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.
Entry Filed under: Dispelling a Myth About the Umbilical Cord
33 Comments Add your own
1. Kate | October 9th, 2009 at 2:22 pm
Very interesting and informative, thanks for passing that along.
2. Joe Hart | October 10th, 2009 at 6:24 pm
Myth?
My son (in a breech position) was scheduled for a c-section at 39 weeks on October 8th. On October 5th he didn’t move as frequently as normally so we went to the hospital to find out what was happening. Our baby had no heartbeat not long after he had a strong, measured heartbeat at a regular appointment. He was delivered by c-section on October 5th with the cord wrapped around his neck four times, and this was indicated as the cause of his death.
I find it very irresponsible for you to claim in your story that this is a “myth”. I would strongly encourage all parents to pay very close attention to regular fetal movement. If you have any slight indication there might be something out of the ordinary going on, take it very seriously.
3. Deb | October 12th, 2009 at 8:04 am
Hi Joe,
I am terribly sorry to hear of the loss of your son.
I also thank you for sharing your story and your disagreement with Dr. Fischbein’s article. I believe the message behind the article is to explain the tragic occurrence of fetal death through cord compression is very rare and not often solely because of this condition. This is not to dismiss your experience in the slightest and to say it doesn’t ever happen, however for the 30-40% of babies born with a nuchal cord, this is usually an easily remedied situation at birth.
I completely agree with you that parents should pay close attention to fetal movement through out pregnancy and contact their care provider should they experience something out of the ordinary.
Again, I offer my condolences for the loss of your baby.
Warmly,
Deb
4. amanda | December 19th, 2009 at 8:01 am
maybe the baby isnt breathing through its mouth to cut off air to the lungs but it can be wrapped tight enough to cut off blood supply and oxygen to the brain! are you a real doctor?
5. Deb | December 29th, 2009 at 7:30 am
Hi Amanda
Thank you for your response. No I am not a medical doctor, nor have I ever claimed to be. I am a certified labor support doula and childbirth educator. The blog you commented on was written by Dr. Stuart J. Fischbein, MD FACOG, BAC , who has over 20 years experience as a OB/GYN.
The point he is making in his article is, the baby can not be “strangled”, however there is a very, very slight chance that the cord can be compressed enough to cut off the oxygen to the baby.
Thank you for your comment.
Deb
6. Frank | October 19th, 2010 at 11:11 am
This is a bunch of crap…..my friends baby just died from the cord wrapping aroung the baby neck and killing it just 4 days before it was supposed to be born !
7. Sarai | October 19th, 2010 at 7:33 pm
my friend’s baby died this moring for this very reason…i totally agree with Frank…a bunch of crap
8. Deb | October 21st, 2010 at 10:05 am
Hi Frank and Sarai
I am truly sorry to hear of your devastating loss and appreciate the time you have taken to add a comment to my blog.
While, I am in no way discrediting the circumstances for which your friends are suffering through- I did want to pass along some information that might help remove the fear and concern for future pregnancies that you or your friends may encounter.
These two articles are from medscape- a well respected medical website and the March of Dimes.
http://emedicine.medscape.com/article/262470-overview
Nuchal cord
The cord may become coiled around various parts of the body of the fetus, usually around the neck. Nuchal cord is caused by movement of the fetus through a loop of cord.
One loop around the neck occurs in approximately 20% of cases,27 and multiple loops occur in up to 5% of pregnancies.28
Nuchal cord has been associated with labor induction and augmentation, prolonged second stage of labor, and fetal heart rate abnormalities. One report has described a decrease in umbilical cord pH at delivery with nuchal cord, but the difference found (7.32 vs 7.30) does not appear to be clinically significant.29
Nuchal cord can be detected using color Doppler ultrasound, with a sensitivity of over 90%.30
Nuchal cords rarely cause fetal demise and are not intrinsic reasons for intervention.28,31 Given the minor decrease in pH, fetal monitoring in labor would appear to be prudent, but no data are available to address this issue.
http://www.marchofdimes.com/professionals/14332_4546.asp
What is a nuchal cord?
About 25 percent of babies are born with a nuchal cord (the umbilical cord wrapped around the baby’s neck) (1). A nuchal cord, also called nuchal loops, rarely causes any problems. Babies with a nuchal cord are generally healthy.
Sometimes fetal monitoring shows heart rate abnormalities during labor and delivery in babies with a nuchal cord. This may reflect pressure on the cord. However, the pressure is rarely serious enough to cause death or any lasting problems, although occasionally a cesarean delivery may be needed.
Less frequently, the umbilical cord becomes wrapped around other parts of the baby’s body, such as a foot or hand. Generally, this doesn’t harm the baby.
Again, my sincere condolences for your loss.
Deb
9. Holly | October 29th, 2010 at 9:44 am
My baby boy died from nuchal chord. The evidence was in that , not only was the chord around his neck twice, but also there was NO amniotic fluid around him, meaning that the flow of blood and nutrients was stopped. I don’t and will never know why this RARE thing happened to my boy. All I know is that despite the many people, doctors, etc. who say it, nuchal chord does kill babies, just rarely. My case had hard evidence in the lack of fluid. And, no, I didn’t leak any out. My bag had to be ruptured when I was induced. It was empty. This was a shock to me and my Doc.
10. Stuart | January 25th, 2011 at 10:17 pm
Oops, its 2 arteries and 1 vein. Sorry. Dr. F
11. Jeanine | February 18th, 2011 at 7:46 pm
I also believe that the cord wrapped around a babies neck in the womb can be damaging. My sons cord was wrapped around his neck three times. I was 37 weeks and was delievered by section. Thank god I still have my son today. But he is affected in the way that he is unable to feed on his own. He has been unable to suck properly since birth most of his feeding is done by tub. What they are giving me for an answer is called central hypertonia. His mouth neck and back is affected by this and it makes me wonder that his cord being around his neck was not the cause of this.
12. Inga | February 26th, 2011 at 8:08 pm
This is not true my baby died because of this when i was 7 months pregnant it got strangled in the womb.
13. Julie | February 27th, 2011 at 9:55 pm
Like Holly my son died of the cord being wrapped around his foot. I stopped feeling his fetal kicks the day before at 36 weeks. I had no fluid no rupture I was completly intacted. In the hospital they discoved no fetal heart rate. He is my percet angel named Zachery.
14. vero1225 | April 1st, 2011 at 8:50 pm
thank you so much i feel so much better now n relaxed. i went to get a sonogram done n later on seeing the dvd saw that the cord was kind of around the babys neck n worried alot since i had 2 mc within 7 months. so reading this was like God giving me a sign everything was going to be ok. Thk u
15. ann | April 23rd, 2011 at 9:45 pm
Thank you also, this article makes sense. to the people making alarmist comments … “nature” would not provide such dangerous condition for a fetus! our pop. would be low.
2) to those whom suffered losses (reading between the lines)- I also believe something else was going on inside. I also, know the umbilical cord is very long in thelast trimester. I also know most OBGYN see you every week prior to you due date. With all that said.if future mommies are STILL worried…. buy a stethoscope & monitor your baby 35 week to the due date.
The womb = wonderful & amazing .
16. ann | April 23rd, 2011 at 10:02 pm
2nd theory here: Malpractice insurance is very high $350k TO 1/2 a million is common. Most obgyn do no carry it for this same reason. I looked up nuchal cord its very RARE & when death happen the full recorded is missing from the hospitals… which means someone cut the umbilical cord too early or messed-up the delivery.
Easy scaped-goat = is the umbilical cord.
because the parents will grief BUT not $ue
17. Crystal | May 5th, 2011 at 3:05 pm
Wherever you got your information from is wrong.Whatever you have to say here doesn’t change the fact that I held my dead son in my arms.Looked at his purple face and unwrapped the cord from around his neck twice.He was strangled by the cord in utero 8 weeks prior to my delivery.Stop spreading misinformation about this.It is insulting to those that have lost their children from it.
18. Kate | May 13th, 2011 at 6:20 pm
Crystal, I’m so sorry for your loss but what kind of a doctor would allow you to unwrap the umbilical chord yourself without trying some kind of resuscitation?
My son was also born with the chord wrapped tightly around his neck. As others have mentioned, for him, the fear was a lack of oxygen to his brain which would then have caused his organs to shut down (first). Thankfully he lived and is healthy and happy almost ten years later.
19. Julie | May 28th, 2011 at 7:17 am
28 years ago my oldest daughter almost died from a cord wrapped 4 times around her neck and shoulder during delivery. While I was pushing her heart rate dropped dramatically and the delivery room staff flew into action with the OB cutting me through my rectum, using forceps and nursing staff pushing on my stomach until she was delivered as a 1 on the Apgar scale. She is normal and healthy in everyway and I thank my lucky stars that I was in the hospital surrounded by medical professionals who knew what to do and saved her. She is my miracle baby!! My niece was not so lucky yesterday and I write with tears in my eyes. She attempted a home delivery with her second baby. The baby had the cord wrapped around her neck and by the time the midwife called for assistance and they got to the hospital the baby girl was dead. Our family is heartbroken and in shock. All I can say is that wrapped cords are SERIOUS and should be taken VERY SERIOUSLY.
20. amol | June 18th, 2011 at 6:55 am
just 2 days before we lost our baby because the cord was wrapped around his neck and it was very tightly wrapped. The baby was healthy and we were just week behind the due date. We dont have words to explain how we are feeling. This is very very sad reason.
21. Naraa | June 26th, 2011 at 1:02 am
I am 34 years. from Mongolia. I have one child who is 9 years old boy. I can`t give birth 2 times since my lovely son. I want to give birth, but I can`t it. First time, In 2009, when my baby died at 14 weeks cause of the cord was wrapped around his neck 3 times, I thought that in the next time it would not happened me again. I really hoped it. Then about 15th of June, 2011, I felt very bad energy and I went to doctor . The doctor said me that your baby was died, no heart beating. I was shocked and I don`t understand what was happened me. Baby was 18 weeks. For this reason my husband and I went (took off) to do analysis to the Beijing Wuzhou woman`s hospital of China. He was delivered on17th of June with the cord was knotted 50 times ( get tied up), and this was indicated as the cause of his death. My and baby`s analysis will be ready after 1 month. Our RH is fine, not B, C and any viruses, triple test was fine during my pregnancy. Now I feel sometimes angry or very depressed. I would love to know how it was happened. My husband and I are researching the good hospital that which has rich experience at birth control. Please tell me If any body listen that fact. My address is naraa_3549@yahoo.com
22. L. Moore | August 3rd, 2011 at 6:28 am
My daughter was born with her cord wrapped around her neck twice, very tightly. She was blue and white when she was born, the color of marble. It took a team of 7 to get her to breathe after she was delivered and the cord was cut. Her first Apgar score was a 4. We feel lucky that she has only slight mental disabilities from her delivery.
I have one friend whose baby boy died in utero after she was sent home from the hospital while in labor. His cord wrapped around his neck.
The mother of one of my students lost a baby when the cord wrapped around the baby’s stomach and killed her in utero.
I know people involved with deliveries want to minimize the danger of birth, but that should not include denying the realities of what can happen.
23. jt | August 18th, 2011 at 4:26 pm
Well..my friend just lost her baby girl at 37 weeks because the cord was tied in a knot…so..it is a big deal and maybe a c section isn’t such a bad choice if it could possibly save your baby
24. hollye | September 21st, 2011 at 7:16 pm
im sorry but i do not care what doctors say about babies not taking a breathe to be strangled. babies are strangled! when there is something squeezing around the neck and preventing oxygen and circulation to a very important body part, they are being strangled! Last week on sept 13th 2011, at 38 weeks, i went to the hospital for lack of fetal movement. thought for sure i was going to be told he was cramped inside my womb not moving as much, but he had no heartbeat. i had to deliver him. 408 am on the 14th i delivered my son. it was the hardest thing ever, found out he had the cord wrapped 5 times tightly around his neck and once around his body. he was a very active baby. he was strangled and killed by the cord no more or less. if the cord wasnt around his neck id have him right now. oh and its a load of crap that babies born sleeping are not conscidered humans because they never took a breathe! r.i.p. evan mommy and daddy love you.
25. Andra | November 4th, 2011 at 10:54 pm
Nice post. I was checking constantly this blog and I am impressed! Extremely helpful info specifically the last part
I care for such info much. I was looking for this certain info for a very long time. Thank you and best of luck.
26. Renee | November 16th, 2011 at 11:21 am
i am very worried now i am 28weeks and at times i hardly feel my baby move usually she moves alot but she has been moving less and less can this be something i should talk to my doctor about a.s.a.p? Reading all these comments really got me thinking and got me sad i’m sorry for all of you tht loss your babies sad thing and now i’m very worried and i’ panicing. What should i do?
27. Lina | November 22nd, 2011 at 1:26 pm
Very good information! I have been seeking for things similar to this for a time today. Thank you!
28. Natasha | December 8th, 2011 at 7:48 pm
I have not yet had the pleasure of having a child so I have never experienced these problems, nor do I know anyone who has. I am deeply sorry to those that have had losses from the cord wrapped around their unborn child.
However, I have to say that the people leaving comments about the article being irresponsible or wrong must not have paid very close attention. It says it is RARE, not impossible, for the cord to kill a fetus. Obviously, those people are part of the RARE statistic.
True, a fetus can not be killed by strangulation, but they can be killed by SUFFOCATION.
Suffocation: To kill or destroy by preventing access of air or oxygen.
Clearly this can happen if the CORD or NECK of the fetus is squeezed too tightly as it is cutting off the blood supply to the brain therefore preventing oxygen from reaching the brain.
Just to make it clear though, I am not any type of medical professional, I’m just not stupid.
Under the same subject, but a different topic, if you are in labor and something doesn’t feel right, don’t let the doctor talk you out of a C-section. Yes, there is a point where it’s too late for a C-section but if you’re not there yet, stand your ground. I have heard and read so many stories about parents asking for a C-section because something seems off but they let the doctor bully them out of it and their child died or had severe mental or physical disabilities because of it.
In fact, don’t let a doctor do ANYTHING to you period without your permission and knowing what it is first. This is called battery and is very much illegal.
29. Nae | December 14th, 2011 at 3:38 am
my son was born with the cord around his neck. he is perfectly fine. it is RARE that babies die from this. my midwife talked to me about it after i gave birth. i thought it was something that was dangerous but when she told me it RARELY is, then i calmed down about it.
not to make any one mad or anything but the article states that it is RARE not IMPOSSIBLE. so pls be kind. they are just informing you.
one again please be kind.
30. carrie | January 26th, 2012 at 11:52 am
My daughter was born at 36 weeks with her cord around her neck 2 times, and it basically strangled her. So I dont understand why someone would say this is a myth. My daughters face was bruised when she was born and you could see the spot on her neck where the cord was so tight.Its sad to say that some people think that this can not happen, it actually upsets me that this “DR” thinks that this can not happen. If he would have seen my baby, then he would have known that she was actually strangled
31. Rachel | January 27th, 2012 at 5:44 pm
Babies can strangle. Mine strangled at 37 1/2 weeks the cord was around her neck 5 times and she had a true knot. Blood flow was stopped to her brain causing her death, Thats strangulation. The kicks and kicks and kicks before she died was indicitive of this. We couldn’t get her out in time. It is important to teach mothers warnings signs and not sugar coat reality.
32. Nick | January 29th, 2012 at 9:10 pm
Whoever wrote this article has no clue what there talking about.
33. Lauren | February 3rd, 2012 at 12:14 pm
My son was just born with a very tight nuchal cord. It had to be cut before he could be delivered. His face was swollen and deep purple from the bruising and he had blood in his eyes from the intense pressure the cord had placed on his face. He spent 6 days in the NICU recovering and we were told by many NICU nurses how lucky we were that he hadn’t suffered any facial paralysis or death because they had seen that happen with cases just like his.
We’re 3 weeks post partum and his eyes are still badly bruised with blood pooled in his eyes.
I would challenge anyone to take one look at my little boy and tell me that nuchal cords aren’t serious.
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