A nuchal cord is rarely a problem: dispelling a common myth

Midwife Rachel Reed assesses the risks of a common condition which many parents fear.

“Only very occasionally will a nuchal cord prevent the baby descending once the head is born, in which case the midwife can use a ‘somersault’ manoeuvre to free the baby so that the cord can remain intact.19 If this manoeuvre is unsuccessful, the worst case scenario is that the cord snaps as the baby descends, and requires clamping.”

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Cord around the neck – what parents & practitioners should know

somersault image
The Somersault Technique promoted to assist births where the cord is short and/or tight

Nuchal cords are rarely found to be the cause of adverse outcomes in studies of pregnancy and birth. Several authors have concluded nuchal cords “ordinarily do no harm” (5,6,7).

Some studies have associated nuchal cord with an increased rate of variable fetal heart rate decelerations during labour, and tight nuchal cords to a higher proportion of fetal distress and low Apgar scores. (3,4,8) However, in these retrospective studies the definition of tight nuchal cord were those ‘clamped and cut before delivery of the shoulders’ – therefore short-term morbidity was more likely caused by the interventions rather than the presence of nuchal cord (3).

 

(To learn more about nuchal cords, how babies can and are born with loose/tight/multiple nuchal cords, and why they aredisproportionately associated with risk and adverse outcomes, please read Nuchal Cords: the perfect scapegoat.)

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Practitioners that respond clinically, not routinely, to a nuchal cord – and with the least intervention possible – are more likely to protect normal physiology and anatomy and avoid iatrogenic injury.”

**Trigger Alert: Hospital Images**

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Nuchal Cords: the perfect scapegoat

“To get this blog going I decided to write about a slight obsession of mine: The fear of, and routine midwifery management of nuchal cords at birth (umbilical cord around the neck). I have written and presented about this topic and have bored the pants off many a person who has made the mistake of mentioning the subject. So, despite telling my colleagues that I had put away my ‘nuchal cord’ soap box I am bringing it out to launch this blog. The content of this post is based on part of a literature review I carried out for my PhD thesis. If you are interested in finding out more you can download a journal article here, a poster here, or my full literature review in my thesis here.”

Below is a minimally assisted hospital birth. The baby has the cord wrapped around 4 times and is doing great!

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9 Surprising Facts About The Cord Around A Baby’s Neck

“A nuchal cord (cord around the neck) is one of many things that mothers-to-be fear about childbirth. The thought of their precious baby being ‘strangled’ by their umbilical cord can cause so much worry.

Luckily, unborn babies get nutrients and oxygen via the umbilical cord, not by breathing it in through their nose and mouth, which may eliminate some fear right there. They don’t need their neck to breathe.”

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