So I found out that the baby had a knot in his cord and it was wrapped around his neck... but does this alone warrant a c-section? I have heard of plenty of vaginal births where the baby comes out with the cord around their neck and they just make sure and fix it as the head is coming out. Thoughts? I just want to know where I would start if I ended up talking to her about it someday.
Some statistics estimate that up to 30% of babies have a nuchal cord. (most statistics put it closer to 20%) 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, and multiple loops occur in up to 5% of pregnancies.
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.
Nuchal cord can be detected using color Doppler ultrasound, with a sensitivity of over 90%.
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.
There are differences in "knots" and true knots. True knots only occur 1% of the time. The cord forms helices and often times people see "knots" and they are actually false knots. They are common and pose no danger.
So to answer your question: No a nuchal cord and/or "knot" is not a reason to c-section. A baby repsonding poorly to labor with bad heart rate recoveries would be though. I have seen docs get impatient and do a c/s and then tell the mom it was a nuchal cord. In fact there was a recent birth on the tollway here and the parents were told "OMG you are so lucky bc the baby had the cord around it's neck" I think many doctors play that card to be much worse than reality to make moms feel better. i have never heard a doc come out and say "Oh well the baby was fine - I called that one too early" to a mom. With the amount of information in your post it's impossible to say at this point.
Homebirthing, breastfeeding, sling wearing, cloth diapering momma to 3 girls ages 7 and 6 year old twins and peanut #4 due sometime in late September
Wow, so unfortunate. Pretty sure that both those associations were true with her. And yes, it makes sense that they would play that card. The cord around his neck just *sounds* bad to people who just aren't familiar with it at all. Sigh. This is why I want to go into being a doula - so I can advocate against scare tactics like this!!Nuchal cord has been associated with labor induction and augmentation, prolonged second stage of labor...
I think many doctors play that card to be much worse than reality to make moms feel better.
I'm sorry, I know that I haven't been that active on here, but I am planning on going as natural and intervention free as possible. I probably shouldn't say anything, but this thread has been seriously disturbing me for days now; it just feels like so much judgement being heaped on this poor woman who isn't here to defend herself or her decisions. Like:
Seriously? A woman you don't know that well or have much emotional investment in didn't have her baby the way you would have wanted her to (heck, maybe not even the way SHE would have wanted to) and because of that you can't think of anything nice to say to her about having had a baby? How about "Congrats, he's beautiful, glad you're both doing well."Now I don't even know if I have any words that I can say to her that would really be nice right now. :/
I can tell you right now that even having read what Erika just posted, if my dr said to me "We think the baby has a knot in his cord and it's wrapped around his neck and we feel he needs to come out now" I would let them give me c-section because risking having the baby die (even if it's a small risk) would be too scary for me. Maybe that's a dumb emotional decision, but I can pretty much gaurantee that's what I would do. To me, it's pretty easy to empathize with.
I just don't think that any of us are well served by sitting around and judging each other, whether that's "She chose not to have an epi??? She's crazy!!!!" or "She listened to her doctor and ended up having a c-section...what a dumb dumb!" In the end, a birth that results in a healthy baby and a healthy mom is a pretty good birth, IMO.
I think my comment was taken out of context. I went ahead and removed it because of that. I just feel like this board is a safe place to VENT and say things that I would never DREAM of saying to her.
And I do know her; and especially because my husband is close to hers I feel like I do have a relationship of some sort with her. I think if she were just an acquaintance of a sort, I wouldn't be as concerned about it. This is just something I'm very passionate about and again, I would NEVER EVER preach to her about all of this. I find it helpful to read what Erica posted because it can help me in the future if others have questions about things like that.
And I did say congratulations to her and I might even say that I hope she's healing well; I just was so bummed at the time that I couldn't say anything else to her. I'm not mad at HER, I'm mad at the healthcare system and how they do stupid things sometimes that you can see coming a mile away. (ie induction)
I'm sure if the doctor said something to me about the cord, I would do the same thing, but if at all possible, I wouldn't have been induced in the first place knowing how much it can go downhill.
I'm not trying to judge her; again, I'm more here to VENT VENT VENT <--can't emphasize that more - about the state of our healthcare system when it comes to birthing babies. I am more against the doctors than the patients here! And I hope that someday I can educate more and more people about their options.
And if you don't agree with that, that's fine but it's pretty much the attitude of people who post on this board. That's why I came here and not on our birth board because I KNOW people would be offended.
ETA: I'm not saying that doctors are bad, or they all make the wrong decisions when it comes to birthing, etc., but I do believe that IN GENERAL doctors are not the best people to be birthing normal, low risk babies/pregnancies. But of course that's a whole 'nother animal.
You're right, your attitude is probably a lot more "the norm" on this board than a birth board. I'll know where to stay from now on.
I know you are venting and while I share a lot of the same views with you, I'm also inclined to trust the professional in front of me. I even told my midwife that last week when I saw her. I try not to go a'googling my hunches to validate my views. Decisions made in the medical field are made quickly. Sometimes those decisions are for the best and sometimes they are made prematurely. The important thing is, is that your friend and her baby are doing well. In my opinion that is a successful birth.
Also if your friend has any kind of anxiety issues... that may have led her to not advocating for herself. I have serious, SERIOUS medical anxieties. I guess you can say I'm a hypochondriac. I will probably tell my midwife and doula that I'm dying numerous times during labor. My hypochondria is the same reason I don't want an epidural or c-section though. Haha. But seriously if the cord was wrapped around my baby's neck and my midwife said I'm going to need a c-section, heck I'd do it. Also I know in some states midwives can deliver a breech baby, but in Texas that is illegal. If the baby is breach, you are required to have a c-section. So I best not be judged if that is the scenario.
I'm a professional myself (not medical related) but it irritates me when I have to go to school for 6 years and then take 5 years worth of exams and then another 3 years to get a license and people feel like they know how to do my job better than I do. So I highly suggest that if she asks, point her in the direction of a professional such as a midwife to help answer her questions.
I think if your friend is genuinely concerned about her birth experience then by all means SUPPORT her, HELP her find her answers. But I think its a bad approach to judge her and convince her there is only one correct way to birth. She may not even be eligible for a VBAC. Not everyone is.
I rarely post here. But I have to admit that I am hesitant to do a birth lodge here when my time comes. I fear that I will be in that 3% group that planned for a natural birth and did everything right and ended up with a c-section. I am afraid I will be judged if I do have a c-section. I'm afraid I will think its my fault that I had to have a c-section. So much freaking pressure man.
Elizabeth, I really hope you don't feel like that here.
I had a c-section with my first because of eclampsic seizures and even though I wish it hadn't happened, it was the best decision at the time and still would be if it happened again.
I think the most important thing is that you're informed - you know your options and if you want an epidural, c-section, etc. than by all means do it. But the thing is you KNOW the risks, you're not just following the doctor's orders.
And FWIW I trust my midwife totally. I don't think you should have a care provider that you don't trust. I've read lots of books and such as well but yes, when it comes down to it with my pregnancy, my midwife is the one I trust the most.
I'm really not trying to be a know-it-all about everything. If you knew me in person, I'm not like that at all. I won't push my beliefs on someone who's not interested but if someone is, then I'm all about telling them what they want to know. But I realize it's my opinion and they need to make their own decisions.
I don't want to convince anyone that there is one way to birth; I just believe my way is the best way to birth for ME but it's not for everybody.
I think the whole thing that bothered me is that she had an induction 3 days after her due date and that really got me. But again, it's true that it's not for me to judge her choices. I just want people to be informed.
Never mind. Just, yes Elizabeth, I agree with everything you said.
Last edited by Alissa_Sal; 01-23-2013 at 07:41 PM.