Friday, March 29, 2013

Q: What if the cord is around the baby's neck?

A: You unwrap it. 



I've heard so many birth horror stories ending with "...and the cord was around the baby's neck!" Most of the time, a nuchal cord is of no significance to the birth process. You simply unwrap it after the baby emerges.

I'm thinking of making another video using footage from Inga's birth, titled "What if the baby doesn't breathe right away?" Her resuscitation was slower and less aggressive than NRP protocols, though. I'd probably need to make a note of that...

Dramatic effect thanks to Igor Stravinsky's "Rite of Spring" and Claude Debussy's "Reverie."
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13 comments:

  1. I've been watching for more from you...after viewing I say out loud: superhero. amazing as ever.
    sneak peek at the pro birth photos looked really lovely. Impressed. (and btw I have a french first and middle name Nicole Helene)

    Congratulations!

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  2. So calm and prompt with appropriate movements.
    Neat how you are still surprised and awed by birth the forth time.

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  3. Love the music!

    One of the stories about my birth is about my aunt freaking out when I was coming out because I had a triple nuchal cord. Obviously I was fine though :)

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  4. My brother had the cord around his neck, but in his case it was causing his heart rate to go crazy during pushing and needed a little help from the vacuum.

    Then there was my brother-in-law, who had the cord wrapped around HIS HEAD. Yeah, that made for a crazy delivery.

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    1. Wow, cord around the head--that is crazy! Cord compression/restriction can happen in other locations, but for some reason our culture focuses on the the "around the neck" part almost exclusively. Yes, a baby can have a nuchal cord that causes bad heart tones or delays descent...but so can a cord around the shoulders/neck/waist/head/whatever. Or even a cord that's not wrapped around anything but is being compressed during labor.

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  5. Love this. It's so frustrating to hear people freak out about something that happens in almost 30% of all births. Check out this awesome birth video just happened to watch a couple days ago. It's a super hands off hospital birth, squatting mama picks up the baby (after a very fast exit!) and unwraps the nuchal cord 4-5 times! It's awesome.

    http://www.youtube.com/watch?v=xk5k2kHdGYI

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    Replies
    1. I just watched it--pretty cool! And that is one crazy long cord.

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  6. Exactly. My goodness. I can't tell you how many times I explain to patients, it's ok. Common, even. Congrats on your newest little one :)

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  7. Nothing irkes me more than when people say nuchal cords are no big deal. Sure, many times all that is needed is a little unwrapping at birth. Sometimes though, it's a big deal. Huge deal. The cord can be wrapped so tightly around the neck that it becomes compressed and every push restricts oxygen flow to the baby. It's not rocket science. A loose cord can be easily taken off. A short and tight one, not so much. Nuchal cords can even be rendered so short as to not allow decent of the baby. I'm glad that everything turned out fine with your baby, but to say that nuchal cords are never a problem is misleading, not to mention completely false.

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  8. Nuchal cords on sono has become the new section crusade in my area. A nuchal noted on your 34 week sono will get you weekly NST's and BPP's right up to your scheduled 38 week ssection. Nuchal cords can present a problem but they occur in at least 25% of all deliveries. Obviously we do not have a 25% stillbirth rate.
    As far as immediate crying goes: I find that as long as the cord is not cut and the placenta appears to still be functioning (cord pulsing) the only one that gets butt-hurt is the nursery personell. The placenta was the lung before delivery and seems to work fine for a short time afterward in most cases, so immediate crying is necessary why?

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  9. Rixa, I love your levelheadedness! Thank you for helping to take the fear out of "cord around the neck". This is something I endeavor to tell my CBE students. In Penny Simkin's "3 R's" dvd, there is a birth with a nuchal cord and the midwife just slips the cord off. That scene always draws amazed commentary from my students.

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  10. Was always dumbfounded by the fear of nuchal cords. MIL suggested not homebirthing in case of nuchal cord when we were having our firs. Huz said "I don't think we need a medical degree to unwrap a cord" lol. Last month I put together a post about umbilical cords with info I've learned from other birth workers and some interesting pics :)

    Umbilical Cords

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  11. All four of my babies had their cord wrapped and the first was a hospital birth. Kbow what they did? Unwrapped it.

    Zoe-#2 had hers wrapped twice!

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