Pregnancy brings with it a veritable dictionary of new terms, and many of them sound ominous. (Lochia, vernix, and port wine stains, oh my!) What about a nuchal cord, or when baby’s umbilical cord is wrapped around their neck? What is it? Should you stress out over it?

Read on for info on why babies get nuchal cords, the associated risks, and your options when baby has his or her umbilical cord wrapped around their neck.

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What is a nuchal cord?

A nuchal cord is the official term for when a baby has his umbilical cord wrapped around his neck during pregnancy or delivery. As your baby’s literal lifeline, providing him with oxygen, blood, and nutrients, any complications with the umbilical cord can seem critical and a cause of concern. But, thankfully, it turns out that most nuchal cords aren’t dangerous at all.

Umbilical cords can be wrapped once, twice, or even multiple times around a baby’s neck, but amazingly, it’s usually nothing to worry about.

A healthy umbilical cord is protected from blood vessel compression by a soft, gelatinous filling called “Wharton’s jelly”. This jelly is designed to keep the cord free from knots, meaning that regardless of how many somersaults your baby does in-utero, they’ll be safe.

How common are nuchal cords?

It turns out that nuchal cords are common and rarely dangerous — most doctors won’t even mention them during delivery unless there is a complication with the cord.

In fact, about one in three babies are born (completely healthy) with the cord around their neck. (Source) 

Furthermore, most practitioners can’t tell if the baby has a nuchal cord even with an ultrasound.

What about a double nuchal or a knot?

Some babies even have the cord wrapped multiple times around their neck – this is called a double nuchal — and are completely fine thanks to the design of a healthy cord.

Only about one in 2,000 births will have a “true knot” in the cord, which does pose certain risks. However, in the majority of cases the cord won’t tighten, even during delivery, to the extent that it becomes dangerous. (Source)

Here’s a pretty amazing video of a true knot in an umbilical cord

How do babies end up with a cord around their neck?

Pregnant mamas know better than anyone that unborn babies are essentially tiny acrobats, and their crazy moves are definitely a factor for nuchal cords. However, there are medical or biological reasons why a cord may end up around their necks or in loose knots:

  • Insufficient Wharton’s jelly (Source)
  • Poor cord structure
  • Excessive amniotic fluid
  • Abnormally long umbilical cords
  • Having twins or multiples

Are there risks associated with a nuchal cord?

Usually, no. Other than increased stress levels and worry, there aren’t generally any complications that will affect the mother or the baby. If the doctor detects a nuchal cord, they will closely monitor your baby during delivery, and that’s usually all that needs to be done.

In some very rare cases, a nuchal cord does pose a risk to the baby. The most common complication with nuchal cords is decreased heart rate during delivery— a result of poor blood flow to baby due to a compressed umbilical cord during contractions.

If your baby is being properly monitored, the medical team should be easily able to detect this problem. In most cases, the baby is born fine, but if the heart rate continues to decelerate, you could try different laboring positions or an emergency c-section may be necessary. (Source).

Other complications can include:

  • decreased fetal movement
  • decreased development (if the issue arises early on)
  • a more complicated delivery.

The good news is that any complications at all is rare.

Will I have to have a c-section if my baby has a nuchal cord?

Absolutely not.

The only reason for a c-section is extreme fetal distress. In rare cases, a nuchal cord can contribute to the distress of a baby during labor, and a c-section will be necessary. (Source) But there’s no reason why a healthy baby with a nuchal cord would need to be delivered by c-section.

(And if you do require a c-section, remember there are many ways to make it more natural. Read about gentle cesareans.)

In short, you don’t need to make any special preparations if you learn that your baby has a nuchal cord.

Your birth plan can still be executed as planned. Home births and hospital births alike can be equally successful in delivering a baby with a nuchal cord (and even a lotus birth if you choose one).

Make sure that your birth team is skilled in this kind of delivery and won’t make any premature interferences or jump to any unnecessary labor interventions.

What now?

Although it can be a lot to take in, remembering that nuchal cords generally aren’t a big deal can put your mind at rest. In the weeks or days before your delivery, remember to take it easy. Rest when you need to.

Here are a few things to do in the meantime:

Now you know the 411 on one of pregnancy’s most common misconceptions.

Birth is an incredible and yet normal biological process. Worrying about the things you have no control over certainly won’t help, and it will always do more harm than good. Speak to your healthcare provider for reassurance about baby’s nuchal cord if need be.

How about you?

Does your baby have a nuchal cord? Or have you delivered a baby with one? How did it turn out? Share with us in the comments below!

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