R. Renee Gaiski MSN, CNM

R. Renee Gaiski MSN, CNM Nurse Midwife in Hastings, MI

07/11/2025

Raise your hand if this is among the top ten questions you get from people considering a non-hospital birth.

Reposted from .labornurse

A nuchal cord is a medical way of saying that baby’s cord is wrapped around their neck. ⁣⁠
⁣⁠
This is something you’ve probably heard about and you may even know someone who had this happen during their birth. ⁣⁠
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❗This isn’t at all surprising because nuchal cords are actually quite common – occurring in a little more than 1 in 3 births!⁣⁠
⁣⁠
And even though the idea of the cord being wrapped around the neck seems very scary, in reality, the chance of any complications is rare. ⁣⁠
⁣⁠
Sometimes we know about nuchal cords ahead of time because they are seen on ultrasound, but in many cases, we don’t know until baby is born.⁣⁠
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👉🏻 The most common complication occurs during labor. ⁣⁠
⁣⁠
Basically, when the cord is wrapped around baby’s neck, it can be compressed during contractions, which in turn reduces the amount of blood (and therefore oxygen) that is getting to baby. ⁣⁠
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Often time, we see a decrease in baby’s heart rate on the fetal monitor, which tells us the cord is being compressed in some way - and many times we can intervene!⁣⁠
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🤔 Did you know that this usually isn’t a cause for complications during birth?⁠

04/15/2025

You read that right.

Per the American College of OB/GYN's 2019 VBAC guidelines, the risk of maternal death during a planned vaginal birth after cesarean (VBAC) is 0.0019%.

Expressed another way, that is a risk of 1 in 52,600.

Did you have any idea the risk was that low?

Whereas the risk of maternal death with an elective repeat cesarean after one cesarean is 0.0096% or 1 in 10,000.

Again, both really small numbers but the risk of maternal death is five times higher in a repeat cesarean.

This is why when pregnant people are threatened with "you could die if you plan a VBAC," it falls flat.

But it is often really successful in coercing someone into a repeat cesarean... as well as eroding patient autonomy and any trust when the birthing person learns the facts.

As a L&D nurse told us, "There is no real informed consent anymore."

This is just yet another example.

ETA: Some people asked in the comments about the risk of fetal death. We discuss that here: https://vbacfacts.com/2012/04/03/confusing-fact-only-6-of-uterine-ruptures-are-catastrophic/

Others have asked about vaginal birth after classical cesarean: https://vbacfacts.com/2021/08/10/vbac-after-classical-t-j-incision/

… or after two cesareans: https://vbacfacts.com/vba2c

… or after three or more cesareans: https://vbacfacts.com/vba3c

Also, you can download our free resources including:

- a report debunking the top 5 uterine rupture myths: https://vbacfacts.com/report

- a handout busting the top 3 VBAC myths using national guidelines: https://vbacfacts.com/acogmyths

- and a VBAC planning checklist: https://vbacfacts.com/checklist

VBAC Facts

03/07/2025

AJOG Expert Review in Labor: Water birth: a systematic review and meta-analysis of maternal and neonatal outcomes https://ow.ly/nr7O50R9Nzi

12/10/2024

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