Nuchal Cord

The umbilical cord is how babies receive oxygenated blood and nutrients before birth. Some have called it “the lifeline of life”. However, the very same lifeline that keeps the baby alive can be the cause of birth injuries that can sometimes prove to be fatal.

A nuchal cord occurs when the umbilical cord becomes wrapped around the baby’s neck and can be dangerous to the baby’s access to oxygen in the womb, increasing their risk for brain injuries like hypoxic ischemic encephalopathy (HIE). HIE is an irreversible form of brain damage at birth that is caused by a prolonged restriction of oxygenated blood from traveling to the baby’s head. It is the leading cause of cerebral palsy.

Healthcare providers must carefully monitor the baby during pregnancy and during labor and delivery to ensure any complications from a nuchal cord do not pose a serious threat to their life. When they fail to act or miss the signs of an issue altogether, it may give the affected family legal standing to make a medical malpractice claim.

Over the past three decades, the nationally recognized team of birth injury attorneys, registered nurses, and nurse-attorneys at Miller Weisbrod Olesky have established a proven track record of delivering justice for children and families across the United States who have suffered from all types of birth injuries.

We are prepared to meticulously investigate the circumstances of your case, gather crucial medical records, consult with top medical experts, and fight tirelessly to secure the compensation you deserve for your child’s injury, all at no upfront cost to you.

We represent families and their children in numerous service areas throughout the United States. You can contact us today to Schedule your free legal consultation by calling our toll-free line at (888) 987-0005 or by filling out our online request form. We work on a contingency fee basis, meaning you won’t pay any legal fees unless we win your case. We only receive payment once you do.

A nuchal cord is a type of umbilical cord problem where the cord gets wrapped around the baby’s neck.

A nuchal cord can happen either during pregnancy or during delivery, depending on when and how much the fetus moves around in the womb. The condition is relatively common, with an estimated 25% of babies having a nuchal cord at some point during their mother’s pregnancy.

Nuchal cords can be simple (meaning just one loop is wrapped around the neck) or multiple (multiple loops wrapped around the neck). Multiple nuchal cords are much less common, estimated to occur in between 2 to 8 out of every 100 births.

Nuchal cords typically happen due to excessive fetal movement in the womb. There are a couple of different risk factors that can make a nuchal cord more likely with increased fetal movement. These factors include:

• Polyhydramnios: Excessive amniotic fluid within the womb will give the baby freedom to move around more, which can increase the possibility of them getting the cord wrapped around their neck.
• Long Umbilical Cord: A typical umbilical cord is between 19 and 23 inches. Cords longer than 27 inches are generally considered “long.” Naturally, a baby is at an increased risk to wrap a longer cord around their neck as they move around within the womb.
• Complications with Twins: When a mother is pregnant with twins or even more children, they will have less space to move and can become easily tangled in the umbilical cord.
• Post Term Pregnancy: A baby with a longer amount of time in the womb (past 40 weeks gestation) has more time to move around and get tangled in the umbilical cord, increasing their risk.

The difficult thing with these risk factors is that they cannot really be managed. Issues like twin pregnancy or long umbilical cords cannot be changed, but they can indicate to healthcare providers that the mother’s pregnancy must be more closely observed.

This may include scheduling additional prenatal testing visits and running additional screenings and ultrasounds to watch for nuchal cord and other pregnancy complications.

Many cases of nuchal cord resolve on their own with the baby’s head slipping out of the loop. Sometimes doctors can even manually slip the loop over the baby’s head as they deliver through the mother’s birth canal.

However, when the cord is wrapped tightly or wrapped multiple times around the baby’s neck, serious complications can occur.

The biggest concern is that the nuchal cord will restrict the baby’s access to oxygenated blood. This can cause a number of problems, depending on what stage of pregnancy it occurs it. Prolonged restriction to blood and nutrients can affect the baby’s size, resulting in a condition known as intrauterine growth restriction.

When the baby’s brain is deprived of oxygenated blood flow it can result in hypoxia (restricted oxygen) and ischemia (restricted blood flow) for the baby and lead to birth asphyxia (a complete cutoff of oxygen to the brain).

If not immediately remedied, this cutoff of oxygenated blood will likely result brain injuries like hypoxic ischemic encephalopathy upon birth. Before birth, there will be signs of this happening with the baby’s fetal heart rates decelerating, indicating fetal distress.

Nuchal cord can also lead to additional umbilical cord complications during labor and delivery, such as umbilical cord compression and umbilical cord prolapse (when the cord is delivered before the baby is).

Upon birth, the baby may have skin abrasions around the neck. In severe cases, the increased pressure to the head from nuchal cord can result in broken blood vessels in the eyes (known as a subconjunctival hemorrhage), which can lead to vision impairments. There may also be additional bleeding from the face.

If the baby was delivered after fetal distress was suspected, they may suffer from respiratory distress syndrome at birth and may require treatment such as neonatal resuscitation or assisted ventilation.

In the most extreme cases, a nuchal cord can cut off a baby’s oxygen for too long and result in fetal demise. This is incredibly rare: CDC data from 2024 estimates that stillbirth occurs in 1 out of every 175 births in the United States each year, and umbilical cord problems as a whole (not just nuchal cord) account for around 10% of those cases.

Of those cases, nuchal cord was not identified to be a significant risk factor in predicting stillbirths. This means that stillbirth due to nuchal cord is rare, however it is still within the realm of possibility.

When nuchal cord happens early enough in the mother’s pregnancy, it can be caught through Doppler ultrasound screening during a prenatal testing appointment.

Additionally, OB-GYNs and other medical professionals can perform a physical test during these prenatal appointments. In this test, the OB-GYN presses on the mother’s abdomen where the baby’s neck should be. They pinpoint this spot using the ultrasound imaging.

During this time, the baby’s fetal heart rate is being monitored. If the pressure causes fetal heart rate decelerations, it means that there is likely either a nuchal cord or umbilical cord compression.

During labor and delivery, a baby with a nuchal cord will typically show variable decelerations on the fetal heart rate monitoring strips. When there is marked variability, it indicates the baby is in fetal distress. This can be a sign that the nuchal cord is cutting off the baby’s access to oxygen, requiring urgent treatment.

If doctors notice the nuchal cord before labor has begun, they may decide to try a procedure where they manually rotate a baby’s position (known as an external cephalic version). External cephalic version is typically used to get the baby out of an abnormal fetal position, but it has also been successful in the past for managing nuchal cords.

There is no way to fix or undo a nuchal cord once labor has begun. The baby’s fetal heart rate (FHR) must be carefully monitored when nuchal cord is known or suspected. If there are rapid drops, doctors may attempt to manage it by repositioning the mother, providing supplemental oxygen, or administering IV fluids.

If none of these options are working and the baby remains in fetal distress, an emergency C-section delivery is required to prevent the risk of hypoxic brain injuries or death.

Yes, a “normal” vaginal delivery is still possible in many cases of nuchal cord. However, labor and delivery complications are more likely when the cord is tightly wrapped or wrapped multiple times around the baby’s neck. Luckily, these cases are rare.

During vaginal delivery, the OB-GYN may be able to look and feel for a nuchal cord. If the loop is loose enough, they may be able to slip it over the baby’s head.

No, nuchal cord cannot be prevented. The risk factors that increase the likelihood of nuchal cord (such as twin pregnancy or long umbilical cords) aren’t manageable, but they can signal to healthcare providers that close monitoring of the mother’s pregnancy will be required.

A child’s nuchal cord often resolves on its own. However, medical professionals must not mistake this favorable prognosis for not needing to monitor the baby as closely.

When birth injury medical negligence occurs, such as failing to reposition the baby when possible or delaying an emergency C-section delivery, it can lead to severe and preventable birth injuries for the baby and count as medical malpractice.

If a family believes medical negligence worsened a child’s injuries or caused their death, legal support may be an option. A specialized birth injury attorney can review the medical records and circumstances to assess whether a claim exists.

Parents whose children suffer from the long-term effects of umbilical cord problems deserve to know whether it could have been prevented. Our dedicated birth injury lawyers want to help you find those answers and obtain the funds necessary to improve the quality of life for your child.

If your child has been diagnosed with an injury, and you suspect this may have been caused in part by medical mistakes, Miller Weisbrod Olesky will thoroughly investigate the facts and hold the responsible medical providers accountable by pursuing medical malpractice claims against them.

Sometimes families are hesitant to reach out to a medical malpractice attorney or law firm. They may feel overwhelmed by their circumstances or are worried that a law firm will not be able to help them. But the only way to find out if you have a case is to talk to an attorney who understands how birth injuries can lead to developmental delays and other birth complications that require long-lasting medical support.

A statute of limitations (SOL) is a law that sets a time limit on how long an injured person has to file a lawsuit after an accident. It is essential to understand that statutes of limitations vary based on the type of case and the state where it is filed. For instance, the deadline for birth injury claims is typically different from other claims, such as injury to personal property, fraud, contract disputes, and collection of debts.

Generally, the clock starts ticking on the date the injury occurred. However, there are exceptions to this rule, and in some cases, the statute of limitations starts when a person discovers or reasonably should have discovered an injury. When dealing with government agencies, SOLs can become even more complex.

For example, if the party that injured you was:

• A federal employee
• Employed by a military hospital, Veterans Administration facility, or a federally funded medical entity

You may need to file a birth injury claim under the Federal Tort Claims Act (FTCA). In FTCA cases, claimants must go through certain administrative procedures before filing a lawsuit. In some states, if the negligent party was a local or state government hospital or the doctors and medical providers are employees of a governmental entity, the time period in which you must give "notice" may be shorter.

If your case is filed outside of the statute of limitations, it will typically be dismissed, and you will not be eligible to recover compensation for your injuries. Determining when a statute of limitations begins on your case can be tricky. If you're considering pursuing compensation for a birth injury, contacting an attorney as soon as possible is in your best interest.

Nuchal cord cases often don’t result in injuries, but it takes a detailed expert review of the facts and circumstances of a mother’s pregnancy and her child's birth to determine whether any injuries sustained were the result of medical malpractice.

Our Process

At Miller Weisbrod Olesky, a team of committed birth injury attorneys, nurses and paraprofessionals uses our detailed medical negligence case review process to assess your potential birth injury case. We start by learning more about you and your child and the status of meeting/missing developmental milestones.

We then gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused you or your child's injuries.

If we feel medical negligence caused or contributed to complications with your pregnancy or your child's injuries, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do. The sooner you reach out to us, the sooner we can begin investigating your case and gathering the evidence needed to support your claim.

We work on a contingency fee basis, meaning you won't pay any legal fees unless we win your case. Contact us today to schedule your free consultation by calling our toll-free line at 888-987-0005 or by filling out our online request form.