Friday, April 17, 2009

Nuchal Cords

"Nuchal Cord: A nuchal cord is an umbilical cord that is wrapped around the fetus's neck. A nuchal cord occurs in about one fourth of deliveries. Normally, the baby is not harmed.

Before birth, a nuchal cord can sometimes be detected by ultrasonography, but no action is required. Doctors routinely check for it as they deliver the baby. If they feel it, they can slip the cord over the baby's head. Sometimes if the cord is tightly wrapped, it is clamped and cut before the shoulders are delivered."

Recently I have heard about several women who had to have a cesarean birth due to the baby having the cord around the neck. But it happens according to this research a fourth of the time. So why does it cause issues for some and not others? In fact my grandson was born with the cord around his neck four times- without any issues at all.

What happens is if the baby is not allowed to maneuver and stretch the cord- making his or her way down the birth canal on his or her own time. But what happens is a mom gets an epidural and then is limited in her ability to move- helping the baby move. If we want to move the baby we move the mom. But if she is immobile then that is limited at best. Then the epidural slows labor down, especially if given too early. And the need for pitocin is increased. And since she is medicated now to not feel the pain, the use of pitocin is usually much more accelerated than it is when a woman does not have an epidural and needs to be able to manage the augmentation.

Pitocin can sometimes slam a baby down into the birth canal and there is no time for the cord to be able to stretch or the baby to move to accommodate having the cord around his or her neck. So the very interventions that are selected can end with an unnecessary surgical birth due to a baby going into distress.

So, just having the cord around the neck of the baby is not a reason for a cesarean birth. I know for me as a doula, I have seen nuchal cords at least 20% of the time. It is easily slipped over the head of the baby or the baby easily slides through the loop as he or she is being born. How often are cesareans performed that could have been avoided if the laboring mom was not induced or augmented during her labor- therefore causing the very problem that would not have been a problem otherwise. Sad.

1 comment:

Teresa Howard said...

This quote was from the Merck manual online.