Everyone understands the importance of the umbilical cord in a baby’s development, but there are still many questions and myths surrounding it. From cord wraps to the myth of the “killer cord” to postpartum care with the umbilical stump, get all your questions answered in this comprehensive article about the umbilical cord!
What is the umbilical cord, and what is its function?
The umbilical cord is like a tubular cord that connects the fetus to the placenta. It consists of one vein and two arteries and is filled with a gelatinous fluid called Wharton’s Jelly.
Through the cord, the baby receives oxygen and nutrients from the mother’s blood, along with hormones that aid in development and help “clean” the baby’s blood of waste. However, the umbilical cord’s function doesn’t stop there; it also helps regulate the baby’s temperature and blood pressure inside the womb. When cut after birth, the cord leaves behind a mark—it’s the belly button.
Nuchal Cord and the "killer cord" myth
We often hear about a baby having a “nuchal cord” after an ultrasound. Since this condition is rarely explained to women, combined with fear and lack of knowledge about the birthing process, many end up opting for a cesarean section, even with a healthy pregnancy and a desire for a natural birth, fearing the “nuchal cord“.
A “nuchal cord” simply means that the baby has the cord wrapped around its neck. Stated like this, it may sound dangerous and frightening. The immediate concern is whether this could strangle or asphyxiate the baby during delivery.
Therefore, it’s crucial to know a few things!
The cord wraps and unwraps many times during pregnancy
Especially in the first seven months when the baby has ample space in the womb to stretch and practice movements, the cord can wrap and unwrap numerous times. In fact, you may see the baby interacting with and moving the umbilical cord in ultrasound images and videos.
In other words, your baby may appear to have a nuchal cord in one ultrasound and be without it in another, done later. The wrap itself poses no risk to the baby since the cord is made of soft tissue and filled with a gelatinous fluid.
Nuchal cord is NOT a real indication for a cesarean section
Many babies are born not only with one but several nuchal cords. Being a very common occurrence and with the cord being gelatinous and quite long (about 60 cm, varying from case to case), the nuchal cord itself is not an indication for a cesarean section.
In most cases, the nuchal cord has no impact on the delivery and the baby’s health. It can unwind during delivery or be manually unwound after delivery. As a doula, I have assisted many births where the baby was born with nuchal cords, including Pedro, who was born at home with three nuchal cords!
Regarding this, I recommend reading the article “The fallacy of nuchal cord,” written by Dr. Melania Amorim, a PhD in Gynecology and Epidemiology (it’s in Portuguese, since Melania is Brazilian, but perhaps you can use the translator?).
However, there are unusual cases where the cord is shorter than normal. In such cases, if it’s tightly wrapped and not long enough, it may prevent the baby from descending further through the birth canal, making a cesarean section necessary to safely deliver the baby and avoid the risk of oxygen deprivation.
The length of the umbilical cord can be identified in ultrasound, and therefore, this is not a last-minute emergency scenario but one that can be predicted and planned safely.
Clamping of the Umbilical Cord
Clamping the cord is the procedure of cutting the umbilical cord and ‘clamping,’ or closing it using a kind of “clamp” called Polyacetal (POM). The cord should be clamped after cutting to prevent bleeding and infection, as, as we mentioned at the beginning of the article, the cord has two veins and an artery through which the blood of both the mother and the baby flows.
For a long time, the medical practice was to cut the cord immediately within the first minute after the baby’s birth. However, this practice is no longer recommended. After scientific studies proved the benefits of delayed cord clamping, the new medical recommendation, also endorsed by the World Health Organization, is to wait until the cord stops pulsating before cutting it.
Benefits of Delayed Cord Clamping
It’s worth waiting for the umbilical cord to stop pulsating before finally cutting it because the benefits of this delayed clamping are numerous. Not only does the baby receive all the blood still flowing from the placenta through the cord, but they also get more stem cells, which are essential for the baby’s protection.
Some of the major benefits of delayed umbilical cord clamping include:
- Allows the baby to receive more oxygen and nutrients from the placenta.
- Helps stabilize the baby’s blood pressure and temperature.
- Reduces the risk of anemia and respiratory problems.
- Stimulates the baby’s immune system and protects against diseases and infections.
Who can cut the Umbilical Cord after birth?
Upon the mother’s request or if it is part of her birth plan, the medical team attending the birth may allow the mother, father, or another companion to cut the umbilical cord at the time of birth. If nothing is specified, the doctor is likely to perform the clamping, as it is part of routine procedures.
The most important thing is to ensure that the cord is cut correctly and safely, using a sterilized tool (usually a specific clamp in hospitals and maternity wards), and after the cut, it should be properly clamped with Polyacetal. This is extremely important to avoid potential infections since, after the cut, the baby has an exposed point susceptible to bacteria and other unwanted invaders.
After the cord is cut, it is essential to place the baby on the mother’s chest or abdomen immediately for skin-to-skin contact. This helps regulate the baby’s body temperature and heartbeat.
Caring for the Baby's Umbilical Stump
After cutting the cord, the umbilical stump remains on the baby’s belly and can take up to 7 days to fall off. This is when the baby’s little belly button will form. However, while the umbilical stump has not fallen off, some precautions are necessary to keep the area clean and dry, ensuring the baby’s health without exposing them to the risk of infection.
How to clean the baby’s umbilical stump
- Wash your hands and nails thoroughly before starting.
- Wet a cotton ball or swab in warm water and 70% alcohol;
- Gently wipe the cotton over the umbilical stump and the surrounding area in gentle circular motions;
- Dry with a clean, soft cloth, such as a fabric diaper.
What to avoid
- Avoid submerging the stump in the bathtub or pool.
- Do not apply moisturizers, lotions, or similar products.
- Do not pull on the umbilical stump or try to remove it manually.
- If you notice bleeding, swelling, or discharge, contact your pediatrician.
- Keep the stump away from pets and other animals.