Dispelling a Myth About the Umbilical Cord

October 9th, 2009

My friend and future midwife, Jocelyn, passed this article on to me. I thought it was a great piece to post on the blog since I often hear women say, “Thank goodness I had a cesarean! The cord was wrapped around the baby’s neck and was choking the baby!” I completely understand why one would think that, however about 1/3 of babies are born with the cord either around the neck or entangled around the baby’s torso. The majority of the time this is completely harmless, the doctor will clamp the cord and cut it as the baby is emerging. Other times, the care provider can actually somersault the baby out and disentangle the baby.

Dr. Stuart J. Fischbein, MD FACOG, BAC wrote a wonderful article going further into details about this phenomenon. Please read and enjoy!

Dispelling a Myth About the Umbilical Cord

The umbilical cord around the fetus’ neck cannot strangle your baby! There, I said it. Now, let’s discuss the logic behind this truth. Nature has devised a system to nourish the developing baby inside the womb of all mammals. The placenta and umbilical cord are an amazing creation of both form and function. The placenta acts as a factory for hormones to support the pregnancy, a filter that among a myriad of tasks acts to bring in good things and remove waste and provides a reserve of blood and oxygen to support the baby through labor. The umbilical cord is the conduit by which nutrients such as sugar and oxygen help feed the baby via its two veins while through its one artery passes the waste by-products of growth.

Understanding how a baby gets its oxygen allows us to understand why a baby cannot strangle or “choke” on its cord. In order to choke, one must be using its trachea to breath air. Clearly, there is no air in the uterus, the baby does not breathe through its throat and, therefore, cannot choke. When an ultrasound reveals the cord around the neck it is a normal human response to anthropormorphasize the intrauterine baby to our extrauterine experience. But this is not the case and there is no reason to have fear. So, let’s dispel once and for all the rumor that a cord around the neck (nuchal cord) is more dangerous than any other situation. About 35-40% of normal term babies are born with the cord around the neck at least once. It can also be wrapped around the body or legs or even at times have a true knot. None of which are usually significant as the cord is designed to deal with this.

Cord compression can occur anytime during pregnancy. The cord is well equipped to handle temporary squeezing as the 3 vessels are cushioned by a matrix called Wharton’s jelly and the surrounding amniotic fluid. In labor, sometimes after the bag of waters breaks and fluid leaks out, the cord can be repeatedly compressed with contractions. This is not uncommon and is not, by itself, a sign of distress. Your practitioner or nurse can listen to or interpret the fetal heart rate pattern to know whether any intervention is necessary. And the compression of the cord almost never is an emergency or a cause for the tragic death of a baby inside the womb. When that tragedy occurs we all want to know why and often, mistakenly, we are told it was a “cord accident”. Compared to the number of times I have heard this mentioned by patients or news stories the real truth is that this is a very rare event.

Please be reassured that your baby will not strangle on its cord because it is not breathing through its neck like you and I. If you hear someone repeat this rumor you would be doing a great service to pregnant women everywhere by logically explaining to them the reasons why.

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