On Nuchal Cords and Other Things I Knew Nothing About

I just finished reading Rachel Reeds blog post on Nuchal cords and had to share with other Doulas. I think when many of us (Doulas) start out, most of us just know that we want to help women and babies. At a MANA conference in Mexico, I sat in on a class taught byWhapio Diane Bartlett, she said two things that really stuck with me, one was  you don’t need to be a mother to help a woman in labor. This was important to me as many new Doulas have come to me expressing their lack of experience made them feel unsuitable as a Doula. I love to share with them that all they need is to come to the birth with humility, love and respect for the new family being born. Later in her talk though she said that it was the UTMOST importance to know your physiology if only to what is NORMAL during labor and what is not. Now, I am not a Midwife (someday…~sigh), but I do believe that it’s important for Doulas to have a strong working knowledge of the female body and of what is normal and not normal about birth. So as you are learning your craft, do make time to learn more about what is normal and what is not. I remember one of the first births I attended my heart skipped a beat as I watched the baby emerging and I spied a thick cord wrapped not once but twice around his neck. I felt panicked and as the father looked at me I flashed him the hardest attempt at a look of reassurance. But that look was forced and came from a place in my mind that said if there is something wrong we’ll discover it soon enough and if there isn’t, then great! Everything was fine of course but I felt terrible afterwards that my knowledge about what is normal or not was so limited.

So what’s a nuchal cord? It’s an umbilical cord around the neck, it  is a common occurrence during birth. Around a third of all babies are born with the cord around their neck (please be sure to read her blog post in its entirety). According to Rachels post;

When a c-section is done for fetal distress or ‘lack of progress’ the presence of a nuchal cord is often used as the reason… “ah, look – your baby was stressed because the cord was around his neck”. The cord is unlikely to have had anything to do with the stress or ‘lack of progress’. Most likely other interventions carried our during labour led to the end scenario (eg. syntocinon). Not surprisingly fear about nuchal cords is embedded within our culture.

I really do believe that even within birth word, there is a pervasive fear of many things surrounding birth. As a midwifery assistant at a home birth, I had started oxygen and pulled out the  resuscitation board and had dialed 9-1 on my cell after 1 minute had passed (it seemed like forever compared to other births I had assisted at before) and sweet little baby was still blue. The midwife instructed the couple to call to their baby and as soon as they did, she began to pink from her chest out. The couple had not seemed phased but I was terrified. I only later shared my earlier terror with the midwife hours after the birth. She assured me that my fear was normal for someone who had seen so few births at that time.

My point in sharing this is,  it’s imperative that as Doulas we understand as much as possible about what is normal and what is not concerning birth. We should not be complacent in our work and should always be striving to learn as much as we can. I have included some sites that I visit often in our links category under DOULA SCHOOL.

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2 responses to “On Nuchal Cords and Other Things I Knew Nothing About

  1. Hi Gena!
    Thanks for the mention and the FB ‘friend’. I agree that anyone attending births including Doulas need to understand what is normal. The problem is we have got to a place where most midwives and Obs (and therefore Doulas) have never seen an uninterrupted physiological birth. The situation you describe with the ‘slow’ neonatal transition is a typical example. It can be really hard to sit back and trust when all you have been taught is fear. Even now I sneak a feel of the cord to reassure myself the placental circulation is still providing oxygen when a baby decides to take their time.

    • I’m so glad you said this. Thanks, that’s huge, it’s hard when you have been brought up in this culture to truly have faith in a woman’s ability to give birth. To have faith that her child knows how to be bored. I believe in these things when mom is left alone and rarely interfered with. When she is allowed to listen to her body and act on her instincts, when she is allowed autonomy and is supported by everyone else in the room who also has faith in her, she is successful. The only complications I have ever been witness to were accompanied by lack of support and faith by the woman’s care givers. Thanks for inspiring me Rachel! Much respect!
      -GENA

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