cord wrapped around neck

aetg

I must have read five posts this week about mommas who are so happy they had a csection because the cord was wrapped around their baby's neck.

Now I know I'm a statistic of one, but my son had his cord wrapped around his neck four times and he was born vaginally with no distress and his apgar scores were high.

Not knocking anyone choice if birth, but cord wrapping is not necessarily the end of the world

dobbysmom

Another anecdote: I was born with my cord around my neck, at home, blue. Midwife resuscitated me, and my Mom is still our biggest supporter of us doing a natural birth at a birthing center. Our midwives are trained medical professionals, we trust them, even if something turns into an "emergency". Not just in best case scenarios.

nikkitaplin

We knew the cord was wrapped around my daughters neck three times because of u/s.  I delivered naturally.   

moroccojade

My grandmother's first child died from this. 

I almost died from this....   (My mom birthed me vaginally, though.)  

My daughter was having major decels and nothing was making her heart rate come up (I stalled at 6 cm due to spontaneous, premature pushing which made my cervix swell).  She was terribly wrapped up in her cord as well. 

I didn't love my cesarean, but I don't regret it either.  I do believe it saved my daughter's life (as does my midwife).  But I sure do not want another one if I can help it!

MuchlyGen

Yeah, generally cord wrapped around the neck really doesn't matter, unless it is unusually tight, or the cord is getting compressed for some reason. 

It actually provides the added benefit that it shortens the cord, which reduces the risk of cord prolapse!

Definitely not the end of the world. 

moroccojade

MuchlyGen said:

Yeah, generally cord wrapped around the neck really doesn't matter, unless it is unusually tight, or the cord is getting compressed for some reason. 

It actually provides the added benefit that it shortens the cord, which reduces the risk of cord prolapse!

Definitely not the end of the world. 

Tell that to my grandmother.

MsMacual

@moroccojade- I know of a few families where the same thing happened and it is just heart breaking. You are right that it can be very dangerous. 

   

Our son's cord was wrapped a few times and was part of why I was having a hard time getting him out- I ended up with a vacuum assist and all was fine.  I think there are very real situations where a cord being wrapped is dangerous and life threatening.  In our case, we were monitoring him pretty closely and his vitals were very strong so there wasn't a reason to rush into the OR.  We would have gone that route had the vacuum not worked, though.  

MrsP7309

I can think of 3 babies off the top of my head who had cords wrapped around their necks: DD, my brother, and a former co-worker's DS. All 3 had very different stories.

DD was born vaginally. Her cord was loosely wrapped 3 times around her neck. I pushed for about 10 minutes. It took her a few seconds to start crying, but she had perfect APGARs. No problem.

My brother was also born vaginally. His cord was much tighter though, and he was gray at birth. My dad thought he was stillborn. He had an APGAR of 2. He's fine now, but let's just say my brother's birth was NOT my mom's favorite.

My former co-worker was in labor for a day and a half before she started pushing. After a few hours of pushing, her son started to experience some very alarming heart decels. She had a c-section, and that's when they discovered that he was wrapped up in the cord. The length of the remaining cord was keeping him from properly descending.

Wrapped cords can be no big deal (like DD) or it can be life-threatening.

MuchlyGen

moroccojade said:

MuchlyGen said:

Yeah, generally cord wrapped around the neck really doesn't matter, unless it is unusually tight, or the cord is getting compressed for some reason. 

It actually provides the added benefit that it shortens the cord, which reduces the risk of cord prolapse!

Definitely not the end of the world. 

Tell that to my grandmother.

I am so sorry, I didn't mean to make light of something that has certainly resulted in serious consequences.

What I meant was that the mere /fact/ of a cord being around the neck is not dire, is not the end of the world. It isn't something that, if seen on an ultrasound, warrants panic or emergency C-section - unless there are other indicators that something is wrong - usually decels. It is tragic, but a rarity, for a cord around the neck to cause problems. 

moroccojade

MuchlyGen said:

moroccojade said:

MuchlyGen said:

Yeah, generally cord wrapped around the neck really doesn't matter, unless it is unusually tight, or the cord is getting compressed for some reason. 

It actually provides the added benefit that it shortens the cord, which reduces the risk of cord prolapse!

Definitely not the end of the world. 

Tell that to my grandmother.

I am so sorry, I didn't mean to make light of something that has certainly resulted in serious consequences.

What I meant was that the mere /fact/ of a cord being around the neck is not dire, is not the end of the world. It isn't something that, if seen on an ultrasound, warrants panic or emergency C-section - unless there are other indicators that something is wrong - usually decels. It is tragic, but a rarity, for a cord around the neck to cause problems. 

No worries....

My daughter's heart rate dropping down to nearly nothing during contractions was enough to get me in the OR.  I wanted an intervention-free birth so badly but as soon as my baby was in considerable distress, I was game for anything.

As for my next birth in a few months?  My MW said we could do a late term US to see what is happening with this baby's cord.  Not sure if I will take her up on that or not....   But we just do not have good luck with cords in our family.   

jenn43

Umbilical cords are very tough, so that they don't get compressed.  It's the compression on the cord that decreases oxygen to the baby, not the fact that it's around the neck (since the baby isn't breathing yet).  My baby had a nuchal cord as well- the MW popped it off after his head was out.

mandi195

The cord was around my son's neck; he was all sorts of tangled up in it. When they broke my water (I was induced this way instead of with drugs) his heart rate dropped dramatically (doctors believe is he was compressing the cord between his body and my ute). However, we tried flipping me around a bit, and found that if I was on my left side his heart rate was fine. I remember when I was pushing, I was mid-push and OB told me to stop (near impossible) so he could get the cord off my sons neck; and then I continued right away. For us, luckily, it wasn't a big deal. However, when we were flipping me around, the doc did say that if the heart rate didn't come back right away I would've been in the OR for a C-section right away. 

jennypolkadots

I've heard a lot of cord wrapped stories. From what I've read, it is very common and happens in 1 out of 4 vaginal births... can't remember where I read this. The cord is not tight and usually just loosened and slipped over the neck. Most doctors do this without ever mentioning to the parents because it sounds alarming if you don't know much about it. We usually think of cord wrap = strangulation = brain damage which just is not the case 99% of the time. Umbilical cords are usually around 2 feet long in full term babies! Plenty of length for wrapping. 

soulcupcake

What does the data show? In large case studies nuchal cords are not associated with a significant increase in fetal demise. 

Nuchal cords

Dispelling the Fear About the Umbilical Cord

Just because a nuchal cord was present does not mean it is the cause for prolonged variable decelerations. Decelerations could point to another problem. Correlation does not mean causation. There are causes involving cord stricture, but this is often the result of an umbilical cord abnormality, a lack of Whatron's jelly.

Cord stricture

And there are also other abnormalities involving the cord, like a cord that is too short, which if there is entanglement it can lead to fetal hypoxia. And the same for cords that are too long that can increase the chances of severe cord entanglement affecting bloody supply.

And situations involving tight true knots *and* other cord complications like SUA and velamentous cord insertion and vasa previa.

sprky79

Its not that easy.  Its a case by case analysis.  If my mom had refused a section when I got tied up in the cord I'd be dead right now instead of 12 weeks along with my first baby.

I am all for going as natural as humanly possible.  I will do my part to avoid medications and epidurals for my own personal reasons.  But I'm also pro "hiring doctors that I trust and trusting that they are literate competent professionals and finding a new one if I do not think that anymore."  

sschwege

sprky79 said:

Its not that easy.  Its a case by case analysis.  If my mom had refused a section when I got tied up in the cord I'd be dead right now instead of 12 weeks along with my first baby.

I am all for going as natural as humanly possible.  I will do my part to avoid medications and epidurals for my own personal reasons.  But I'm also pro "hiring doctors that I trust and trusting that they are literate competent professionals and finding a new one if I do not think that anymore."  

I think that's what it boils down to is finding a provider you trust.  C/S save lives no doubt about it, but you can't tell me that a c-section rate of 33% is a good thing; that one third of women can't have their babies vaginally.  I wanted a provider, a MW in my case, where if she said, "We need to get to the operating room!" I didn't have to question it.  

iris427

sschwege said:

sprky79 said:

Its not that easy.  Its a case by case analysis.  If my mom had refused a section when I got tied up in the cord I'd be dead right now instead of 12 weeks along with my first baby.

I am all for going as natural as humanly possible.  I will do my part to avoid medications and epidurals for my own personal reasons.  But I'm also pro "hiring doctors that I trust and trusting that they are literate competent professionals and finding a new one if I do not think that anymore."  

I think that's what it boils down to is finding a provider you trust.  C/S save lives no doubt about it, but you can't tell me that a c-section rate of 33% is a good thing; that one third of women can't have their babies vaginally.  I wanted a provider, a MW in my case, where if she said, "We need to get to the operating room!" I didn't have to question it.  

I don't think anyone says that 1/3 women can't have their babies vaginally. First of all, that figure is 1/3 births, not 1/3 women. A significant number of those are repeat cesareans, many of which are maternal choice. If a woman has her first baby vaginally, she is much less likely to have a cesarean in a future pregnancy. Even in primary cesareans, the recommendation to have a c/s doesn't mean "you can't have a baby vaginally." It usually means in this case that the doctor thinks that a c/s is the route most likely to result in a healthy baby and mother. For example, if there is a 5% risk of something like shoulder dystocia, it doesn't mean the doc is saying you can't deliver vaginally, since there is a 95% chance everything will be fine. But the doctor may still recommend a cesarean to avoid even that risk--in that case a cesarean is most likely to have a healthy outcome. But yes, you should find a provider whose judgment you trust, so that if they recommend a c/s you can feel confident it's the best option. Or conversely if they say everything is fine, that it actually is.

sschwege

iris427 said:

sschwege said:

sprky79 said:

Its not that easy.  Its a case by case analysis.  If my mom had refused a section when I got tied up in the cord I'd be dead right now instead of 12 weeks along with my first baby.

I am all for going as natural as humanly possible.  I will do my part to avoid medications and epidurals for my own personal reasons.  But I'm also pro "hiring doctors that I trust and trusting that they are literate competent professionals and finding a new one if I do not think that anymore."  

I think that's what it boils down to is finding a provider you trust.  C/S save lives no doubt about it, but you can't tell me that a c-section rate of 33% is a good thing; that one third of women can't have their babies vaginally.  I wanted a provider, a MW in my case, where if she said, "We need to get to the operating room!" I didn't have to question it.  

I don't think anyone says that 1/3 women can't have their babies vaginally. First of all, that figure is 1/3 births, not 1/3 women. A significant number of those are repeat cesareans, many of which are maternal choice. If a woman has her first baby vaginally, she is much less likely to have a cesarean in a future pregnancy. Even in primary cesareans, the recommendation to have a c/s doesn't mean "you can't have a baby vaginally." It usually means in this case that the doctor thinks that a c/s is the route most likely to result in a healthy baby and mother. For example, if there is a 5% risk of something like shoulder dystocia, it doesn't mean the doc is saying you can't deliver vaginally, since there is a 95% chance everything will be fine. But the doctor may still recommend a cesarean to avoid even that risk--in that case a cesarean is most likely to have a healthy outcome. But yes, you should find a provider whose judgment you trust, so that if they recommend a c/s you can feel confident it's the best option. Or conversely if they say everything is fine, that it actually is.

Thank you for taking the time to explain that.  That 33% is far less alarming than I realized, after reading what you wrote I realized I was looking at that figure wrong.  Still too high though and I hope in time that number will come down.

shellybean3788

My midwife explained to me that 1/3 of babies are born with the cord wrapped around the neck. They simply ask you to stop pushing for a second, unwrap it, and continue on with life. 

Worst case scenario: It's wrapped REALLY tight, and they have to go ahead and cut it before the final push. 

usernewname

DS had the cord around his neck and body. My MW just stated it matter of factly, unwrapped it and I finished pushing. DS ended up being fine with great apgar scores.

But it can go differently though.

RayRay007

I had an emergency c/s with DD when an NST was showing prolonged brady with contractions. They literally ran me down the hall when they lost her HR and couldn't find it for something like 3 minutes. She had a nuchal cord x2 and they think that is what was causing the problem (I continue to say "think" because how can we really know?). I think the c/s was necessary but I have never thought "my baby would have died" because again, how can we really know? [ps. they found her HR as soon as we got to the OR so I had time for a spinal instead of general and she came out fine, good apgars]. Despite my experience I am not afraid of nuchal cords. It is relatively common and in most cases not a problem. 

lookame3639

DD labor and delivery was a mess. I went in for a growth ultrasound, turned out she stopped growing and i had pre eclampsia , DD wasnt moving and the next thing i know I'm getting magnesium, blood pressure meds and being induced. During labor when I'd have a contraction her heart rate would decel pretty bad and at one point it was so bad I had 5 drs in my room giving me a shot to stop contractions and an amnio infusion. I was flipped all around and she got content for a minute but she still had decels with every contraction (if you looked at the tape everytime i had a contraction her heart dropped the exact same as the contraction).

I was moved into a new position, she dropped and her heart rate declined pretty bad, again 5 drs in the room. i didn't even have time to wait for the dr from my practice she had to be delivered asap. I had one dr pushing on my stomach and another getting a vacuum.

as soon as she came out it was discovered she had a cord wrapped around her neck twice (which I now know is why during the growth scan the tech focased so much on her cord) and she had a satillite placenta (where the placenta sections itself off from itself). She weighed 3 lbs 7 ozs her 5 minute apgar was perfect but when she came out she couldn't cry and was blue. I delivered vaginally but not without a bunch of interventions in between...

emp06c

Variable decels in FHR= cord compression

Late/Prolonged decels in FHR= Utero-placental insufficiency.

Typically, the variable decels accompanying a nuchal cord are not cause for a C/S, especially if they occur with a ctx. We usually do just about everything else for variables before discussing C/S with our patients. Interventions usually range from repositioning the mother, slapping oxygen on, fluid bolus, and an amnio-infusion, if ROM has occurred. A STAT C/S is indicated if there are any late or prolonged decels in addition to the variables, or the variables are occurring repeatedly and independent of the ctx pattern.

Nuchal cords, alone, do not cause panic unless, they are tight. In and of themselves, they are not an indication for a C/S, unless the baby is in distress. They can be serious, but the baby will usually exhibit some kind of alarming pattern on the fetal tracing before a responsible provider will declare it an emergency. Also, some OBs are quicker to cut than others, so if you want a C/S as an absolute last resort only, be sure you know how skittish your OB is, and their personal philosophy on C/S. I work with a physician who will cut at the first sign of distress, without the more non-invasive interventions I mentioned above. Needless to say, he will not be my OB.

Just bear in mind nuchals are actually quite common, and no, they should not be considered an emergency in all cases. But as birth can be unpredictable, emergent situations can arise, including true knots, cord prolapses, placental abruptions, and shoulder dystocias. In those cases, I think most women would be agreeable to medical intervention, if it meant saving their baby's life. We are not always as in control of the process as we like to think we are. Baby runs the show, for the most part.