When the Umbilical Cord Wraps Around the Baby's Neck

Ever wondered what happens if the baby's cord is around its neck at birth? Parents are often frightened to think about the baby's umbilical cord being around the neck at birth, also called a nuchal cord.

The umbilical cord is covered with a thick protective coating known as Wharton's Jelly. This is like gristle in texture and prevents the baby from compressing the arteries and vein that run through the cord. So the cord being wrapped does not usually pose a problem for the baby.

How a Diagnosis of Cord Around the Neck Made

Currently, ultrasound technology is not very useful at determining a nuchal cord. One study showed that there was only a 65% chance of finding the cord around the neck via ultrasound. There was also a 19% false positive rate, meaning that nearly one in five women were told that there was a cord around the baby's neck when there was not. This, as you can imagine, causes much concern. 

What Happens If the Cord Is Around the Neck?

Once the practitioner has determined that there is a cord, they will decide how to best proceed. Typically the cord is wrapped loosely enough for the cord to be slipped over the baby's head. If the cord is wrapped multiple times this may take a while. Typically you will be asked not to push for a minute while this happens.

Sometimes the cord is wrapped too tightly and the cord will be cut before the baby can be born. This is done by your midwife or doctor by placing two cord clamps and cutting between them. This necessitates the baby's birth fairly rapidly since it is no longer getting nutrients from the mother via the placenta.

Occasionally the baby will be born so rapidly that neither of these methods can be employed. A skilled practitioner will hold the baby's head very even and close to the mother's body as the baby's body is born through the cord. This almost looks like the baby flips out as it is born. The cord being around the neck usually requires no additional monitoring of the baby or mother.

Other Umbilical Cord Issues at Birth

There are other issues with the umbilical cord that may cause issues. This includes cord compression and cord prolapse.

Sometimes this is alleviated by having the mother change position, even something as simple as rolling from her right side to her left side. It may also mean other interventions may be needed, like oxygen for the mother, or amnioinfusion. (This is where fluid is put back into the uterus to provide more cushion for the baby and the umbilical cord.) Sometimes if the fluctuations in the baby's heart rate are severe enough or are not responding to treatment, a cesarean birth may be necessary.

The vast majority of the time, a baby who has a cord prolapse will have an emergency cesarean birth. This may also mean that general anesthesia is required.

Having the cord around the neck is something that is not necessarily going to reoccur in future births. It is also not caused by lifting your arms over your head in pregnancy, as many folklore tellers like to have you believe. If you are concerned, speak to your doctor or midwife about how they handle this at birth.