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

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

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

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Cord around the neck – what parents & practitioners should know

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

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

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

 

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

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

**Trigger Alert: Hospital Images**

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