Could a midwife or other knowledgeable person tell me a little more about this. If the doctor spies a cord around the neck during an ultrasound, is this sufficient reason for an immediate c section? My cousin had her baby today, and while it's hard to get full info from 3000 miles away, apparently they just gave her a c section, and the baby is in NICU with respiratory distress, and they said it was because the cord was around the neck. She's a first time mom and had no trial of labor, they gave her the C-section within 3-4 hours of arriving at the hospital with mild labor pains.
This seems wrong to me on many levels. Any comment?
i don't know what protocol is, but i had a vaginal birth with ds, who had the cord wrapped twice. he *did* end up in the NICU in resp distress, but it was unrelated to the cord issue, or so i was told.
Again, I don't know what protocol is at your cousins hospital, but my ds was born with the cord around his neck twice. He was born vaginally and had no respitory distress.
My son was born with his cord wrapped around his neck 3 times- Apgars of 9 and 10- no distress at all.
Probably about 1 in 3-4 babies has a cord around the neck. Most of the time it doesn't cause a problem, and can be slipped over the head after crowning, the baby can be born through it, or the baby can be sumersaulted out and the cord unwrapped after birth.
Very rarely is it so tight that it hinders birth, if it's long enough to get around the neck, it's long enough to allow birth to happen. I've attended births where the cord was 3 times around the neck with no trouble.
The c-section is most likely what caused the resp. distress. C-born babies don't get squeezed out through the birth canal and are likely to have fluid in the lungs, especially ones who are born without labour. Vaginally born babies have a small gush of fluid from the nose and mouth when their heads are born and their bodies are still inside, sort of a natural Heimlich manouvre.
Unless the baby's heart tones were freaky, it's unlikely that the cord was a problem.
As the previous poster mentioned, the cord being wrapped around the neck is actually fairly common.
DS was a homebirth baby with the cord around his neck, his arm and his chest, totally squeezed it and he was up to a 9 at 5 minutes (born limp & blue, though). The assistant was supposed to help DH catch him, but he was really wedged in because of the cord loops and so the midwife stepped up. I didn't even realize there was a *real* problem (as the midwife & assistant discussed cutting the cord and starting mouth to mouth) because they handled it so well.
Was there, perhaps, a knot in the cord? That is much trickier, so I have heard.
No, nuchal cord does not equal c-section necessarily. They may have done a cord doppler study to see if there was any reduced blood flow to the baby, or resistance in the cord. If there was, a c-section may have been a reasonable option. Nuchal cords are so common that I personally wouldn't worry about one if I knew about it in the absence of any fetal heart rate decelerations.
My comment is that Dr.'s often encourage cesareans when they could be avoided (and at worst, when they are absolutely and totally unnecessary)
My last baby was born with a cord twice around her neck. They just unwrapped it. Sometimes if it is too tight, they may have to cut while baby is half in and half out, but that isn't too common. Out of the 60 or so births I have been to, at least one third to one half had cords.
My DD had her cord around her neck in each of the three u/s I had. I was told of it but it did not concern my midwife who said it could unwrap but if not no biggie. So she did indeed have the cord around her neck and she was born in respiratory distress with horrible apgars but they were not related. I was offered a section due to her size several times but never due to the cord.
Maybe I'm uneducated so correct me if I am but what does the cord around the neck have to do with being able to breath? Baby isn't breathing on the inside only after its born. So I'd think as long as the cord wasn't tight and that if the cord was not cut immediately then baby should be fine.
Add my oldest dd to the list of having the cord around her neck, twice in fact. It was long enought that the mw was able to enlarge the loops so dd was able to slip right through. She had high apgar scores.
Thanks everyone. You all told me basically what I already know, but needed to hear again.
The rumors over why she had to have surgery ranged from nuchal cord, to "twisted" cord, to a knot in the cord, but her mother emailed me and said that they saw some stress with the baby's heart beat and recommended a csection. That's a pretty vague answer but probably the truest so I'd say we'll probably never know why she had to have the surgery. She's a nice girl but not knowledgable at all about birth and didn't bother going to labor classes or anything, just read her What to Expect books. I feel sorry that she hasn't seen her baby yet (he was born 9 hours ago) and he is in an incubator with an IV in and no one to hold him. It's a shame and my gut instinct is that it could have been prevented.
That's probably unfortunately true halah. I still read stuff all the time (even here sometimes) that indicates people believe a cord around the neck is a serious complication that does justify/indicate a c-section. One of my entertainment magazines had a sidebar with celebs who need had "emergencies" during their pgs/deliveries which included Celine Dion needing a c-section three weeks before her EDD because the baby's cord was around its neck. Just made me shake my head.
It's also possible that she wasn't just there for a routine ultrasound - there may have been some other indication that something was going wrong with the baby's blood supply. If the baby wasn't moving, or heartrate was doing unusual things, or wasn't growing as expected, an ultrasound might be used to see if they can find out what's wrong.
If someone were to go for a routine ultrasound and the baby and mother were both fine, but a loop of cord was around the baby's neck - and that was cause a c-section, that would be ridiculous.
However, if someone were in labor and dilating, but the baby just was not descending at all - and the ultrasound showed a tight loop of cord and a short cord - then it would make more sense. It's all about context.
All five of my children had their cords around their necks.
One had it around her arm also. One around her arm and torso.
My first DS had his cord around his neck three times. I had an emergency c/s at 10 cm... 2 hours after being transported from a birth center. He had fetal distress (hb droped to 20). He was very sick, ended up with mechonium in his lungs.. was born blue. The doc said I do not know how lucky I was to have a child. The cord was so tight around my sons neck they had to put the insterments into my uterus to cut it before they could even take him out. But all of my next 4 births were PERFECT!
Oh that's too bad that she hadn't seen him yet.
Well, the story keeps changing.
My cousin's husband emailed me late last night with pictures of the baby (before it was sent to NICU). He said , "Affter 9 hours of labor (painless thanks to the epidural), she had not progressed enough as she should have, so the docs*decided*to perform a C-Section. Everything went great during the operation. She was the perfect patient
[emphasis mine], and baby R came out with a struggle."
If this is true, then
The baby's still in an oxygen incubator. They're "hoping" to get to see him today.
My VBAC baby had her cord wrapped around her neck, twice, very tightly, and had absolutely no problems whatsoever, other than being a bit bluish right at first. My water broke as her head came out, and she was born before my midwife realized or had a chance to even try to get the cord from around her neck.
I think there may be something we don't know contributing to your cousin's problems. She might never know the whole story herself, unless she requests a copy of her hospital records.
Dd had the cord wrapped around her neck once, Apgars of 9 and 10, no distress whatsoever.
Ds had the cord wrapped around his neck twice, Apgars of 9 and 10, no distress whatsoever - actually, he started crying while just his head was out!
Both of mine had 'longer than average' cords according to the attending midwives (CNM at hospital with dd, CPM at home with ds). I suppose if there was a nuchal cord with a significantly shorter than average cord it could be a big problem, but...
Sounds like your pretty basic run of the mill "failure to progress" c-section. I don't see anything about the cord or distress in this email so I'm guessing that wasn't a big factor. Maybe they just originally thought that or someone was confused along the route the info got to you. That email does make me want to hurl but at least a 9 hour trial of labor is somewhat better than the 3-4 hours you were originally told.