A cord around the baby’s neck at birth is a common occurrence. It happens in about a third of all births. This video will show how to manage a tight cord around the neck; including demonstrating a practice known as the somersault maneuver.

Many birth attendants are taught that a cord around the neck at birth needs to be removed or clamped and cut before the baby is born. They worry that the cord will either tighten too much around the neck, or will prevent the birth of the baby, or might pull the placenta off the uterine wall. The biggest risk to the baby is, in fact, clamping and cutting the cord too early – before the baby is born. This action cuts off his supply of oxygen from the placenta. The woman must push hard and get the baby out fast. This is an emergency. Then, you need to be ready to help the baby begin to breathe if necessary.

Let’s see how to manage a cord around the neck safely. If the baby’s cord is loose enough, it can be slid over his body. Or, the cord can be simply left alone. A loose cord around the neck will not get in the way of the descent and delivery of the baby’s body.

Occasionally though a cord is tight – as in this hands and knees birth. Or there are several loops around the neck. Then further descent of the baby’s body may be limited and another approach is needed.

Be sure the baby has rotated, then gently push his head towards the woman’s thigh in the direction the baby is facing. Be sure her legs are wide open. Keep the baby’s head close against the woman’s thigh. A push from the woman brings the baby’s body out as the head stays close to the thigh. Now unwind the loops of cord from around the neck. Then dry the baby and care for him in the usual way.

Here is an example of this maneuver with the woman in a hands and knees position. Again, pause for the baby to rotate. When he isn’t coming easily; a tight cord is discovered. Now gently push the baby’s head towards the woman’s thigh in the direction the baby is facing. Keep his head close against the woman’s thigh as the baby’s body emerges. Then unwind the loop of cord around his neck. This practice prevents the emergency of early cord clamping before the birth of the baby. It’s safe, can be performed no matter how many loops of cord are around the neck, and can be used in any birth position. It also allows for the baby to receive the benefit of delayed cord clamping.

Remember, the biggest risk of a tight cord around the neck is clamping and cutting it too early – before the baby is born. Instead push the baby’s head against the woman’s thigh and keep it close as the baby is born. This safe practice can be used in any birth position.