N is for Nuchal Cord
Something that people get really worried and scared about when it comes to birth (and I often get asked about this on my Hypnobirthing & Antenatal Courses ) is their baby being born with their umbilical cord around their neck - which is also known as a 'nuchal cord'.
I get it. It’s one of those fears that sounds really scary, but in reality it’s actually not something to worry about. It’s another of those ‘birth myths’ that I really love to debunk. So here’s more about it so you can remove your worry by understanding what it is, how common it actually is, and why it’s not an issue.
what is the umbilical cord?
Firstly lets look at the umbilical cord and what it does. Because it is an amazing structure (just like the placenta is utterly amazing too - learn more on the placenta here).
~ In utero the umbilical cord connects your baby to the placenta, and takes the oxygen and nutrients to your baby that it needs to be created and to grow. It connect at what will become your babys tummy button, also know at the ‘umbilicus’.
~ The umbilical cord is genetically part of the baby, and contains 3 three vessels. There’s one vein which pumps nutrient rich, oxygenated blood to the baby, and two arteries which transfer
deoxygenated and nutrient depleted blood back to the
placenta (to then be re-oxygenated & renourished).
~ The umbilical cord forms by the 5th week of pregnancy.
~ The umbilical cord lining is rich in stem cells.
~ The umbilical cord is amazingly resilient, a substance called Wharton's Jelly protects the blood vessels in the cord - that are supplying baby with oxygen and nutrients - from being squeezed by kinks, or being compressed and from knotting (although knots do happen, and that’s OK too).
Is a ‘nuchal cord’ common?
Yes! It is very common for babies to be born with their umbilical cord around their neck (called a nuchal cord). Around one in four babies are born with a nuchal cord. You usually only find out about it when the baby is being born.
Is a nuchal cord a problem, should I be worried?
Most of a nuchal cord causes no problems and the baby can be born without intervention. Lets talk about the worrys people have about the cord, and then understand how your body has a clever system in place to cope with those.
What most people worry about is the baby being somehow ‘strangled’ by the cord, their oxygen being cut off and that they won’t be able to breathe. But this doesn’t happen because at the point babies are born they are not yet breathing - they are still getting their oxygen and nutrients from the placenta via their umbilical cord. And the Whartons Jelly I mentioned above prevents the cord being compressed - so even if it around babys neck it can still function and get oxygen to your baby. Clever.
Also during labour and birth your baby, the umbilical cord and the placenta all move down together as the uterus moves them down to be born. Which means that your baby stays around the same distance from the placenta, it’s not that the umbilical cord gets suddenly pulled tight or stretched.
There is research on nuchal cords and the vast majority of it shows no associations of worrying outcomes with nuchal cords. Infact some research even shows favourable outcomes of birth. For example here: https://pubmed.ncbi.nlm.nih.gov/20397541/ 'Nuchal cord are
necklaces, not nooses' by J Cohen. It states that intervention for the supposed presence of single or multiple loops of nuchal cord or a true knot, suspected by ultrasound prenatally, is unjustified because diagnosis by ultrasound is unreliable and intervention involves greater risk to the baby than the nuchal cord itself. Since nuchal cords are not associated with adverse perinatal outcomes, practitioners and women should consider their presence reassuring and normal.
Babies are no more likely to come to harm when they have their cord round their necks like a necklace, than when they don't.
WHAT IF THERE IS A RARE PROBLEM?
Should there be a (rare) issue with the umbilical cord, for example when the cord is short and the nuchal cord tight, it may prevent the baby from being born in the usual way with the head going straight out and the body following the same line. There are generally signs in advance that your midwife will be looking out for - just in case. That’s one of the reasons midwives are so very brilliant - they are highly trained and skilled to spot the ‘what ifs’ - so you don’t have to,.and you can get on with focussing on your hypnobirthing techniques and the labour and birth.
If there is the rare occurrence that the umbilical cord is too tight around babys neck to allow your baby to be born then your midwife will not cut the cord (this would reduce blood flow to the baby as this could actually cause a dangerous situation when the shoulders and body do not follow immediately after cutting the cord), and she also doesn’t want to pull on the cord either. Instead there’s something called the ‘Somersault manoeuvre’ that helps which is a minimal intervention, allowing baby to be born with an intact cord and for delayed cord clamping to happen. You can read more about this on this website if you’re interested - https://www.somersaultbirth.com. But really there’s no need to - because your midwife will know all about it.
Then once the baby is born and the cord has gone white and stopped pulsing, and we know that the blood transfer from placenta to baby has stopped the cord can be clamped or tied and cut. The little cord stump that’s left will then dry out over a few days, shrivel and simply detach. The tummy button may take a few days/weeks to completely heal up. You can read more about ‘optimal cord clamping’ in this article.
I hope that’s reassuring, and helps reduce any fears you may have about nuchal cords and the false stories around them. Because my work really is to support pregnancy folk in having a more confident and less anxious pregnancy. For more support, practical techniques, ands of evidence-based information and up to date research do join one of my Hypnobirthing & Antenatal Courses
Susan x