"He could have died if I'd had a home birth -- his cord was around his neck." You've heard that, right? Heard people also say that their baby wasn't breathing at birth, because the cord was there, or that their baby had medical issues, even anemia or brain damage due to the cord?
However, it appears that we shouldn't be as terrified of this. A cord around baby's neck is actually very, very common. As in, 1 in 5 babies are born with the cord around their neck, and rarely is it ever a problem. But despite that, many doctors are still doing c-sections or manually yanking the cord over the head, which actually is risky for both us and our babies. Yikes.
There are two kinds of "nuchal cord." Type A, the most common, has the cord around the neck, sometimes even multiple times, but isn't "locked" in any fashion. Type B, which happens much less often, in 1 in 50 births instead, is where the cord has "locked." This one is the one that can be responsible for issues.
Out of the 22.85 percent of births where the cord goes around the neck, almost all of them are only one little loop, which has shown no risk really whatsoever, no negative outcome for baby, no increase in admittance to the NICU or in interference from the doctor. In other words, it's normal, and it happens, and we need to stop freaking out about it.
Rachel Reed of Midwife Thinking explains how movement in pregnancy or normal rotation coming down the birth canal can wrap the cord around the neck, and it's not a concern. She even shows a technique for vaginally delivering a baby whose umbilical cord is short, though she also notes that as the placenta is squished down with the baby and uterus, the umbilical cord obviously moves down with everything, making this a rare issue as well.
The part she really stresses, though, is that if a baby comes out not breathing, remember that they're still receiving oxygen through their cord, not their mouth. Also as we know, if for some reason a baby does need resuscitation, keeping the cord ATTACHED can be the difference between life and death, or at least brain damage or not.
Commonly, lots of us have seen or had someone reach up in the vagina as baby's head becomes visible, feel for a nuchal cord, and slip it off if it's present. But even aside from Rachel's traumatic experience where that maneuver caused the cord to snap and spray blood in her face, it's also unnecessary and can actually cause the cord to start restricting blood flow, tear the placenta/the umbilical site on the baby, or damage the cord.
Of course, the Type B I mentioned can rarely cause some scary issues, but considering you have a very, very good chance that seeing a cord around the neck is normal and okay, according to both midwives and scientific studies, it is actually safer to not go pulling on the baby's head, and not cut the cord until you know the situation. Especially when messing with a Type A can cause more problems than it helps. Not surprisingly, another "get your hands off" situation. Seems really contrary to TV shows, which always freak out about it, doesn't it?
Did your baby have the cord around their neck? If you are pregnant, are you worried about this? What would you opt to do?
Image via jencu/Flickr