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#1 of 51 Old 03-19-2006, 09:41 PM - Thread Starter
 
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So I've always thought a baby who had a cord around the neck was an automatic c-section. Started when I was 11 and my stepmother had a C because my brother's cord was around his neck, and since then every story I heard like that ended in a c. My mom told me a coworker's baby died due to this.

Then I read a post here (by Pamamidwife? not sure...) that cord around the neck isn't a big deal since the baby isn't breathing anyway. That makes a lot of sense! As long as the cord blood can flow, we're good!

So aside from a really short cord (how often does that happen anyway?) is there any reason to worry about a baby with the cord around its neck?

Wondering how to answer this because the question seems to be coming up a lot when I mention the word midwife... :
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#2 of 51 Old 03-19-2006, 10:07 PM
 
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My MW told us that she sees it about 25% of the time. The most she has seen was a baby that had the cord around it's neck 4 times - she just kept unlooping it and baby was born perfect

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#3 of 51 Old 03-19-2006, 10:12 PM
 
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My dd had the cord wrapped twice around her neck and the midwife just had me stop pushing and did a little unwrapping and some strange manuvering. DD was fine. I think its pretty common. If the cord is too tight for the body to come out, or to unravel they will just cut it so baby can come out.
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#4 of 51 Old 03-19-2006, 10:20 PM
 
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I have five (5) children. My first born was an E-C/S at 10 cm due to fetal destress. His cord was around his neck. I never one time pushed (was 10cm for 2 hours). Day after my E-C/S the Dr came and told me that I was lucky, that had I pushed even one time that they would not have been able to save my son. He was a blue baby at birth. The Dr said they had to put the clamps into my uterus and cut his cord just so they could pull him out. His cord was 3X around his neck.

My next four VBACs all had cord around their necks. With my last, I pushed til her head was out. Then stoped to just feel her for a moment. My MW looked at me and said "C, her cord is out!" I immediately knew what this ment. You can see on my video when she says this I began to push as hard as I could.. I did not even care if I riped. I knew this baby had to come out NOW!


I guess according to the PP MW that I am so not the average.
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#5 of 51 Old 03-19-2006, 11:21 PM
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I was born with the cord wrapped tightly around my neck and I did almost die from it. I was born near death with purple/blue coloring and had to be revived. I wasn't a c-section but probably should have been.
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#6 of 51 Old 03-19-2006, 11:43 PM
 
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My 1st DD was born with her cord wrapped tightly around her neck four times and she did spend her first few days in the NICU but only had to stay one night more than me and she is a healthy 3 1/2 year old now!
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#7 of 51 Old 03-19-2006, 11:57 PM
 
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DS was born with the cord around his neck, then around his chest and then all the way around his shoulders. He got fairly stuck and came out blue and limp. With a bit of O2 he pinked right up and had an apgar of 9 by the 5 minute mark.

I was SOOOO glad that he was born at home so he was not whisked off to the NICU!

My friends baby was recently born with the cord twice (midwife in a hospital) and they immediately cut the cord and revived him away from her but still in the room. No problems.

Cord around the neck is actually pretty common from what I understand.

 

 

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#8 of 51 Old 03-20-2006, 12:10 AM
 
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Quote:
Originally Posted by TiredX2

My friends baby was recently born with the cord twice (midwife in a hospital) and they immediately cut the cord and revived him away from her but still in the room. No problems.
This is what happened with my DD (except it was an OB in a hospital). I stopped pushing, the OB cut the cord, and I pushed the rest of her out. My DH went across the room with her, and she was pink and yelling in about 2 minutes.

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#9 of 51 Old 03-20-2006, 12:13 AM
 
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My first was having fetal distress while I was pushing. They did an episiotomy and the cord was tight around her neck. The doc cut the cord while only her head was out. They took her away to check her and she was fine, she pinked up right away.

My second was coming really fast so I don't know if he was having any fetal distress, but the cord was also around his neck. The doc just lifted the cord over his head and then they placed him on my tummy. He stayed kind of dusky and took longer to pink up, so the nurse took him and gave him some blow by oxygen.

My third didn't have the cord around his neck at all.
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#10 of 51 Old 03-20-2006, 12:19 AM
 
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My third child had a very short cord wrapped around her neck. We didn't know it until she crowned and my uterus started to prolapse. The Dr. told me to stop pushing, braced her hip against the baby's head (weird, I know) and cut her cord while she was still inside. She was delivered with one push. She came out very dark, but perfectly fine.
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#11 of 51 Old 03-20-2006, 03:51 AM
 
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I was born in the hospital with an OB: with my cord around my neck. There was a big hooplah and a huge cut then tear for my mom and forceps. But all that was cuz I wasnt coming "fast enough". I had to be given oxygen, but I still have an IQ well over 130.

My second son was homebirthed: born with his cord 3 x neck, 2 x left leg. He took about 5.5 hours to get just right position and for the cord to stretch and then about 1/2 an hour to push out. They looped some of the cord off his neck, but then I just pushed him out.

I knew he was going to be wrapped in his cord before birth.

And the midwife said that if you give them enough time, the cord will stretch on it's own. Have never heard this before, but it makes some sense.

mv
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#12 of 51 Old 03-20-2006, 04:01 AM
 
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My brother (now in his 30s) was born (vaginal delivery no meds) with the umbilical cord wrapped tightly around his neck. He was a blue baby who had to be rushed to the adjoining room to get supplemental oxygen. He spent his first day or two away from my mom and under observation. He's perfectly fine today.

I worried about the cord being around DD's neck because she had a two-vessel cord. But she didn't have the cord around her neck at all. Whew!

Normal is just a setting on your dryer.
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#13 of 51 Old 03-20-2006, 04:13 AM
 
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That's why most midwives use fetal monitoring (using doppler or fetoscope) during labor. If the baby doesn't tolerate contractions or desending through the pelvis, they try lots of tricks to get the baby happy again (positioning, oxygen, etc). If the baby doesn't respond, then a c-section or really fast birth might be considered.

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#14 of 51 Old 03-20-2006, 04:26 AM
 
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my daughter had a short cord wrapped 1x around her neck, that nurse had me stop pushing so she could cut the cord before my daughter came (quickly) out. Apgars of 7/9.

this and shoulder dystocia are the 2 things that i worry about with a UC, if i can convince my fiance' on a UC, so i plan to educate educate educate

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#15 of 51 Old 03-20-2006, 10:20 AM
 
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I am surprised by how many MWs and OBs cut the cord when only the head is out. I asked my MW about this when I intereviewed and she said she would never cut the cord because 'What if the shoulders get stuck?' Her feeling is that if the cord is still intact the baby is getting some oxygen via the cord but once the cord is clamped and cut with only the head out and the shoulders get stuck your time is VERY limited because baby has NO oxygen. I guess it depends on the circumstances. Maybe some caregivers can tell if the shoulders aren't going to get stuck? Or maybe they just have a lot of confidence that Mom will be able to push the baby out. I guess I can see it both ways. My MW said in her 27ish years she has never had a cord so tight it couldn't be unwrapped but maybe she's been lucky.

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#16 of 51 Old 03-20-2006, 10:36 AM
 
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Thai women in general, if they can afford it, will do a C-section. Not my friend BeBe (who is also the only Thai woman I know to EBF for 9 mo!). She was so determined to have an unmedicated vaginal birth. The baby was a normal size, her water broke, she went into labor, but the head just would not move past -2 station. They tried everything. She finally consented to a C-section. The cord was wrapped so tightly around the next 3x that (like a PP said), they had to cut the cord inside. I doubt that baby would've come out alive vaginally.

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#17 of 51 Old 03-20-2006, 02:34 PM
 
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My youngest, now 19 months, had her cord wrapped around three times. The cord was loose enough not to be a problem, but was short enough to make her mal-postioned and very high up long after she should have dropped. She was turned to present correctly by my ob while she was being born and the cord was unwrapped asap. She was bruised all over, but okay. Oddly enough though she LOVES having things around her neck. I'm always having to watch that she isn't going to choke herself.
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#18 of 51 Old 03-20-2006, 02:42 PM
 
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Quote:
Originally Posted by kerikadi
I am surprised by how many MWs and OBs cut the cord when only the head is out. I asked my MW about this when I intereviewed and she said she would never cut the cord because 'What if the shoulders get stuck?' Her feeling is that if the cord is still intact the baby is getting some oxygen via the cord but once the cord is clamped and cut with only the head out and the shoulders get stuck your time is VERY limited because baby has NO oxygen.
Okay, I know this is a dumb question, but if the head is out, why wouldn't the baby have oxygen? Can't the baby begin to breathe the oustide air?

ETA: Okay, I thought about and think I answered my own question! I am guessing the baby's head is out, but since the cord is around its neck, it can't breathe the outside air because the cord is choking it. Thus, NOT cutting the cord should ensure the babe gets oxygen from the cord. Am I correct here?

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#19 of 51 Old 03-20-2006, 03:00 PM
 
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All of my babies have had their cords wrapped around their necks, all have been delivered vag. My first did go to the NICU for loss of volume or something like that. This last baby born on Wednesday was "swaddled" in his cord, but it was extremely long and he had no problems being born.
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#20 of 51 Old 03-20-2006, 03:49 PM - Thread Starter
 
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Originally Posted by TechnoGranola
Okay, I know this is a dumb question, but if the head is out, why wouldn't the baby have oxygen? Can't the baby begin to breathe the oustide air?

ETA: Okay, I thought about and think I answered my own question! I am guessing the baby's head is out, but since the cord is around its neck, it can't breathe the outside air because the cord is choking it. Thus, NOT cutting the cord should ensure the babe gets oxygen from the cord. Am I correct here?
Ok, I have a dumb question to stem off of yours then Just to confirm: if the cord is wrapped too tight around the baby and cutting off blood flow in the cord itself to the baby, then there's trouble. And if you cut the cord before the baby emerges as a result of that you'd better push that baby out really fast because for that period of time between cutting and baby being completely out, the baby is getting no oxygen. Major catch-22...

So given the above, it seems like there are a lot of risks to having a cord around the baby's neck - I'm getting that even just from reading this thread... am I interpreting that right? Can we assume that in all the instances where the baby was blue or needed O2 that the cord was tight enough to cut off blood flow to the baby?
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#21 of 51 Old 03-20-2006, 04:53 PM
 
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DD's cord was wrapped around her neck (twice I think?) but t was easily unwrapped while I rested a bit between birthing her head and the rest of her body.

I remember reading one UC birth story where the baby's cord was wrapped tightly and keeping the baby from descending as it normally would, but in the end mama let the baby guide himself out and he did a little flip as he moved from the vagina (I believe that's how it went). The only adverse affects that I remember reading about was that the babe needed an adjustment from the chiropractor.

The only problem that comes to mind with the cord is prolapse (when the cord comes before the baby, and can cut off the oxygen supply).
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#22 of 51 Old 03-20-2006, 05:08 PM
 
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Quote:
Originally Posted by TechnoGranola
Okay, I know this is a dumb question, but if the head is out, why wouldn't the baby have oxygen? Can't the baby begin to breathe the oustide air?

ETA: Okay, I thought about and think I answered my own question! I am guessing the baby's head is out, but since the cord is around its neck, it can't breathe the outside air because the cord is choking it. Thus, NOT cutting the cord should ensure the babe gets oxygen from the cord. Am I correct here?
I am hoping a midwife comes in here with the correct answer, but I am assuming babies can't breath until they are out ebcause they cannot inflate their lungs while they are still in the vag. canal. Way too much squeezing pressure for them to fight against. this is just a guess, though.
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#23 of 51 Old 03-20-2006, 07:11 PM
 
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My dd had her cord around her neck twice and shoulders once. She was born at home with no problems. LONG labor (31 hours) LONG pushing stage (~6 hours) but everything was fine because no one messed with anything. Her water didn't break until moments before she was born so she had a nice cushion the whole time.

-Angela
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#24 of 51 Old 03-20-2006, 10:03 PM
 
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ds's cord was wrapped 3 times around his neck- fairly loosely as he had a really long cord. No problems- his apgars were 9/10. I think most of the time the midwife or the mother herself can easily just unwrap it, but sometimes it needs to be cut before the baby can be born (if it's wrapped extremely tight around the neck or the cord is very short- which is rare)

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#25 of 51 Old 03-21-2006, 12:23 AM
 
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OMG- I just wrote this long post and dd erased it all!
She had a tight cord around her neck that we did not catch until I brought her up- she was born in water. I had a midwife. Dh got the cord off cause midwifes hands were wet. She had a low apgar at 1 minute and a 8 apgar at 5 minutes. She is FINE.
I think cutting the cord is not a good idea- at all that is the babies oxygen supply- and as long as the cord is attatched she/he is getting vital oxygen.
I also think taking the baby away from the mom is a HUGE mistake in these circumstances. DD being white and quite unresponsive nursed right away-....
I think that made a HUGE difference.

I can go into more detail for you if you wish- if you are planning a homebirth.
I also suggest you read Birhthing From Within along with the birth stories on here.
Midwifes are REALLY trained for these circumstances. I knew she would probally have a cord from MW's last fetal monitoring.... I heard a hiccup in her heartrate. I do not think a cord is a reason to decide a hospital birth.

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#26 of 51 Old 03-21-2006, 10:28 AM
 
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Just thought I'd share. Luke was born in hospital vaginally and it's a miracle he's alive and totally undamaged. I now believe I could have had him at home too, probably, except there might not have been as many hands there to help.

What happened: once I pushed his head out, it became evident that he had major cording around his neck. 6 loops, in fact, drawn very tight. I pushed his shoulders out and was asked not to push anymore (easy because all that was left was body). They cut and clamped 4 times, all while two of the nurses held him just so that the blood wouldn't run back out of him via the cord, since we couldn't get his whole body out. Not enough cord. It was also under his neck twice.
Once he was untangled and free, we discovered there were also two knots in the cord. One was pulled tight. We think that's why he was small and skinny.

Anyways, the moral of the story is: what happened to him is incredibly rare. The crazy thing is, I had stress test after stress test with him because I was way over, and an ultrasound 2 days before he was born, and no knowledge this was happening. He had to have been like that for months. Every now and then on the stress test his heartrate would drop a bit, but never below 90. They said to me that they thought he might be putting a little pressure on his cord. I think they suspected a nuchal cord, but didn't tell me. And they didn't do a section! If we would have known I know I would definitely have opted for one, because he was on the razor's edge of survival in there. My water even broke before labor started, so no cushion or anything. He did need a chiropractic adjustment.
However, we made it vaginally. So, no, it isn't always necessary! The thing is, there's no way to know. U/s can't see a cord, apparently. I don't know if those 3-D ones are able to show you one. The only way to know, in my experience, is by the heart rate dropping. If it doesn't, no one knows.
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#27 of 51 Old 03-21-2006, 10:04 PM - Thread Starter
 
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This is a very informative thread!

I went a-Googling to see what I could find too Here's a good link:

http://www.storknet.com/complications/salafia/cord.htm

What I got from this is that death resulting from nuchal cord is usually due to other problems with the baby/ placenta/ pregnancy. I'm curious what everyone's thoughts are on this one.


Here's a good "how to handle it" article:

http://www.gentlebirth.org/Midwife/nuchlcrd.html

I did have a question about this bit of the article:

Quote:
I noticed that when midwives talk about waterbirth, they sort of ignore the whole "checking for cord" step, which I couldn't figure out until I realized that the baby's just kind of unwind themselves if the cord is impeding their exit.
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?
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#28 of 51 Old 03-21-2006, 10:11 PM
 
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Hmmm I am not sure.
I think maybe since they can not see as well it is not as good to be under water?
I will be interested to hear the answers.
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#29 of 51 Old 03-24-2006, 01:58 PM
 
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Quote:
Originally Posted by Tummy
I have five (5) children. My first born was an E-C/S at 10 cm due to fetal destress. His cord was around his neck. I never one time pushed (was 10cm for 2 hours). Day after my E-C/S the Dr came and told me that I was lucky, that had I pushed even one time that they would not have been able to save my son. He was a blue baby at birth. The Dr said they had to put the clamps into my uterus and cut his cord just so they could pull him out. His cord was 3X around his neck.
Same type of thing happened to me when i had my DS. I labored for 9 hours with him, until he started having lots of heart decellerations, into the 20's. I got to 7 cm before his heart rate went to 25 and stayed down, so i had an emercency c-section. Turns out the cord was wrapped twice around his neck and was pulling tightly with each contraction, and thats why he never engaged in my pelvis at all thru all my labor. He was also born blue and needed oxygen. the doc told my Dh in the operating room that he would have lost us both within another hour of labor - DS from lack of oxygen, and me from uterine rupture. But of course any midwife with a doppler could have seen that coming, since DS had multiple decell's before they did the csection, and gotten us to a hospital.
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#30 of 51 Old 03-24-2006, 02:49 PM
 
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mine was 2x around my neck, and my mom delivered me vaginally

*~*Ashley*~* newly single mama to Tristan 10/01/2007
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