Umbilical Cord Around the Neck - should we worry?

The greatest fears an expectant couple has relate solely to the safety of their unborn child. There are so many things that could go wrong, even though they rarely do these days. At the top of the list of the fears about the safety of the foetus is the worry that the umbilical cord will unwittingly wrap itself around the neck of the infant, essentially choking him or her.

For YEARS I have been telling the couples in my prenatal classes (and there have been thousands of couples in my classes) that this is not the case. I let them know that I, personally, have seen the cord around the necks of approximately 30% of the over 250 births I have witnessed without any peril to the baby in any way. To tell you that they are flabbergasted and barely willing to believe me is an understatement. Almost every time I tell a class this I am challenged with a birth story that someone in the class has heard which suggested the exact opposite.

I know it sounds cocky and cavalier to say this but my own feelings are this: when it comes to knowing the true reason behind any of the “emergency procedures” performed on a mother and/or her baby during the birth process, the mother (and often the unpregnant partner) usually proves to be an unreliable witness.

WHY IS IT HARD FOR THE PARENTS TO KNOW THE REAL REASON FOR THE CHOICES MADE DURING LABOUR?

My reason is simple and not at ALL intended to offend. Mothers and their partners are so emotionally invested in the birth that all they can think about is the health of the baby. When a careprovider tells a mother that her labour is not unfolding in a predictable fashion or that the baby seems to be experiencing “some distress” so a caesarean birth is being recommended, she is not able to process everything she hears subjectively. She will be looking for ANY reason as to why her baby and her body are not performing the way she anticipated.

What will often happen, again this is in my own experience, is that while the mother is undergoing a caesarean birth the OB will run a commentary about what s/he is witnessing with regard to the baby. If the cord is around the neck once it may or may not be commented on. If the cord is around the neck a couple or several times this will likely be noted with surprise in the voice, not because the cord around the neck was causing trauma to the unborn foetus but rather because it is unusual to see. The real cause for the concern with relation to the necessity of the surgical birth is unlikely ever to be revealed, sometimes because it is never truly known.

As a culture we have been hearing about the worry associated with umbilical cords and birth for a LONG time. There have been myths established and perpetuated for decades: “don’t raise your arms over your head while pregnant or the baby will wrap itself in the umbilical cord.” If parents are not given the true reason for the surgical birth, if it is not really known or if the parents are willing to see the surgery as having been necessary by believing that the cord was the risk, then so much the better for the liability of the careproviders; especially when the reason for the concern that presented during the labour is not easily identified.

I don’t mean to suggest the OBs are performing caesarean sections unnecessarily, although the Society of Obstetrician and Gynaecologists of Canada (SOGC) may disagree with me. I mean to suggest that the reasons may not always be what they originally seem to be.

What prompted this ramble about umbilical cords? I was directed to have a look at this blog entry and these websites. It is something that I hear fear about quite often and so I wanted to put my voice “out there” as well and let others know their babies are safe.

PS – I know it IS possible for a baby to be in such a position that the body of the baby compresses the umbilical cord decreasing oxygen and blood flow to the baby. This is MUCH less likely than a cord around the baby’s neck but it can, and does happen.

Posted by Sam