Title

The nuchal cord at birth: what do midwives think and do?

Document Type

Article

Publication details

Jefford, E, Sundin, D & Fahy, K 2009, 'The nuchal cord at birth: what do midwives think and do?', Midwifery Today, vol. 89, pp. 44-46.

Published version available from:

http://www.ncbi.nlm.nih.gov/pubmed/19397163

Peer Reviewed

Peer-Reviewed

Abstract

Background: There is no good evidence to support the practice of routinely checking for the nuchal cord which historically developed as a medical intervention in birth. There is some evidence of damage to the baby as this practice more frequently leads to prematurely cutting the cord. The vaginal examination, that routine checking requires, may be damaging physically and/or emotionally to the women.

Question: What do midwives say about their training and current practice in relation to the possibility of a nuchal cord at birth?

Method: Questions about nuchal cord at birth were posted to two on-line discussion fora and responses were invited.

Participants: Twenty six midwives from 10 countries who engaged in online discussion fora concerning maternity care responded to questions on nuchal cord practices.

Findings: The teaching and practice of routinely checking for the nuchal cord at birth is widespread according to at least some participants from all 10 countries. Other midwives from the same countries argued that, although they were aware that the procedure is the dominant midwifery practice, many midwives neither teach it nor perform it routinely.

Conclusion: In the absence of clear evidence there are firmly entrenched positions being argued for and against routine checking. The debate is infused with high emotion. Those arguing for routine checking cite safety for the baby as their main concern. Those arguing against checking cite the need to keep birth normal and the wellbeing of the baby as their primary concerns. There is a need to reconsider how the possibility of nuchal cord at birth should be conceptualised from a midwifery perspective so that all decision-making is woman-centred.