The Truth About Nuchal Cords And Your Baby’s Safety
Published Date:November 5, 2025
By Ali Weatherford
After having taught hundreds of group birth classes, I can safely say that one of the top 5 fears that people take into birth is the idea of the umbilical cord getting wrapped around the baby’s neck. This is called a Nuchal Cord.
What is the Umbilical Cord?
The umbilical cord is the lifeline between mother and baby. There is one vein sending nutrient-rich oxygenated blood from the parent to the baby and two arteries remove deoxygenated blood and waste products from the baby. The umbilical cord is soft and rubbery. It’s coated in an outer covering of amnion and made up of connective tissues and a lot of a substance called Wharton jelly. This substance helps give the umbilical cord its rubbery texture and protects it from compression, kinking and damage. Umbilical cords can be long or short, with the average length being 20-23 inches.
What is a Nuchal Cord?
Babies move and twist, and umbilical cords can definitely get loopy and tangled. Sometimes they can even wrap around the baby’s neck. When a baby has the umbilical cord wrapped around its neck, this is called a Nuchal Cord. It can sometimes be spotted on an ultrasound.
Why Parents Worry About Nuchal Cords
Most people consider strangulation. For us, when the neck is compressed, it cuts off our supply of oxygen. This makes sense since we are using the trachea to breathe. This is the windpipe. The thought of an umbilical cord compressing a baby’s windpipe is VERY scary!
What Really Happens When a Cord Wraps Around the Baby’s Neck
Fortunately, this is not really what is happening when an umbilical cord gets wrapped around a baby’s neck. A fetus is not breathing through its neck. It’s not breathing at all. A baby is getting oxygen from the blood that comes through the umbilical cord. So, they don’t get strangled the way we would if something was wrapped tightly around our necks. A nuchal cord occurs in 1 out of every 3 to 4 births or around 20-30% of the time. That’s a lot! Luckily, it’s almost never an emergency situation. What usually happens is that the care provider sees the cord as the baby’s head becomes visible, and can simply unwrap it so the baby continues out. It might be wrapped once or even more. You may not even know it happened, or you might hear them say the cord is around the baby’s neck, but then nothing bad happens.
In rare cases, it can be a problem. If the baby has an especially short cord or if it’s wrapped many times around, it can prevent the baby from descending and cause distress. If the cord is wrapped many times around, it can actually start to tighten, compress the cord, and might minimize the blood flow coming through. But the majority of nuchal cord births do not result in any problems at all.
According to a lot of recent data, a Nuchal Cord wrapped once does not cause problems. If it’s wrapped twice or more, it might cause problems. The vast majority of Nuchal Cords are just wrapped once and not at all dangerous. A cord that is wrapped three times or more is associated with a higher incidence of complications but only occurs in about .1-.2% of births.
What To Do About Nuchal Cords
Although these can be spotted in ultrasounds, it’s not part of standard prenatal care that people get one just to find out about a Nuchal Cord. If you do have an ultrasound showing a Nuchal Cord, most providers will consider that a variation of normal and not recommend any different course of action. If the Nuchal Cord is wrapped three times or more, it’s possible that some extra monitoring could be recommended, but even then, you might not need to do anything differently. The position of the cord can continue to change as the baby stays in and even during labor and birth. Also, even a triple Nuchal Cord does not guarantee a bad outcome.
So, hopefully this can put some minds at ease. Umbilical cords are designed to nourish and protect your baby. It makes sense that things would get a little tangled in there sometimes, but even then, birth almost always works out for the best. I always like to recommend focusing on the majority of births that do not occur with a Nuchal Cord. AND ALSO that the vast majority of Nuchal Cord births have normal outcomes.
References:
127: Multiple nuchal cord loops and neonatal outcomes – American Journal of Obstetrics & Gynecology
Adverse pregnancy outcomes and multiple nuchal cord loops – PubMed
