# "he had the cord wrapped around his neck and WOULD HAVE DIED!!"



## craft_media_hero (May 15, 2009)

So it seems like whenever I mention homebirth, I get one of these cord horror stories in response. Instinctually, I don't believe it, but I'm not a birth professional and don't really know enough to understand what's really happening here.

The most recent was my godmother's story--she had the fetal monitor around her belly, every time she'd have a contraction his heartbeat would "stop", so the doc cut her a full episiotomy, reached in and pulled the baby out. This was all due to the cord being tightly wrapped around his neck and cutting off oxygen. Apparently had the doctor not intervened and cut and pulled the babe out, he would've been stillborn. This is what my godmother was told and what she believes 30y later.

The story before that was that the momma was laboring for about 60-70 minutes. The fetal monitor showed that the heart rate dropped during contractions. Mom received an emergency cesarean, and the babe was born "with the cord tightly around his neck". This was "a close call" and if they hadn't had a cesarean, I am told the babe would have died. FWIW this mom had a very "medical" OB attending her.

Can we talk about this?

It's my understanding that the cord is around the neck in 1/4 or 1/5 births. Can the cord around the neck really cut of oxygen and cause stillbirth? Would the babe be born, cord unwrapped, and isn't it still receiving oxygen from the placenta even if the cord is wrapped?

What about the heart tones slowing or "stopping"? Is this caused by the nuchal cord? Even if the heart rate slows during ctx, could that birth work out ok w/out interventions?

Without the fetal monitor, would these births have simply progressed naturally with the babies pinking up after birth? Or would they really have been stillborn because the cord was too tight? At that point, isn't birth pretty much imminent?

I hated the fetal monitor and only let them put it on my for a minute, and I don't want one in this next birth I'm preparing for either.

I'd like to understand what's really going on here and dispel the "horror cord" myth. Can you all help me out, here?


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## GreenTeaGinger61 (Oct 10, 2009)

I don't have a medical answer for you but my daughter was born, vaginally with the cord wrapped around her neck twice and with a true knot. Her heart rate dropped a bit towards the end but nothing drastic and there certainly wasn't any talk of cutting me open in any way shape or form. She was fine when she was born. The Dr. put her on my belly and had the cord undone in about five seconds. There was a bit of panic but nothing serious. This didn't happen with my other two births.


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## MaterPrimaePuellae (Oct 30, 2007)

My DD was also born with the cord around her neck (once or twice, I don't remember). Her HB did decrease during contractions, and they had me roll on my side during them. It stabilized.
I do know someone whose baby was stillborn because of a cord around his neck-- but I think (I'm fuzzy on the details) that the baby died before labor. In any case, the baby was delivered in a hospital, and that didn't make a difference for him.
The vast majority of babies who have nuchal cords are just fine.

Especially with the births that happened so many years ago, I would question the quality of the EFM.


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## ScarletBegonias (Aug 24, 2005)

student midwife here:

both of my children had the cord around their neck, ds also had a true knot.

one reason it's so common because as the baby is descending into the birth canal, often he/she will go through a "loop" of cord and by the time baby is out it's been caught around their neck.

it's typically a non-emergent occurrence, and as the research bears out, the more monitoring/interventions, the more likely that something happening during labor/birth that is non-emergent will *become* emergent directly due to interference.

and i agree with MPP: i would be wary of any results from efm that was going on 30 years ago.

eta: the very nature and construction of umbilical cords make them nearly impervious to *most* compression during labor/birth. they are designed to withstand intervals of great pressure, while still delivering oxygen to baby. all babies will experience heart tone variation during labor. it is completely normal for the heart rate to slow some during a contraction, and then pick up again when the ctx ends. mama is working hard, but so is baby. it's not like baby is just chillin' and hangin' out. baby puts out energy and physical force to make birth happen.

what makes a difference is the rate of decel and recovery: how baby is handling ctx's.


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## roadfamily6now (Sep 14, 2006)

In addition to what scarlet mentioned, babies don't "breathe" through their mouths or noses while in utero. They get oxygen from the blood that flows through the umbilical cord. A cord wrapped around the neck wont cut off oxygen to the baby in this way.

A true Knot might reduce blood flow thus oxygen rich blood, to the baby.


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## Charmie981 (May 30, 2002)

Yes, it's important to note that the issue is not having something around the neck causing asphyxia (as it would when we're yelling at our kids "don't wrap that jump rope around your neck and run!"), but that cord tightly wrapped can cause cord compression, which can interfere with the flow of oxygenated blood from the placenta to the baby. Cord around the neck compresses more than cord around, say, the foot, just because there are more folds in the neck and the cord can be compressed between the neck and a shoulder. The worst cases of cord compression I've seen, though, resulted with cord around the body and therefore getting compressed between baby's arm and rib cage.

Because the blood flow is changed via cord compression, any cord compression is going to show up via EFM, especially continuous EFM. The key is to understand that when cord compression from a cord around the neck is likely to be most severe is when birth is imminent because the cord is being stretched to the maximum. In the case of the massive episiotomy and vacuum extraction, it sounds like birth was pretty close anyway and someone who trusted the mother's ability to birth a baby could have encouraged her to push with everything she has and get the baby out just as quickly, with less tissue trauma. In the case of c-sections for cord compression, I find that they are often the result of a fetal distress call made because baby isn't tolerating contractions well, is having deep, late decels and isn't recovering quickly after a contraction. That is considered a non reassuring FHT, and I guess in those cases the only logical choice is a c-section, although I always wonder...if we weren't obsessively listening to those babies, how many would be born vaginally and recover just fine? It's a purely hypothetical question, of course, because no one is going to see a non-reassuring FHT and say, "well, let's just wait and see what effect this is really going to have on the baby."

There are cases where the cord compression could be severe enough to stop blood flow through the cord altogether (which is what happens when a baby dies in utero due to a "cord accident"), but those cases are rare and every study of EFM ever done says that the only thing continuous EFM does is increase the rate of surgical delivery, NOT decrease the rate of fetal demise.


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## katelove (Apr 28, 2009)

Quote:


Originally Posted by *craft_media_hero* 
The most recent was my godmother's story--she had the fetal monitor around her belly, every time she'd have a contraction his heartbeat would "stop",


Frankly I don't believe this. Although I'm prepared to believe that this is what she was *told*. It takes a serious insult for anyone's heart to stop beating and, when it does, it requires some considerable effort to get it started again.

What is more likely is that contact was lost between the monitor and the foetal heart during contractions. This is a very common problem with EFM.

It is also fairly common for the heartrate to drop during contractions. This is due to the pressure on the babe's head and is called an early deceleration. It is a normal response and not a sign foetal distress.

A quick review of the literature seems to suggest that a nuchal cord may be responsible for foetal death during labour in some circumstances. However those circumstances - cord wrapped multiple times tightly around neck and/or an unusually short cord which is pulled tighter than a cord of average length would be - are very rare.


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## eastkygal (Feb 19, 2006)

My second c-section was a homebirth transfer to the hospital. My baby was 11 pounds and posterior, but what I believe ultimately caused a necessary c-section was cord issues. Her cord was wrapped around her arm at least three times, tightly. My water broke before labor started and there was quite a bit of meconium in the fluid. I stayed home for 24 hours without consistent labor. When we transferred to the hospital I labored intensely for more than 7 hours going through all stages of labor in emotion and intensity, but I never dilated passed a three. All during this time Ivy would pass meconium on and off. Also, she would go through short periods of decels, but recovered well. The final decision for a c-section came when she didn't do so well after a period of decels at recovery and I had seemed to go through transition and my contractions were definitely strong enough to have been causing me to dilate, but I did not. I was also 41 weeks and 6 days gestation, which could have been the reason for the meconium, but we were unsure of her stress levels and the cause of her not being able to engage in the pelvis. In the end, seeing her arm and the pressure knots and bruising it caused across her arm and her back, I believe that the cord was too short to allow her to engage. Despite all this, I don't believe she ever lacked enough oxygen. My baby was not born pink, she was born red and lively - ready to nurse. So, after that experience, I believe it would have to be something very very severe to cause a stillbirth.


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## jenfl (Oct 20, 2007)

My daughter had her cord wrapped around her neck once and again around her shoulder. The midwife was monitoring her heartrate during pushing contractions intermittently, and noticed some decels. She had me roll onto my side (from my back), and DD's heartrate evened out.

She's 2.5 and totally fine.


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## member234098 (Aug 3, 2002)

I agree with all the PPs and want to note to you, the OP, that a cord around the neck will in most cases prevent a prolapsed cord.

This is nature's way of preventing the cord from falling out when the doctor decides to prematurely rupture the membranes.

As for decels in the baby's heart tones, the baby is gently getting ready to live outside the womb and will have some stress as the birthing process takes place, but the baby needs to be ready to breathe.


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## onetwoten (Aug 13, 2007)

just a few minor points I haven't seen yet. I've seen several people mention that it's normal for baby's heart to decel with contractions-- I also believe that the professionals tend to get nervous a/ if it doesn't change at all with contractions, because well, like someone mentioned, labor is hard work, and if it's not effecting the baby at all, that's a little weird. And also that b/ The most common time for people to get worried isn't the heart dropping- but the heart rate not increasing again after the contraction ends.

There's a large number of babies whose moms don't even know they had the cord around the neck because the dr just loops it over the head as the baby delivers. Most of the time it's no big deal.


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## craft_media_hero (May 15, 2009)

Ahh! Thank you all for responding; I am finding this to be a very enlightening thread.

Charmie981, thank you for your very thorough explanation.

I'm understanding this subject a lot better now and am feeling much reassured about "cord horror" lol.


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## CharlieToaster (Mar 10, 2008)

I had a birth center delivery and my son had the chord wrapped around his neck. He was rather blue when he was born and it did cause the midwives to cut the chord right away and give me a shot of pit to deliver the placenta right away to be sure but all was fine.


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## SashaBear (Aug 24, 2006)

The cord was wrapped around my son's neck as well. There was never any indication that he was in danger. When his head came out the dr saw it, told me to stop pushing, unwrapped the cord, and I pushed DS out the rest of the way. No biggie! The dr. didn't even say anything. The only reason I know this is is because DH was watching.


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## Cheshire (Dec 14, 2004)

Quote:

I'm understanding this subject a lot better now and am feeling much reassured about "cord horror" lol.
My son did die from a cord issue and his birth was horribly traumatic. Having suffered through this loss I've met many other mommas whose children have died from cords being wrapped around necks and from true knots in cords. It's not a "myth" when it happens to you and it happens more often than people know. From the Pregnancy Institute's study:

Quote:

Umbilical cord accidents are the stuff of which nightmares are made. Occurring in otherwise textbook pregnancies, they result in the deaths of one in every thousand babies. The mortality rate is noteworthy enough -- twice as many babies die from cord accidents as from SIDS -- but it only tells part of the story. Another three in every thousand babies are left severely disabled as a result of cord accidents.
I would just encourage you to not doubt all of the stories you hear because, first, you weren't there and aren't a medical expert so you can't be sure, and second, because I'm sure there are plenty of cases where it does save a life versus the cases where it may have been an unnecessary intervention. Give that mother the benefit of the doubt - she doesn't need her birth second guessed because the listener believes they know more about birth than the care providers she trusted.


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## Galatea (Jun 28, 2004)

My sister's first son had his cord wrapped around 4 times.
It did prevent him from descending or moving and he had major meconium aspiration, so she did have a c-section, and then he was in the NICU for 2 weeks recovering. But he is fine today!


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Charmie981* 
every study of EFM ever done says that the only thing continuous EFM does is increase the rate of surgical delivery, NOT decrease the rate of fetal demise.










I think that's important to note!

Quote:


Originally Posted by *jenfl* 
My daughter had her cord wrapped around her neck once and again around her shoulder. The midwife was monitoring her heartrate during pushing contractions intermittently, and noticed some decels. She had me roll onto my side (from my back), and DD's heartrate evened out.

Yup, this was my experience. I was on my hands & knees, DS' HR was dropping, MW asked me to get down on my left side to push & that helped. I was in the hospital, so they gave me some oxygen to breathe too in order to increase oxygen flow to the baby.

His HR recovered, so the MW said I could get back on my hands & knees (side-lying was more painful AND felt less productive), but when his HR dropped again, she said, "Meg, you may like that position, but baby doesn't."

Cord was wrapped 2X around his neck & once his head was born, MW unwrapped it. With the next push, I birthed his body & DH caught him.








He was fine - great shape after about 45 min total of pushing.

Quote:


Originally Posted by *Cheshire* 
I would just encourage you to not doubt all of the stories you hear because, first, you weren't there and aren't a medical expert so you can't be sure, and second, because I'm sure there are plenty of cases where it does save a life versus the cases where it may have been an unnecessary intervention. Give that mother the benefit of the doubt - she doesn't need her birth second guessed because the listener believes they know more about birth than the care providers she trusted.

I'm sorry for your loss. And you're right - it DOES happen, so we should "Give the mother the benefit of the doubt" & not doubt her story. *However, that mother should give the original poster the benefit of not fear-mongering! Telling horror stories & scaring Mamas away from home birth isn't right.*


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## JessicaA622 (Jan 25, 2010)

The cord was wrapped very tightly around my son's neck. His heartbeat dropped significantly with every contraction. Once I got his head out the OB had to cut the cord because she couldn't unravel it. If the delivery had lasted much longer I truly believe I would not have my son today. He came out completely white and not breathing. Thank God, he is fine now. That being said, I would NEVER discourage someone from doing a home-birth. What happened to me was not the norm. Would I ever try a home-birth? Based on my experience with delivering my son, no, but that doesn't mean I should go around telling everyone my story and saying that home-births are dangerous (especially when they're not). Some people just need to keep their stories and opinions to themselves. Let people think for themselves!


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## Cheshire (Dec 14, 2004)

Quote:

However, that mother should give the original poster the benefit of not fear-mongering! Telling horror stories & scaring Mamas away from home birth isn't right.
Every mom should have the right to decide where to give birth with the care providers she wants. But, we also shouldn't leave moms to believe that home births are all rainbows and butterflies.

No one should fear monger and having had three children I've heard plenty of horrible birth stories while pregnant and have one of my own. I do not share it with pregnant women IRL - I hardly share it at all, who wants to hear about babies dying? I do feel my son had a small chance because he was born in a hospital with a NICU team readily available. If I had given birth at home he would have had no chance (he needed immediate blood transfusions, he lost most of his in a matter of heartbeats due to a cord rupture).

Women need information to make informed decisions. Women need to know that good and bad outcomes happen no matter where you give birth. Women need to be free to make decisions that they will be able to live with no matter the outcomes of those decisions.

I agree that mom's shouldn't try to scare pregnant moms towards any decision (there are plenty homebirthers that make every single hospital and hospital birth seem awful - it goes both ways). Learning to offer support without judgment would be utopian - it has to start somewhere so why not with us?

And, as every pregnant woman quickly learns, you can listen to those stories or not, you can choose to surround yourself with people who won't try and scare you either direction but support your pregnancy journey no matter what decision you make.


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## Mom to E and A (Jul 11, 2005)

I have not read all the replies, but did want to offer this:
My daughter was stillborn last April due to the cord around her neck (5 times) and a true knot. She was delivered in a hospital and had been dead for at least a day or two before I went into labor. I honestly had no idea until the hospital was unable to find her heartbeat with the monitors. Had she been born at home it would have made no difference as she was already deceased before labor even began. So while a little different than your situation, my point is that YES babies can be stillborn becasue of "cord accidents" BUT it can happen just as easily in a hospital. For me, it wasn't labor that killed her.
FWIW, I was told that cords around the neck 1, 2 or even 3 times is fairly common and generally not a big deal.
Congrats on your pregnancy and Good Luck on your delivery...everyone has a horror story about everything...don't let em get to you! Do what YOU feel is best for you and your babe


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## gcgirl (Apr 3, 2007)

Quote:


Originally Posted by *MegBoz* 
:
I'm sorry for your loss. And you're right - it DOES happen, so we should "Give the mother the benefit of the doubt" & not doubt her story. *However, that mother should give the original poster the benefit of not fear-mongering! Telling horror stories & scaring Mamas away from home birth isn't right.*

It's my understanding that a trained midwife generally knows how to deal with cord issues. I don't see why the possibility of a cord issue would mean a homebirth is out of the question.


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## mamakori (Dec 19, 2008)

Both of my children had nuchal cords and both were totally fine (DS #2 had mec., but Apgars of 9). Cord accidents do happen, but in the vast majority of cases, there's no issue. I haven't looked into the statistics myself, but going by what others posted, if 1/5 babies has a nuchal cord and nuchal cords are responsible for 1 death in 1000, that means that only 1/200 or 0.5% of nuchal cords are fatal. That's not zero, but it's pretty similar to the risk of uterine rupture during a VBAC.


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## Sweetiemommy (Jul 19, 2005)

Excellent points being made on this thread. I do want to give my personal opinion that an experienced midwife is more likely to have a few tricks up her sleeve for dealing with cord issues, as compared to an OB who is more likely to resort to a c-section or to perform some other heroic measures, while he/she has the NICU handy. I'm trying to say that a homebirth midwife has to use a different skill set to ensure safety and has more experience dealing with difficult birth situations in a natural way. The doctor is more likely to intervene in a completely different way. With that said, I haven't heard of any babies having serious complications with cords at home (in my personal experience) but I do hear of them happening at the hospital from time to time. One example, a doula I know told me this story, the hospital OB felt for a cord when the baby's head came out, it was loose enough that a midwife might have just looped it over the head or waited, he decided to cut the cord while the baby was still inside. The shoulders were suddenly stuck and of course the mother was on her back with an epidural. So it was suddenly a very serious emergency and the baby ended up in NICU (he was fine, but it was an ordeal!). Now I'm just being the Monday morning quarterback, but I think a midwife would have handled that completely differently. So whenever someone asks me about cord issues, I tend to say, "my midwife knows a lot more about how to resolve a cord issue than an OB in the hospital." And she's also completely unlikely to break my waters, which increases the likelihood of such things. Anyway, not a scientific response, but I agree with pp who said that cord issues do happen, but being at a hospital isn't going to guarantee a positive outcome.


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## mamabearsoblessed (Jan 8, 2003)

All of my babies have had nuchal cords. These are our stories... though all my babies were in hosp. births.
First dd was wrapped 3 times, she was perfectly fine at birth.
Ds was wrapped twice with an incredibly short cord, my m/w did cut his cord as he crowned because of the shortness and tight wrap he was not going to come easlily. His first moments were tense for all of us but it was nothing my m/w couldnt' handle and he was safe, thank God.
DD was a requested induction on my part following decreased fetal movement and very very low fluid (after req. u/s nst and bpp found these to be true just as I sensed). Her cord was incredibly long and her body was wrapped so tightly that even though she was engaged she had stoppped moving. WE have pictures immed following birth where her vernix is clumped/lined in spots where her cord lay so tightly against her body. She had 2 true knots, pulled tightly, one under an arm, 1 between her legs, around her neck 3 times, and around her body like spider girl. My m/w was amazed with her birth, the cord was the longest she's ever seen and couldn't believe it. *She had no decels* *during labor or birth* as I was on the ext monitor becasue of a nagging fear and worry I had about her cord throughout her pg. I thank God everyday she is here safe and sound, but at no time during her labor and birth did she decel or stress. My m/w did somersault her out because it was clear she had a nuchal cord. Thta said, had my mw even given me 'the look' I would have been in a c/s before she could even suggest it at that point, I went in there with a feeling her birth would be very diffrerent, and very alert to that.
I'm sorry the people in your life feel its appropriate to scare you when you are preparing for the birth of your baby







. The most impt undertaking is your confidence in your mw and peace with your decision, your instinctual feelings. A hb mw, like other pps have said, will know how to handle what arises.

Congrats on your impending birth!


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## mamabearsoblessed (Jan 8, 2003)

just went back and read *all * posts
*Cheshire and Mom to E & A* ~ I am so sorry for the loss of your Babies, I cannot imagine the pain and heaviness of heart their loss brings.
I know things with my dd2 (and even the others) could have ended very differently, I take nothing for granted.


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## KimL (May 16, 2009)

why wouldn't you believe it? My son would have been a goner if i had not been right there to have an emergency csection.His chord was doubled around his neck and leg. He was in the birth canal and struggling. The very day he was born, a mother (right here from mothering.com) lost a child due to almost the same circumstances, but having him at home.

I was allowed to try and birth naturally, right up until the *hit hit the fan. It was understood that, above all, i wanted to birth this child naturally. Yet, in the end, i am so thankful for my live child.

Even though I'm an extremley alternative parent and person, if I had another baby I would have it at the hospital for this very reason. My childs life isn't anything to take chances with.


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## bandgeek (Sep 12, 2006)

Quote:


Originally Posted by *KimL* 
Even though I'm an extremley alternative parent and person, if I had another baby I would have it at the hospital for this very reason. My childs life isn't anything to take chances with.

Babies have oxygen deprivation and brain injuries in the hospital all the time as well. Often times they can't prep for a c-section fast enough. Not one homebirthing mama on this board is "taking a chance" with her child's life any more than a hospital birthing mama is.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *KimL* 
why wouldn't you believe it?

Well, I wouldn't believe it, because if true cord _emergencies_ were as common as OBs and their patients make them out to be, the human race would have been extinct a long time ago. That's not to say it doesn't happen...but it doesn't happen as often as they like to make it sound. And, I'll tell you something. IME, about 90% of women who are sectioned for "huge babies" that turn out to be 7-8 pounds (or less) are then told that "it's a good thing we operated, because the cord was around his/her neck and he/she would have died if you'd tried to have a vaginal birth".

Quote:

I was allowed to try and birth naturally, right up until the *hit hit the fan.
You are _allowed_ to try and birth naturally at any time, whether the *hit hits the fan or not.

Quote:

Even though I'm an extremley alternative parent and person, if I had another baby I would have it at the hospital for this very reason. My childs life isn't anything to take chances with.
Babies die _because_ of being born in the hospital, too. You can give birth anywhere you want, but please don't perpetuate the "if it's not in the hospital, it's taking chances with the baby's life" stuff. That's the kind of mindset that resulted in me having a social worker come to my door while I was naked in a birth pool in my living room.


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## Hannah32 (Dec 23, 2009)

Quote:


Originally Posted by *Storm Bride* 
Well, I wouldn't believe it, because if true cord _emergencies_ were as common as OBs and their patients make them out to be, the human race would have been extinct a long time ago.

I don't think that's true at all. It was very common in previous centuries for women and babies to die in childbirth. Heck, it's common in some countries today. But women in previous centuries tended to attempt more pregnancies, thus ensuring the survival of the human race. Really, I think you're using a bit of a strawman argument there.

That doesn't mean that people can't homebirth if they want to, because as it's been said, babies can and do die in the hospital. There are no guarantees, but a modern hospital or a skilled midwife today is probably more adept at handling those emergencies compared to previous centuries.


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## member234098 (Aug 3, 2002)

The reason that so many women died in childbirth 100-200 years ago is because doctors refused to wash their hands in their rounds between the morgue and the maternity ward. It was called puerperal fever and doctors blamed it on the mothers and told them it was a mental condition - "it is all in your mind". If you do not believe me, google Dr. Ignaz Semmelweis and see how his colleagues treated him when he confronted them with the truth and with a remedy - handwashing with chlorinated lime solutions to kill the germs.

It is not universal hospitalization that saves women in childbirth today; it is antibiotics for infections and blood transfusions for excessive bleeding, neither of which needs to be in a hospital.

In the 1940s-70s, women would be recuperating in a hospital for a week after the birth. Today, most women are shown the door after three days.


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## ScarletBegonias (Aug 24, 2005)

Quote:


Originally Posted by *Cheshire* 
But, we also shouldn't leave moms to believe that home births are all rainbows and butterflies.

i'm sorry for your loss.

i want to address this statement, in a general way, not directed toward you, mama.

_having a hospital birth does not guarantee a good outcome. we shouldn't lead moms to believe that if they birth in a hospital, all will be well.

either statement is blanket, unfair and untrue.

_NO birth is all rainbows and butterflies. anyone thinking this about home birth OR hospital birth is a fool indeed. research bears this out.

despite what americans are led to believe, *research* shows that mothers who have a PLANNED hospital birth (or an UNPLANNED unattended birth), are more likely to end up with a difficult birth/unnecessary interventions/bad outcome (directly caused by interventions in the case of hospital birth). worldwide statistics and research shows that trained, experienced midwives are more able to deal with possible complications (like nuchal cord), BEFORE they become a complication, and with good outcomes, as compared to their hospital counterparts.

time and again, mothers are told one thing at their baby's birth, and when those same mothers ask for their records, a completely different story is told by the written records. which story is most accurate? in most cases, no one affected by the birth will ever know. this is an important point to bear in mind when comparing personal birth stories and comparing statistics.

eta: fwiw, both of my children had the cord wrapped around their necks at least once, with ds having a true knot that had become "stuck" on a node sticking out of the umbilical cord.


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## tygrss (Sep 4, 2007)

Quote:


Originally Posted by *ScarletBegonias* 

NO birth is all rainbows and butterflies. anyone thinking this about home birth OR hospital birth is a fool indeed. research bears this out.


This is the key to the entire discussion IMO.

Most babies with nuchal cords are fine, some are not. None of us KNOWS what will happen until it does (sucks, but it's true), so we have to make the best decision for ourselves and OUR families. Fear-mongering on either side is unnecessary, as is down-playing another mother's concerns.


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## ~Katie~ (Mar 18, 2007)

to the mama's who have experienced losses.

I think the OP is looking for reassurance and support in regards to her questions, it can be a bit unnerving to hear scary stories as a pregnant woman who plans to homebirth. It is my understanding that cords around necks are common, and true emergencies as a result are rare. I'm not a medical professional so I can only pull from my own experience. My DD was born with her cord around her neck, I felt for it after her head was born and my mama instinct kicked in and I knew to loop it off the back of her head. Then I pushed the rest of her out and she gave a good cry and was fine. I think there are many factors that come into play for every labor and their subsequent birth outcome and each woman has her own individual experience.


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## khaoskat (May 11, 2006)

Quote:


Originally Posted by *bandgeek* 
Babies have oxygen deprivation and brain injuries in the hospital all the time as well. Often times they can't prep for a c-section fast enough. Not one homebirthing mama on this board is "taking a chance" with her child's life any more than a hospital birthing mama is.

Just to back this up...

Miami Valley Hospital in Dayton, Ohio lost a $31+ million lawsuit this past July (2009) on a VBAC gone wrong. The baby was deprived oxygen, has CP, is wheel chair confined and will need skilled assistance 24/7 for the rest of his life. And yes, I have seen this child in person, not just read it on the news. I didn't know what was going on when I was in the Courthouse, but I happened to be walking by the family after one of the kids siblings testified and came out crying. I thought it was a criminal trial of some type, not med mal.


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## khaoskat (May 11, 2006)

BTW, Wikie, for once, has a nice article on this issue, with many references for it.

http://en.wikipedia.org/wiki/Nuchal_cord

Here is one that says single nuchal cord is great for vaginal delivery. Multiple wraps may need more monitoring or earlier intervention. Baby was born with 8 wraps via c/s after 6 hours of labor when it couldn't tolerate it any longer.

Again, along those lines. DD2 had it wrapped 4 times around her neck, and 2 times around her body. She was a textbook reading on the EFM through out my entire labor that I was there. No fetal decels, always passed NST's after finding the wraps with flying colors in about 5-10 minutes. During delivery there was never any indication of fetal distress. I did end up with a c/s, but it was not related to the nuchal cord, it was related to the fact that DD2 turned transverse during delivery and stuck her arm out the birth canal, engaging her shoulder in the pelvis. Even during all this, her fetal heart tones were perfect/text book.

So, that is my experience with a nuchal x6.

I also did research on this issue a while ago, when this happened, and found (but cannot right now) a study showing that there was no difference in waiting for labor on its own vs c/s w/o labor.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Hannah32* 
I don't think that's true at all. It was very common in previous centuries for women and babies to die in childbirth. Heck, it's common in some countries today. But women in previous centuries tended to attempt more pregnancies, thus ensuring the survival of the human race. Really, I think you're using a bit of a strawman argument there.

Do you have stats on how many babies women used to have? I hear all the time that women used to have these huge families, but I never see anything to back it up. Sure - families of 4, 5, 6 kids used to be a lot more comon, instead of the widespread 1-3 we see these days. But, doubling the number of kids isn't going to result in saving the race from cord accidents, if they happened at the rate OBs claim they happen at. They basically claim that every baby with a nuchal cord would have died without their intervention. It's just not true.

Child spacing is discussed here a lot, and the fact that at least some families in the 18th, 19th and early 20th century had a baby every year or two, and ended up with 10-15 kids, doesn't mean that's the norm throughout human history and pre-history.

Quote:

That doesn't mean that people can't homebirth if they want to, because as it's been said, babies can and do die in the hospital. There are no guarantees, but a modern hospital or a skilled midwife today is probably more adept at handling those emergencies compared to previous centuries.
Do you have any evidence? Personally, I'd rather have my life and my baby's life in the hands of a homebirth midwife than a hospital OB. Antibiotics and blood transfusion save a lot more women and babies than hospital protocols (such as nothing by mouth, routine IV, induction, augmentation, multiple vaginal exams, c-section, etc. etc.) do, imo. The fact that midwives 100, 200, 1000 years ago didn't have access to antibiotics doesn't mean they were any less skilled. It just means they didn't have the same tools.


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## lunarlady (Jan 4, 2010)

When I was laboring at home, my daughter's HR dropped dramatically during pushing. One of my midwifes said "I really need to you to take some slow, deep breaths for baby." And I did. I continued to do so every time she said "deep breaths for baby." Each time, you could hear my DD heartrate jump up. It was amazing. In a hospital, I don't think I would have had that same instruction. Deep breaths might have been c-section, or an oxygen line, or some other intervention. My DD was born with the cord three times around her neck. The midwifes said it was like a Circue de Solei birth because I pushed her out so hard that she flipped coming out, the cord caught, and she twirled down to the bed. She was absolutly fine and continues to be so to this day.

While I do feel hospital birth is very safe for most women, I also know that it depends a lot on the hospital you are at. I know quite a few friends who labored almost right until their child was born with very limited checks, only once every half hour or so. One of our good friends didn't even have a doc or nurse in the room when her son started crowning. Her DH had to go out in the hall and yell for someone. What if there had been an emergancy? Would that 10 minutes have made a difference? So in my mind, the benefit of HB is that I have several professionals whose soul focus is me and my birth. Zero time from the start of an issue to the attention of my MW.

I find that most women with positive hospital births went to a hospital where they had nurses checking on them very often, or a doula along who was working with the hospital staff to moniter the birth, so they did get quite a bit of individual attention. It just goes to show that no matter what type of birth you are planning, it pays to plan ahead for your attendents. And that in labor, a good attendant is the key to recognizing and responding to any issues, regardless of the setting.


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## craft_media_hero (May 15, 2009)

Quote:


Originally Posted by *Cheshire* 

I would just encourage you to not doubt all of the stories you hear because, first, you weren't there and aren't a medical expert so you can't be sure, and second, because I'm sure there are plenty of cases where it does save a life versus the cases where it may have been an unnecessary intervention. Give that mother the benefit of the doubt - she doesn't need her birth second guessed because the listener believes they know more about birth than the care providers she trusted.

I'm sorry for your loss. I don't doubt all the stories I hear. I don't doubt your story or any of the other stories on this thread.

I do doubt that every complication that results in c-section actually needs a c-section, so I'm sorry, but I do doubt how necessary some of these procedures are.

I don't "believe I know more about birth than the care providers" which is why I have questions. I do give the mom the benefit of the doubt (I know she believes her story), BUT I also believe that a full episiotomy and the doc pulling her son out may not have been the only way for the birth to be handled with a positive outcome.

I don't believe that all cord stories are myths, either. There are true cord injuries, obviously. There are also A LOT of horror stories that are not true, where any and every complication is blamed on the cord being around the neck. The "myth" I am looking to dispel is that the cord is the cause of fetal distress and cord issues=c-section as the only way to keep the baby from dying.

I'm not fear-mongering. I'm doing the opposite. People are fear-mongering me, and I'm trying to work through their horror stories by taking a grain of salt here with you all.

Thank you all for participating in this discussion; a lot of beneficial information has come forward here.

I feel like I'm getting a more "real" perspective on this subject here than I am IRL where it seems like the second people hear I'm pregnant they have to go on and on about every horror story or everyone they know who has had a bad experience, and it's tiresome and really insensitive.

I'm hearing lots of positive cord stories and also some tragic ones, but in general what I'm getting is that these issues are rare but can happen, they're not always predictable, and even having a fetal monitor can't always tell you if there is a cord abnormality or not.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Storm Bride* 
Do you have any evidence? Personally, I'd rather have my life and my baby's life in the hands of a homebirth midwife than a hospital OB.

I've joked often that "I'd squat alone in the woods before giving birth at GBMC." (hospital in the area with the highest CS rate - 44%.) To those who aren't familiar with the concept of intentional UC, this sounds like an extreme statement. But I really do think that UC can be preferable to some of these awful hospitals. (And I personally WOULD chose it if faced with UC vs. bad hospital.)

That being said, it is a fact that hospital-attended birth is safer for both mama & baby than UC. Of course, no one has studied _intentional, planned UC_ vs. hospital birth. So we don't know how they would compare. But, again, when comparing people who have no medical care whatsoever to even bad hospitals, the hospital outcome, at least in terms of death, is better.

Quote:


Originally Posted by *craft_media_hero* 
IRL where it seems like the second people hear I'm pregnant they have to go on and on about every horror story or everyone they know who has had a bad experience, and it's tiresome and really insensitive.









Yup, that's how it is. Of course, if you mention you're even _thinking_ about HB, you'll get it a lot worse. Because, of course, ya know, "My baby would have died if we weren't in the hospital."







Well, yes, that is absolutely positively TRUE in many cases. But the fact of the matter is that it's probably 100% FALSE in even _MORE_ cases. (OR, the truth is that the hospital interventions CAUSED the fetal distress that the baby needed to be saved from via CS.) Hence... my exasperation at the attitude of Americans towards birth (and the _atrocity_ that is American maternity 'care' today.)

Yes, as others have said, education is key. There are no guarantees anywhere you birth.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *MegBoz* 







Yup, that's how it is. Of course, if you mention you're even _thinking_ about HB, you'll get it a lot worse. Because, of course, ya know, "My baby would have died if we weren't in the hospital."







Well, yes, that is absolutely positively TRUE in many cases.

I agree. I think Aaron would have lived, if I'd transferred sooner, and that's incredibly hard to live with. Of course, if I hadn't been treated with so little respect in my previous hospital stays, I might not have been too terrified to transfer, so I think there's lots of burden to go around there...too bad none of the other people who contributed (the nurses from previous hospital stays, the OB who bullied me into the surgery that cost me so much of my abdominal/pelvic sensation, the person who called CPS on me while I was in labour, etc.) will ever feel the weight.


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## Hannah32 (Dec 23, 2009)

Quote:


Originally Posted by *miriam* 
The reason that so many women died in childbirth 100-200 years ago is because doctors refused to wash their hands in their rounds between the morgue and the maternity ward. It was called puerperal fever and doctors blamed it on the mothers and told them it was a mental condition - "it is all in your mind". If you do not believe me, google Dr. Ignaz Semmelweis and see how his colleagues treated him when he confronted them with the truth and with a remedy - handwashing with chlorinated lime solutions to kill the germs.

It is not universal hospitalization that saves women in childbirth today; it is antibiotics for infections and blood transfusions for excessive bleeding, neither of which needs to be in a hospital.

In the 1940s-70s, women would be recuperating in a hospital for a week after the birth. Today, most women are shown the door after three days.

So why do more babies survive very early childhood today, at least in very industrialized countries? Infant death used to be far more common and I did think that's what we were primarily talking about.

It's quite easy to find human population graphs online. You can study the line for yourselves. Flat flat flat flat, then this dramatic curve upward around the year 1800. That's pretty good evidence, IMO, regarding all sorts of issues...from childbirth to disease survival in general.

None of this means that homebirth is a not a good choice. Midwives also have better tools today, as others have mentioned.

I think homebirth is a totally cool choice for those who want to. I don't think the OP should be afraid. I think she should go for it if that's what makes her feel right.


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## member234098 (Aug 3, 2002)

I was responding to a PPs statement as to why women died 100+ years ago. It was not the women's fault.

There is better nutrition and sanitation today and women are having fewer children per woman. Women are able to recuperate and recover from childbirth more easily. More dependable birth control has lowered the number of children per woman.

Women averaged six children each to about 1750, losing most in early childhood to disease or exposure. This is also shown on historical population charts. Women also died earlier than their husbands, so many men had two families.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Hannah32* 
So why do more babies survive very early childhood today, at least in very industrialized countries? Infant death used to be far more common and I did think that's what we were primarily talking about.

It's quite easy to find human population graphs online. You can study the line for yourselves. Flat flat flat flat, then this dramatic curve upward around the year 1800. That's pretty good evidence, IMO, regarding all sorts of issues...from childbirth to disease survival in general.

None of this means that homebirth is a not a good choice. Midwives also have better tools today, as others have mentioned.

I think homebirth is a totally cool choice for those who want to. I don't think the OP should be afraid. I think she should go for it if that's what makes her feel right.

I think you and I are talking about two different things. I'm not looking at 17th, 18th & 19th century vs. 20th & 21st century numbers. We don't have good data on populations that were reasonably well nourished (eg. moms who didn't have pelvis deformations from childhood rickets), supported by their communities, breastfed and breastfeeding, etc. etc.

Infant death, outside the neonatal period, is a whole other issue, as it can be completely unrelated to anything the midwife/doctor/taxi driver/mother/father/older child/other did at the birth (or even during the pregnancy). Hospital birth isn't going to do anything about the deaths of babies who don't have enough food, or clean water, or anything else we consider basic.

Human population graphs, likewise, prove very little about childbirth, in and of themselves. We're surviving infancy in greater numbers. We're surviving childhood in greater numbers. We're surviving adolescence in greater numbers. None of those things address childbirth.

And, I maintain that if true cord emergencies (or any other obstetrical emergencies) happened at the rates OBs state, or strongly imply, the race would have died out. Mothers wouldn't have attempted more pregnancies, because we'd have been dropping like flies, too.


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## calmom (Aug 11, 2002)

i want to share my story without getting involved in the debate. my son DID die because of a nuchal cord but i also do realize that having a nuchal cord is very common and most babies are just fine. his cord was wrapped very tightly 3 times around his neck. the ob said the point at which it was wrapped played a part in his death. the cord was pulled tightly from his navel directly to his neck and then wrapped around. she said it might have been different if it had been loose from his navel to his neck and then wrapped 3 times. that makes sense to me.

i am a big homebirth supporter (my Matthew was a planned homebirth and I have had 3 successful homebirths) but i no longer think that all homebirths are safe and all hospital births are dangerous like i did before.


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## GuildJenn (Jan 10, 2007)

Quote:


Originally Posted by *craft_media_hero* 
So it seems like whenever I mention homebirth, I get one of these cord horror stories in response. Instinctually, I don't believe it, but I'm not a birth professional and don't really know enough to understand what's really happening here....

The story before that was that the momma was laboring for about 60-70 minutes. The fetal monitor showed that the heart rate dropped during contractions. Mom received an emergency cesarean, and the babe was born "with the cord tightly around his neck". This was "a close call" and if they hadn't had a cesarean, I am told the babe would have died. FWIW this mom had a very "medical" OB attending her.

Can we talk about this?

It's my understanding that the cord is around the neck in 1/4 or 1/5 births. Can the cord around the neck really cut of oxygen and cause stillbirth? Would the babe be born, cord unwrapped, and isn't it still receiving oxygen from the placenta even if the cord is wrapped?

What about the heart tones slowing or "stopping"? Is this caused by the nuchal cord? Even if the heart rate slows during ctx, could that birth work out ok w/out interventions?

Without the fetal monitor, would these births have simply progressed naturally with the babies pinking up after birth? Or would they really have been stillborn because the cord was too tight? At that point, isn't birth pretty much imminent?

I hated the fetal monitor and only let them put it on my for a minute, and I don't want one in this next birth I'm preparing for either.

I'd like to understand what's really going on here and dispel the "horror cord" myth. Can you all help me out, here?

I'll talk about my experience, but as a warning, it's not a happy one.

I went for a hospital birth in a hospital with a low intervention rate and a pretty natural approach to labour. Midwives were available but because of other issues I had opted for an OB, and ended up with the OB on rotation that day.

Labour progressed pretty well until the pushing phase. At that point I pushed for 2.5 hrs; there was an unusual series of emergencies in the L&D ward and the ob was in emergency surgery for much of that time. There was an inexperienced nurse attending and she missed the decel pattern on the monitor, until my daughter's heart stopped (2x nuchal cord). She was revived, but died 4 days later. I pretty much blame the hospital.

To answer your questions - my umbilical cord was WHITE when it came out; the 2x nuchal combined with the pushing resulted in a total failure of oxygen to the baby. Regardless of what interventions should or should not have taken place there was no question that it was the nuchal cord that caused the problem. It may be rare and it may not be something you choose to worry about but I've experienced it personally and yes, it can cause death. Sorry for everyone who thinks that you can will a good birth or that cord accidents are a myth.

The monitoring did indicate a problem but the pattern (not coming up fast enough) was missed. It's not just how long the heartrate drops but how it comes back up. (We didn't know this prior to delivery.)

I probably would have done better with an experienced midwife than I did at the hospital, so I don't really consider it an argument against homebirth.

That said, a c-section would have saved my daughter's life and actually the revival effort could have worked had the period of oxygen deprivation not been so long. The things I learned were:

- when things go wrong, they can go wrong pretty quickly. Whatever your plan is, be sure you have a sense of what will happen at that point.
- your team seriously matters
- you cannot plan for everything and a certain point you have to just accept there are risks

Good luck with your decision. FYI I had my son in a hospital afterwards and it was an uneventful and respectful delivery.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Hannah32* 
So why do more babies survive very early childhood today, at least in very industrialized countries? Infant death used to be far more common and I did think that's what we were primarily talking about.

Well, I think you're both right.
I just don't like when people use the point that, "Women used to die in CB all the time centuries ago." *They often use this as an argument against HB or even against low-tech birth* (i.e. 'expectant' vs. 'active' management.)

But the fact of the matter is that *birth is not that dangerous, most of the time!* Yes, we should have a skilled MW there (or be very well educated & prepared if we're going to UC), and yes, sometimes we will need medical technology and that technology can, and does, save lives. But that doesn't mean that birth is inherently dangerous! it's just not! Most of the time, mamas just need emotional support & a little monitoring to confirm mama & babe are fine. That's it!

I think personally, I just classify the statement of "But women & babies used to die in CB all the time!" as a, generally, ignorant statement made by uneducated people who assume that hospitals, OBs, drugs & intervention lead to the best outcomes. & we all know that's wrong! In that regard, it reminds me of the phrase, "Natural birth makes as much sense as natural dentistry."









While technically _it *is* true,_ it still irks me due to the context in which it's most often used.


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## thefragile7393 (Jun 21, 2005)

No one has mentioned how many years ago the OP's godmother's incident was. 30 years ago birth was very different for a lot of patients. Doctors were trained very differently back then and the extent of the interventions she had shows. I'm not pooh-poohing the possible dangers at all...but it's quite possible the situation wasn't what the doctor made it out to be---doctors still do this now, why wouldn't it have been any different back then? Heck, my own mom was told she was too "old" for a homebirth and "had" to have me in a hospital 30 years ago. Now we know that isn't true....she was a very healthy 41 year old person back then, but she didn't think to question the doctor.

I would take this person's experience with a grain of salt, given the circumstances (I'm sure she believes it's true, and maybe it is, but since there's no way to know for sure, take it for what it is...an experience) and do research, ask the midwife what to do. Sadly unforseen things happen whether at home or at a hospital...but that does not mean that it happens as many times as people think. Since they do happen, educate yourself on the real possibilities, look at the stats, get reassurance from your midwife on what to do in situations...and go from there.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *GuildJenn* 
- you cannot plan for everything and a certain point you have to just accept there are risks

This.
There are risks, no matter where we give birth. I don't subscribe to the belief that homebirth is some kind of guarantee of a good outcome. I just don't subscribe to the belief that hospital birth is such a guarantee, either. There is no guarantee.

Quote:

Good luck with your decision. FYI I had my son in a hospital afterwards and it was an uneventful and respectful delivery.
Yeah. I've had a total of one respectful delivery. Mine was also after my stillbirth. If hospital treated all mothers-to-be the way they treat those of us who have had a loss, I'm guessing their "patient" satisfaction rates would be a lot higher. It was kind of refreshing being on the maternity ward and being treated like I had a brain and deserved some kind of respect and consideration. I think I was actually out of the hospital before it sank in that I'd actually been treated well.


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## annekh23 (Nov 1, 2008)

On a list I'm on, someone summed it up rather nicely, "some babies die because they are born at home, some babies die because they are born in the hospital, right now, the rates are similar".

Which means there is scope for improval in both areas and having read many many case studies, my overall impression is that there may well be more scope for reducing the in hospital rate, because a lot of the hospital ones you can pick up details like lack of continuity of care, poor communication etc which can be improved on. But there is also plenty of scope for improvements in care of homebirths, like good coordination of care, delays between a problem being noticed at home and getting intervention because you have to go through the ER, or the hospital treats you as a newly arrived labour patient, not a transfer from a compentent professional.

However, when you look at the death rates at home for midwives that have developed reputations for outstanding care and have good relationships with doctors. In most scenarios, I'd rather have Mary Cronk, Ina May Gaskin, Gloria Lemay etc, than an OB resident, but ideally they'd work together, so when one of those fantastic midwives says help is needed, help is given, fast.

Sadly, some of these fantastic midwives are forced to only attend births at home or in freestanding birth centers, when there are some situations and individual preferences that would indicate hospital birth, so that back up is available quickly.

The WHO ideal is continuous care from a midwife, with obstetric back up and they put an awful lot of research into that.


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## Pumpkin_Pie (Oct 10, 2006)

Just wanted to add one more nuchal cord story to the thread. My son was born only a few days after his due date, but about 55 hours after my water broke. His cord was around his neck three times, and was so short that it prevented him from descending. I also had an episiotomy and a vacuum extraction and the midwife delivering ended up cutting the loops off his neck before his body was delivered in order for him to fully descend. He was blue and had to be resuscitated with a rub down and oxygen, but was pretty much fine after that.

It was a very scary start (the very first words I heard after he was born were, "Don't worry, he's not dead"), but I feel extremely confident that if I had birthed him at home he would have been just fine with a competant midwife. They only real interventions needed were the episiotomy and vacuum and a bit of oxygen and a towel to rub him down with to stimulate him a bit. Could he have died? Yes, easily. Would I do it again at home? Definitely. Just because there is a cord issue, does not mean being in a hospital will make the outcome different in all cases.

Good luck with your upcoming birth mama. May you have no cord issues!


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## dannic (Jun 14, 2005)

My mom had a stillborn son after me who died a few days before labor from the cord being wrapped around his neck. they didn't know til birth. It would be a very difficult thing to lose a child in any instance, and naturally, any family who does lose a child is going to be fearful of it happening again, no matter the cause. (Whether from cancer, cords, or a car accident). When I planned my first homebirth, one of my first questions was about cord issues and how they would be handled at home. My midwife gave the stats and then proceeded to show me with a teddy bear how she would unwrap baby. My dd born at home did have one loop around her neck and the midwife just sort of somersaulted her as she came out.

For those of you as mothers who have lost a child, my heart goes out to you! I am planning my second hb now. We all have to make our decisions with the knowledge we have and we all have to deal with the consequences of those decisions. They must be our own.


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## 2sweetboysmom (Aug 1, 2006)

Another personal experience. Mine has nothing to do with nuchal cord but a true knot coupled with a short cord.
My third son Elijah was all set to be born at home, we all needed a really quiet, low key birth. He was breach so I went for an ultrasound to see if we could see why. He turned around, but measured small and I was diagnosed IUGR. Through a series of perinatal visits and a naging intuition we decided to induce. (remember I was planning a quiet home birth) So way ramped up on pit my water was broken. 2.5 hours of intense labor later he was born with a single involuntary push. His cord was white between the tight knot and his belly, and the length of the cord was so short that his feet were still in me but the cord was pulled tight.
If I had a more "normal" deliverey at the hospital or home we would have lost him in pushing. Period.
Mothers are given good sense and an intuition for a reason. The choice of place and method of delivery are very personal and even change over a lifetime of experience.
As much as I long for a quiet home birth and fully suppport any woman's right to choose such, after that experience and the mid term loss of Michael and Providence, I am choosing the hospital this time.


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## craft_media_hero (May 15, 2009)

Wow, I am so sorry to hear about everyone's difficult births and those of you who have shared the stories of your losses.


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## AllofGrace (Jul 22, 2009)

The midwife who delivered DD2 tells an amazing story of a baby who was fine (developed normally and had great apgars) with a cord wrapped SEVEN (7!!) times around his neck. The mom was a first-timer with a very normal labor at the birth center. When pushing started, the baby had major decels, but always recovered well. Mom couldn't make any progress pushing, and MW could feel the head not budging at all during pushing.

MW says she normally doesn't transport so quickly for a c/s, but something told her she needed to in this case. The operating OBs were stunned with the number of wraps---the most they had seen in their 30-yr careers. All agreed it was a miracle the little boy not only survived labor so well, but that he had developed normally too.


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## mamabearsoblessed (Jan 8, 2003)

Quote:


Originally Posted by *2sweetboysmom* 
Another personal experience. Mine has nothing to do with nuchal cord but a true knot coupled with a short cord.
My third son Elijah was all set to be born at home, we all needed a really quiet, low key birth. He was breach so I went for an ultrasound to see if we could see why. He turned around, but measured small and I was diagnosed IUGR. Through a series of perinatal visits and a naging intuition we decided to induce. (remember I was planning a quiet home birth) So way ramped up on pit my water was broken. 2.5 hours of intense labor later he was born with a single involuntary push. His cord was white between the tight knot and his belly, and the length of the cord was so short that his feet were still in me but the cord was pulled tight.
If I had a more "normal" deliverey at the hospital or home we would have lost him in pushing. Period.
*Mothers are given good sense and an intuition for a reason. The choice of place and method of delivery are very personal and even change over a lifetime of experience.* As much as I long for a quiet home birth and fully suppport any woman's right to choose such, after that experience and the mid term loss of Michael and Providence, I am choosing the hospital this time.

bolded ~ Yes.


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## erin_brycesmom (Nov 5, 2005)

After having a baby with a tight double nuchal cord suffer an unnecessary traumatic entry into the world because of my choice to birth in the hospital, I feel way more confident birthing at home in the event of nuchal cords.

A nuchal cord is just a variation of normal. It is not dangerous in and of itself:

From AJOG (American Journal of Obstetrics & Gynecology)

CONCLUSIONS: Nuchal cord loops and tight cord do not cause significant peripartum morbidity.

http://pt.wkhealth.com/pt/re/ajog/us...195629!8091!-1

From Perinatal Journal:

Conclusion: There is no significant correlation between nuchal cord entanglement and adverse perinatal outcomes. Therefore nuchal cord entanglement alone is not an indication for cesarean section.

http://www.perinatology.org.tr/journ...ext/txt_05.asp

From NEJM (New England Journal of Medicine)

CONCLUSION: Nuchal cords do not influence clinical management at delivery, and neonatal primary adaption is not impaired.

http://content.nejm.org/cgi/medline/...urcetype=HWCIT

From AIUM (American Institute of Ultrasound in Medicine):

Conclusions. A sonographically detected nuchal cord is not associated with important perinatal complications.

http://www.jultrasoundmed.org/cgi/co...stract/23/1/43

another study:

CONCLUSION: Nuchal cord is not associated with adverse perinatal outcome.

http://www.ncbi.nlm.nih.gov/pubmed/18604054

and yet another study with the same conclusion as above:

CONCLUSIONS: Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary.

http://www.ncbi.nlm.nih.gov/pubmed/16374604


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## JessicaS (Nov 18, 2001)

Quote:


Originally Posted by *2sweetboysmom* 
Another personal experience. Mine has nothing to do with nuchal cord but a true knot coupled with a short cord.

Hey! I had a short cord with a true knot baby too


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## baileyandmikey (Jan 4, 2005)

My ds1 was born with his around his neck three times, very tight, he was purple, and i mean purple, but he was fine. his heart rate was wacky during the delivery, but it all ended well.

my friends ds was in a dire situation at birth, cord was knotted and around his neck multiple times, delivered via csection 4 weeks early due to ultrasounds and fetal monitoring said the baby wasn't doing well. He was on a breathing machine for three weeks due to his lungs not working properly, but I don't think this happens as often as people say.


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## mmaramba (May 17, 2005)

I think the thing that's tough about these stories-- and again, not doubting anyone-- is that (especially in the case of second-and-third-hand retellings) it's very hard to distinguish babies who died _because_ of a cord around the neck from babies who died _with_ a cord around the neck.

AFAIK, when there is no apparent cause of death, but there is a cord around the baby's neck, this is the official "reason" given for the stillbirth, for "the record" and malpractice purposes.

And of course, we have sampling error here. Anyone who lost a baby for known (or even suspected) cord issues-- or who knows someone who did-- will comment that this is why her baby died. Ask this question on a mainstream board and you would get even more such answers.


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## pinchbeck (Jun 23, 2011)

I think home birthing is great! So many women I know have easy births including a mom who had twins and just plopped them out! However, my experience with childbirth has proven difficult. During my second birth (8 years after the first) my son's heartbeat went down to half what is considered normal. His heartrate did not recover. A c-section was performed immediately since they couldn't get in there to loosen the cord. I was told that the cord had been wrapped around my son's shoulders and that my contractions were causing a decel in heart beat. It was sad because I was almost fully dilated and I could have pushed him out (about 40 minutes later). I am thankful he is here.


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## Smokering (Sep 5, 2007)

I researched this during pregnancy, when the ultrasound tech noted at the 20-week scan that DS had a cord wrapped at least three times around his neck. My miidwife kinda freaked out and scheduled a second ultrasound for several weeks later, by which time DS was completely untangled (and I got an awesome ultrasound tech who spent the whole scan muttering about fear-mongering and too much information!).

There is a... thing... where the cord itself is improperly formed, and doesn't have enough Wharton's jelly in it. Wharton's jelly helps "insulate" the blood vessels against compression, so a cord with this deformity is much more prone to causing oxygen deprivation if it's pinched or kinked or otherwise stressed. So in those cases, it's not exactly the fault of the nuchal cord itself that causes issues, but the nuchal cord plus the cord malformation.


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## DizzyDee2308 (Jun 8, 2011)

@ Charmie

Recently a very large study was published (http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937811004807.pdf) that showed:

"the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality."

It was the largest study population used to date and says that previous studies were too small to show the benefit. I thought it was a fascinating study, and personally found it quite compelling.


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## MamatoD (Dec 14, 2009)

Quote:


> Originally Posted by *DizzyDee2308*
> 
> @ Charmie
> 
> ...


This study is not comparing EFM with intermittent auscultation (IA). This is comparing EFM to NO EFM. Midwives use IA throughout labor which is shown to have as good of outcomes as EFM with a decreased rate of c-sections. Although this study is interesting and shows that EFM is better the no monitoring or inappropriate monitoring, I've seen it touted on a particular obstetrics blog as proving EFM is somehow better than IA, it's misleading to compare this to studies which were comparing IA to EFM such as the analysis which is available in the Cochrane Library, they aren't the same.


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## Fulhouse (Jan 21, 2011)

I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend. She was not in labor yet at all.

And this is a weird thing but I watched the special of the poor kidnapped and raped Jaycee Lee Dugard, who was forced to deliver her babies in a filthy backyard (at age 14) and only the sick pedophile Phillip Garrido was there to help. Her first baby stopped coming after hours of labor. So the creep reached in and unhooked the cord which was wrapped around her neck, and labor recommenced. Who knows what would have happened if that sicko didn't for once do a good thing there?

I don't think the cord accidents , the fact that they do exist, mean people have to birth in a hospital. it's just not a good argument. A good doc or midwife at home could at least be as good as the sick creep Garrido.


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## mmaramba (May 17, 2005)

I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend. She was not in labor yet at all.

I'm so sorry for your friend's loss. What about the tightly-wrapped cord caused her baby to die?


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## savithny (Oct 23, 2005)

Quote:


> Originally Posted by *mmaramba*
> 
> I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend. She was not in labor yet at all.
> 
> I'm so sorry for your friend's loss. What about the tightly-wrapped cord caused her baby to die?


You sound as if you doubt her story? Why would you doubt her story?

Yes, its true that Whartons Jelly protects cords.

Yes, its true that "cord accident" is often used to explain stillbirth, without real confirmation.

Yes, its true that MOST cords around the neck do not kill babies. Neither do true knots in cords. The majority -- even the VAST majority -- of cords round body parts or knotted cords do NOT cause death.

However: Compressing or kinking the umbilical cord for too long really can cut off the flow of blood and oxygen, and cause death.

They've watched babies in utero play with their own cords. Sometimes they grab them and squeeze -- and their heart rate drops. Of course, at that point they let go. Cord compression really does have an immediate effect and can be dangerous.

And sometimes, a tightly wrapped cord really can kink or block off long enough to cause death.


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## GuildJenn (Jan 10, 2007)

Quote:


> Originally Posted by *Fulhouse*
> 
> I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend. She was not in labor yet at all.
> 
> ...


Okay look, my baby died due a cord accident - 2 x nuchal cord. What she needed was a c-section. A single loop is completely different than a double loop. It's also important how close to the placenta or navel the wrap is - many of them are fine but if the tension is tight, it's a problem.

In my case we did a full pathology on the cord and the placenta. The deal is that it was so tight against the placenta, I was pushing against the cord in labour - there was stress on the cord at its base due to the vaginal delivery, after which my daughter died (4 days later). My daughter did not have enough oxygen because the cord was tight and bloodflow in the cord was restricted. Her heartrate stayed high, although its variability and when it recovered during a contraction were visible on the monitor. (The nurse, or rather "nurse" who was hell-bent on not letting one of 'her' patients have a c-section, decided it was tolerable until it was too late.)

By the way, we got her out BECAUSE the cord stretched - her heart had already stopped for some minutes - and even so the OB had to do a huge episiotomy...to cut the cord at her neck before the rest of her was birthed.

So sorry to kind of piggyback on your post but YES doctors can save babies from cord accidents - not all the time but they can. And for the love of God, I wish people would stop saying it can't happen when people like me have lost their kids to that issue.

It is exceedingly rare? Yes, it is. My next OB and I calculated the chances of all the various issues (cord, bad nurse, lots of people having c-sections that day) repeating being somewhere around 1:100,000 and the cord accident itself was a 1:1000 chance. However. It does happen.


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## mambera (Sep 29, 2009)

Quote:


> Originally Posted by *Charmie981*
> 
> Yes, it's important to note that the issue is not having something around the neck causing asphyxia (as it would when we're yelling at our kids "don't wrap that jump rope around your neck and run!"), but that cord tightly wrapped can cause cord compression, which can interfere with the flow of oxygenated blood from the placenta to the baby. Cord around the neck compresses more than cord around, say, the foot, just because there are more folds in the neck and the cord can be compressed between the neck and a shoulder.


Doesn't compression of the great vessels come into play here? Sure the baby is not getting oxygen through his windpipe, but his brain still needs it to be delivered via his neck. No?


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## tireesix (Apr 27, 2006)

Last babe was born at home with no contraptions, midwife was late etc, dh wasn't there (he couldn't hear me shouting for hime any way), I aught babe, she had cord round her neck a coupla times, I simply unwound it and and got on with breastfeeding.

I guess problems can and do occur with cords but I think a lot of people freak out about it way too much.


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## Plummeting (Dec 2, 2004)

Quote:


> Originally Posted by *jeninejessica*
> 
> There's a large number of babies whose moms don't even know they had the cord around the neck because the dr just loops it over the head as the baby delivers. Most of the time it's no big deal.


Yes, I never would've known at all if my midwife (at the hospital) hadn't said, "Stop pushing for a minute, I have to unloop this cord." Then she counted out, "One, two, three times! We don't see that every day" or something like that. She also reassured me it was no big deal and everything was fine.

I do think that if the cord had been around my second dd's neck like that, it could've been very serious, as her cord was short and she was a precipitous labor (51 minutes from start to finish). There would've been no time for anyone to do anything about it if she'd been in distress. If it had been wrapped like that, I think it would've pulled too tightly. Obviously that's just conjecture, but I'm a very pro-natural birthing woman and I can definitely see how that could've been very serious. Her cord just wasn't long enough to wrap around her neck like that and still allow her to get out without too much stretching.


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## mmaramba (May 17, 2005)

Quote:


> Originally Posted by *savithny*
> 
> You sound as if you doubt her story? Why would you doubt her story?
> 
> ...


Actually, no, it was not a matter of "doubt," but a sincere question. I was trying to picture how a cord wrapped tightly around a baby's neck cuts off circulation or what-have-you. It's not something I fully understand. That is, I understand that cord compression can lead to death, and I also understand that nuchal cords usually do not cause death, so I was trying to understand why-- how, really-- some do. What the "difference" is, or if anyone knows definitively.


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## kittywitty (Jul 5, 2005)

I am sorry for all of the losses.









Two of my brothers were born with the cords around their necks- they were fine. I don't think any of my kids did. My hb and UC did not. But I have a dear friend who had a C-section last year after FTP after an induction. She just couldn't get him to descend. His cord was around his neck three times very tightly. It was fairly short, she said the doctor told her. So it definitely can happen. Most of the time it's not an issue, but it certainly does happen.


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## loraxc (Aug 14, 2003)

My DD had a triple nuchal cord and a true knot and never decelerated during labor at all and was born pink and screaming. However, she was a 34-hour labor and a birth center-hopsital transfer. I dilated to 4 and stopped, for 12+ hours. I also pushed for more than 2 hours. So...one wonders. She was also posterior, though.

I surely would have been sectioned with an OB, but fortunately I did have a CNM who was able to continue care in the hospital and support my desire for a vaginal birth. I did end up with epi, tons of Pit, the whole 9 yards.

My second child was an easy-breezy 6-hour labor and homebirth, maybe 15 min of pushing. He had a nuchal hand but no nuchal cord or knot.


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