51 Old 03-24-2006, 03:03 PM
 
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Originally Posted by MagentaMom
Oddly enough though she LOVES having things around her neck. I'm always having to watch that she isn't going to choke herself.
My oldest is that way, triple looped around his neck, vaginal birth, two weeks under observation.

Now at age nine, he loves to wrap stuff around his neck. Scarves, stuffed snakes, sweatshirts, you name it will try to wrap it around his neck. He does it when he is stressed out or trying to sleep.
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#32 of 51 Old 03-24-2006, 03:16 PM
 
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Originally Posted by Quagmire
We are planning a water birth so this interested me. Is this because (similar to Angela's comment above) the water provides natural cushioning for the baby and cord to move around freely? Does that mean a water birth can be safer where cords are concerned?
With a water birth, if the baby crowned, but didn't arrive in a contraction or two, the midwife would just dive in and look for a cause. I've seen a mom have to get out of the tub because the delivery was complicated. That's worst-case, as getting out with a baby head between your legs is not fun. In a water birth, the baby gets first chance to resolve the cord and be born through it.

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#33 of 51 Old 03-24-2006, 03:20 PM
 
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Ds cord was around his neck then down around his shoulder and across his abdomen. When I pushed him out my MW looked as though she was unwrapping a ball of yarn she caught him and stated "It's.....a.....Boy" As she finally unwrapped our sweet package. He didn't even show any signs of a problem. Why? Because there wasn't one.
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#34 of 51 Old 03-24-2006, 03:36 PM
 
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not having a doctor present was the only thing I believe that saved my son.
He was born cord 3 times, and a good lenght of the cord came cord first. Because the nurse delievered and there were no interventions and a very short labour (no breaking the waters, no drugs, no pitocin) the bag of waters didn't break until I actually delivered (like push 2-3 out of 4 total)

He was born with piticeal (sp) hemoraging on his face, blood shot eyes.
But if the doctor had broken my water (which in the last 2 deliveries they were always gung ho to do quite early on to speed things up) I have no doubt in my mind that my baby would have gone into severe distress with the pressure on the cord, that because it was before his head, and wrapped.....

basically I can't think about it it makes me very afraid and I don't think I'd ever go into the hospital again without a midwife period. I realised that those convience things (drugs, pitocin, epidural, breaking the water) could have cost my ds some brain cells....and even with an emergency section those still take a few minutes to set up and the doctor was in another section (an emergency..) my ds's brain couldn't have waited any longer.

The nurse was very skilled, and tried to get me to not push too hard, got her hands right in there, clamped, cut, unwrapped as best she could and was kind enough not to tell me (*although I could feel the cord I didn't even ask dh about the experience until the next day)

8 might be enough
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#35 of 51 Old 03-24-2006, 07:10 PM
 
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My SIL just had a baby 3 days ago. The cord was wrapped around his neck and everytime she pushed, his heartrate went waaaay down and soon started going into fetal distress and his heartbeat wasn't coming back up. She refused a c-section and they are saying the baby is "traumatized." He's got a very delayed latch and doesn't latch well, and his eyes are bloodshot, along with bruises around his neck and face. But I don't know how much of what the Dr.'s say is actually true...
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#36 of 51 Old 03-24-2006, 07:39 PM
 
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Lisa - I hope you sister's baby is okay. Did they do blood gases after delivery? That's a measure of how well the baby was doing, right before birth A baby can have bruises and be neurologically fine or have not a scratch and have suffered a large loss of oxygen. I wouldn't be really concerned with his appearance.
Can you get her a pump and syringe? - he may just be a sleepy, lazy baby, I hope.

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#37 of 51 Old 03-24-2006, 11:40 PM
 
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Hi, I'm a midwife. I thought I'd just give my 2 cents on the subject. Having a cord around the neck is very very common and almost always no big deal.

Usually it is loose enough that you can just unwind it from the baby's head while the body is still inside. Another alternative is to just pull a little bit of slack in the cord and then deliver the baby through it (like the baby was diving through a hoop). If it is a little too tight for either of those things, you can "somersault" the baby out, where you just hold the head really close to the perineum as the rest of the baby is born, so the baby does a bit of a somersault without putting too much traction on the cord.

Having to clamp and cut the cord before the body is born is pretty unusual. I've attended about 100 births as a midwife and only done that once. In the 300 or so births that I've observed, I've never seen it done. All the stories that people have shared here with blue babies with really tight cords--those are memorable because they're so scary, but also memorable because that really is a pretty unusual thing.

The only times it would be necessary or appropriate to do a c-section for a cord around the neck is if the cord were so tight and so short that the baby couldn't descend. But you wouldn't know that ahead of time--you would just see a really abnormal labor pattern. Sometimes you see a pattern of changes in the baby's heart rate that are indicative of some kind of pressure on the cord--it might be around the kids neck or it might be somewhere else, but it gets pinched. It sounds like that's what happened with Lisa's sisters baby. If the baby's heart rate is bad enough, then someone might need a c-section.

In answer to the other questions about blood flow and breathing: the baby can't breathe when its head is out and its body is inside because it can't inflate it's lungs. Remember that when the babe is in the womb, it's lungs are full of fluid. It takes a really big breath of air to get all those alveoli (air sacks) in the lungs to pop open and force the fluid out. Occasionally you'll see a baby who gives it's first cry before it is fully born, but that's pretty rare.

Of course when the head is out and there is a tight tight cord, there is minimal blood flow through that cord anyway. If you have to clamp and cut, of course you want to get the baby delivered as fast as possible--the combination of a tight nuchal and a shoulder dystocia is a total nightmare--but even if you hadn't clamped and cut, it's not like the baby is getting a lot of blood flow anyway at that point.

Well that's quite a long post. I would sum it up as: cords around the neck are something that every reasonably well prepared birth attendant knows how to deal with. For UC'ers, I wouldn't worry too much about it--nature made a pretty good system. Hope that cleared things up rather than confusing them more.

Jessi
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#38 of 51 Old 03-25-2006, 12:00 AM
 
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thanks jessie!!!!
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#39 of 51 Old 03-25-2006, 12:45 AM
 
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Originally Posted by Apricot
Lisa - I hope you sister's baby is okay. Did they do blood gases after delivery? That's a measure of how well the baby was doing, right before birth A baby can have bruises and be neurologically fine or have not a scratch and have suffered a large loss of oxygen. I wouldn't be really concerned with his appearance.
Can you get her a pump and syringe? - he may just be a sleepy, lazy baby, I hope.
The night he was born, he was having alot of difficulty breathing, so they kept him on oxygen for the night and on heart monitors. They said his heartbeat was very irregular all night long. He still has episodes every 15 minutes of so where he seems to be "gasping for breath." We are all very worried, but SIL doesn't seem all that concerned. She already said BFing is too hard and not for her, so there's no convincing her now.
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#40 of 51 Old 03-25-2006, 12:49 PM
 
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aawww.... that is too bad... i have a keagan to! is yours a ds or dd? can you nurse the baby? kinda kidding- kinda not! lol
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#41 of 51 Old 03-25-2006, 02:17 PM
 
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Originally Posted by Emilie
aawww.... that is too bad... i have a keagan to! is yours a ds or dd? can you nurse the baby? kinda kidding- kinda not! lol
Mine is a DS. I bet she'd get pretty ticked at me if I asked to nurse her baby.
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#42 of 51 Old 03-25-2006, 03:33 PM
 
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With my first uc homebirth, there was a true knot in the cord. Ds was a 10 lb baby.
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#43 of 51 Old 03-25-2006, 04:09 PM
 
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mine is too! YEAH for boy Keagans! All these folks are naming their girls keagan! Sorry so OT.
Glad the baby is better tho.
Dd was so fine right away. I totally 100% beliueve had we been in a hospital it would have been way way way worse.
For above listed reasons.
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#44 of 51 Old 03-25-2006, 08:34 PM
 
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Originally Posted by jgale
Of course when the head is out and there is a tight tight cord, there is minimal blood flow through that cord anyway. If you have to clamp and cut, of course you want to get the baby delivered as fast as possible--the combination of a tight nuchal and a shoulder dystocia is a total nightmare--but even if you hadn't clamped and cut, it's not like the baby is getting a lot of blood flow anyway at that point.
Jessi
I have some other info but wanted to address this first-- even thought there may be low blood flow at a point during birth once the pressure is off the cord the flow can increase and often does-- this becomes especially important for the depressed baby who does not breath spontaneously but the cord is still pulsing, if at all possible avoid cutting the cord until the baby is breathing- sommersalt is one way to birth around a tight cord.this is where you hold the head close to the perineum and the body comes out past it.

there is some correlation between cord wraps x3 or more and babies with problems but it is not known which comes first- problems that cause babies to move more or more wraps causing problems. or it could have to do with management- cutting a cord too quickly if there are multiple wraps... I will look up the studies again-- i think that the amount of babies born with cord around the neck is 20-30% we see it all the time and no big deal.

things that can be associated with cord wrap- true knots, cords with inadequate warton's jelly (so the wrap causes impingement) -- I think that some people put together any"cord accident" including prolapse and tearing, as a wrap-- some babies that have a cord around the neck will not be in flexion and this can prevent decent-- as can a short tight cord-- but I have seen these born with a vacuum --
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#45 of 51 Old 03-26-2006, 09:26 AM
 
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even thought there may be low blood flow at a point during birth once the pressure is off the cord the flow can increase and often does-- this becomes especially important for the depressed baby who does not breath spontaneously but the cord is still pulsing, if at all possible avoid cutting the cord until the baby is breathing
Yeah, I totally agree...
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#46 of 51 Old 03-27-2006, 12:20 AM
 
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Wow Lisa, that doesn't sound too good. Why did she refuse the c/s? She thinks this baby sounds okay? or she has some sort of attachment disorder? or she didn't think the baby was going to make it? I would be very concerned about a mother acting this way...
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#47 of 51 Old 03-27-2006, 11:00 AM
 
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Even my sOB didn't cut dd's cord before she came out. Her heartrate did go down during contractions but went right back up. Once her head was out, the OB just flipped it over her head. The cord was short though so they cut it when they laid her on my chest. BTW, my waters had been AROM at 4cm so she had no cushion- the pitocin contractions had squeezed out every bit of amniotic fluid, or so it seemed.

Ds' cord was kinda short too, but not around his neck. We'll see how this baby is...

There is the birth in Gentle Birth Choices where the birthing center doc cuts the baby's cord because it's wrapped pretty tightly around baby's neck and they have to do neonatal rescusitation... but it's obvious they handle it quite well.
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#48 of 51 Old 03-27-2006, 11:20 AM
 
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Originally Posted by busybusymomma
Even my sOB didn't cut dd's cord before she came out. Her heartrate did go down during contractions but went right back up. Once her head was out, the OB just flipped it over her head. The cord was short though so they cut it when they laid her on my chest. BTW, my waters had been AROM at 4cm so she had no cushion- the pitocin contractions had squeezed out every bit of amniotic fluid, or so it seemed.

Ds' cord was kinda short too, but not around his neck. We'll see how this baby is...

There is the birth in Gentle Birth Choices where the birthing center doc cuts the baby's cord because it's wrapped pretty tightly around baby's neck and they have to do neonatal rescusitation... but it's obvious they handle it quite well.
but you can do neonatal resuscitation with the cord still intact-- the logistics are awkward but actually better for baby in the long run--- if the placenta is born on the heels of the baby it won't matter much-- but if it is still attached it can make a difference.
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#49 of 51 Old 03-27-2006, 11:32 AM
 
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Chiming in, another cord-wrapped babe. DD was born vaginally w/the cord wrapped twice around her neck. There was a brief moment where the nurses, after the cord was cut, exclaimed over it, swung it around jumprope-style and pronounced it the "longest cord we have ever seen!"

Anyhow, OP, you asked about potential problems. The only thing that was an issue was that the cord was wrapped in such a way that it had forced DD's chin to her chest while in utero. She was thus very delayed in being able to hold up her head as a result; it lolled down to her chest for quite some time. However, she is thankfully now, like all the PPs who wrote about their or their children's experiences, the picture of health.

PS I'm from Rhode Island, too!

Mama to 2 mopheaded rascals
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#50 of 51 Old 04-05-2006, 11:26 AM
 
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I am not thinking this was a cord wrap problem-- the ideal position for a baby is with chin to chest-- that is called flexion and is the way most babies lay in the womb. you look for a cord wrap problem or some other cause of positioning problem if they are not in flexion if they hold their chin up or really lean back and have the face presenting.
after birth most babies do not hold their head up much at all just little moments of lifting they develop their muscles by lifting in gravity and gradually become stronger and hold their heads up more and more-- a few babies have some developed neck muscles and the coordination to hold their heads up for longer periods
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#51 of 51 Old 04-07-2006, 02:22 AM
 
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DS #2's cord was wrapped very tightly twice around his neck. I am sooOOOOOoooo thankful that I did not have any fetal monitoring b/c I feel pretty confident that it would not have looked good and they would have wheeled me in for a c-section at that point. They already knew there was meconium when my water broke in the OBs face while I was pushing, lol.

The OB cut the cord as soon as his head came out. I still don't know if this was the right thing to do or not. I know that it took him a while to start breathing and he needed a lot of help at first. It couldn't have been too bad b/c his apgar was still a 4.

I wonder if the cord wrapped around his neck twice because he was breech until about 37 weeks. The thing that finally worked for me was the Webster technique with a chiropractor and he did flip up and down once more, but with twice weekly visits until I had baby at 42 weeks he stayed down.

Baby stayed high all the way until the very end so maybe the cord was a non issue until pushing?

I'm so glad I didn't have a c-section b/c I don't think it would have produced a better outcome, probably a worse outcome. Man sometimes I wonder why it seemed like EVERYTHING was pointing towards c-section. "Big baby", breech, 2 weeks past EDD, attempted (but not agreed to) forced induction, etc, etc. I had to fight so hard to have a freakin vaginal birth and an awesome one at that besides the whole cord fiasco. Hopefully with baby #3 I will FINALLY get to hold the baby right on my chest immediately after she comes out of me. I was really hoping for that last time. That and so much for delayed cord clamping.

I'm just sooo thankful I didn't have fetal monitoring!!!!!!!!!!!!!

~Erin
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