Umbilical cord around the neck
Q: I am strongly leaning toward homebirth, but recently my sister-in-law gave birth to her baby in the hospital and claims that because her baby’s umbilical cord was wrapping around his neck as he was coming out there was no way for the doctors to anticipate this fetal stress. This lead to complications for the baby and the need for intensive care. Other friends of ours who were on their third home birth (the first two happened beautifully) just had a similar life-threatening experience with the birth of their third baby. Are their complications unforeseeable?
Thank you.
A: Many babies are born with the cord around the neck, in fact the stated incidence is 40%. Any birth attendant, be it midwife or doctor, is trained to sweep the baby’s neck immediately after the head is delivered, looking to see if there is a cord that needs to be removed by one of three mechanisms: the first and easiest method is to take the cord over the baby’s head, therefore unwrapping it. This can only be done if there is enough slack, meaning that the cord has to be long enough. The second maneuver is to gently urge the cord over one of the delivering shoulders. This maneuver is done if there is a little less slack. If there is no slack and the cord is wrapped tightly around the neck, the attendant clamps and cuts it right before the body of the baby is delivered. I have been attendant at births, where the cord has been two and three times around the neck. All these babies are fine. Not one of them has had to go to the neonatal intensive care unit. Sometimes though, if a baby has fetal distress in labor, which can happen for a variety of reasons, and the baby is born with the cord around the neck, the parents remember the cord around the neck as the problem, since psychologically it feels as if the baby would be strangled. Remember the baby does not need to breathe for the first time until after it is out and the cord is unwrapped, so the problem is not that the baby gets “choked” by the cord. Hope this helps.
Cara
Karyn Mendel says:
Thank you so much Cara. It’s so great to get a thorough and truthful answer about what’s really going on. I’m so tired of misinformation, but am so grateful for reliable resources such as your site. Karyn
Katie says:
Hi, I would just really pay attention to fetal movement.
I am the 1 out of 10,000 where the cord was so tight my
son did not make it. On dec 29th 08 I noticed that I hadn’t felt him really kick. The only thing I could remember feeling were
his hiccups the day before but mo kicks or shifting. So I called my doc and she told me to go to the hospital for fetal monitoring. I drove to the hospital trying not to think about it, hoping that everything would be fine. The tech could not get him to move and could not find his hearbeat. I was induced, when I gave birth he was stuck due to the cord being so tight around his neck. The doctor informed me that this was the cause of death.
Knowing what I know now, my best advice I can give you is to invest or rent a fetal Doppler. You can find them at BabyBeat.com. This will allow you to know if your baby is ever in distress.
Brandie says:
Im a soon to be first time parent of May, only 18,
how does your baby get in distress?
today i felt a little pain inside like she was pulling on my belly button cord but she is still moving around alot.
What does it mean?
hilary says:
my best friends baby was born with the cord around his neck. It was so tight, he was lifeless and pale when he came out. he was rushed to the NICU and brought back to life. today he has signs of brain damage from the lack of oxygen to his brain.
Babies can and do sometimes get strangled by the cord. Anything can happen during birth. I had both my babies at a birthing center with no drugs. I am so lucky to have had no problems and a great experience. I feel sorrow for my friend.
I dont write this to scare anyone, just to say that childbirth is very serious and risky. Women and babies often (and still do) died during childbirth. That is why is is is an awesome and profound thing and why women should be revered for the amazing thing they have been doing for millions of years. And why we should be grateful for our healthy babies.
You can still have a drug free and great birth in a hospital or birth center. There is a middle ground, its not either a totally drugged up antiseptic hospital birth or a birth at home in your bathtub. Do your research and be flexible.
Kay says:
As Cara says, a cord around the neck is not usually a problem. Rather, problems arise when the cord is compressed, whether or not it is around the neck. Any qualified midwife or doctor, in any setting, can monitor the baby for signs of distress. Brandie, try not to listen to everyone’s horror stories. It’s a very rare complication. Best of luck to you!