Birth day minus one

Laurel turns one year old next week! I've been celebrating the final weeks before her first birthday with a series of posts about her birth, leading up to her actual birth story. You are reading the third installment of this series; here are links to installments one, two, four, and five.

Laurel was born with her umbilical cord wrapped around her neck.

I didn't know it at the time, however, as I was too busy giving birth to her. (I'll post the actual birth story next week.) Only after Laurel was safely in my arms did the midwife tell me about the cord. I didn't care at the time, however, as I was too busy being (1) profoundly shocked that the baby had arrived so quickly and (2) profoundly relieved that I was no longer in labor.

It wasn't until later that I began to process what the midwife had said. As soon as Laurel's head had emerged, the midwife checked for the presence of the cord and discovered it was wrapped around her neck. She tried to lift the cord over Laurel's head, but couldn't because the cord was too tight or too short. So she instructed me to stop pushing, and she quickly clamped and cut the cord internally prior to my delivering the rest of Laurel's body.

For nearly a year I considered the tightly wrapped cord an unusual complication, perhaps a potentially serious one. I briefly mentioned it in my blog post comparing Laurel's birth with Isaac's, but I didn't examine it more closely. It was sort of scary.

But after doing a little research, it turns out I didn't need to worry. The umbilical cord is wrapped around the baby's neck in at least 20% of births. Twenty percent! (That's for a 360-degree wrap; the cord goes around the neck more than one time in 5% of births.)

It is called a nuchal cord, the word "nuchal" having to do with the nape of the neck. It is associated with chemically induced and augmented labor, which I didn't have with my natural homebirth. It can lead to prolonged pushing in labor, which I didn't have with my precipitous labor. Sometimes it can cause fetal heart rate abnormalities, which my midwife didn't detect.

But basically, a nuchal cord is unlikely to cause complications and no intervention is recommended. In fact, modern midwifery theory suggests that a tight nuchal cord shouldn't even be cut prior to delivery -- they just let the baby somersault out through the loop in the cord, thereby letting the baby benefit from the extra oxygen provided by the uncut cord.

- - - - -

Some studies find that a tight nuchal cord is associated with lower birth weights. I'll never know, but I wonder if it might be one reason baby #1 weighed eight pounds, eight ounces while baby #2 weighed seven pounds, two ounces.