Moms and babies are connected in the womb in more ways than one. Of course, the baby is growing and kicking inside the mother, and she can feel every movement and sneeze. But the two also are physically tied to each other through a cord that connects the baby to the placenta, which connects to the uterus. That special organ even continues the connection after the birth, if only for a few moments, and for many the moment that it is cut or burned is a deeply spiritual moment.
The umbilical cord means a lot for a baby. It develops within weeks of the conception, even before many of the baby's internal organs have formed. And it provides the blood, the oxygen and the nutrients that the baby needs to survive for his nine months in the womb. The cord is the baby's first toy, but it also could hold the key to figuring out issues with the baby's development. During the birth, the cord provides an extra layer of protection that could save the baby's life, and that protection could last for years if the mother chooses to go through cord blood banking.
There are so many things to know about the powerful cord that brings acts as a life line to the baby in the womb. We've got a guide so that parents understand how it works and what it could mean for their little one.
Here are 15 facts about the umbilical cord parents need to know about.
15 Development Period
The umbilical cord is one of the first organs to fully develop for the baby. That's because it is critical to allowing the rest of the baby to develop, since it brings the nutrients that allow the baby to grow.
For the first few weeks, the fetus is able to survive on the nutrients in the yolk sac, but as the cells develop, eventually, a portion divides off to become the placenta, and the cord develops between the baby and the placenta to allow the blood and nutrients to circulate between the two. It forms at around the fifth week of gestation, which is the seventh week of pregnancy. That's before the baby's brain has started to function, and before the kidneys and intestines are fully developed.
Without the early development of the umbilical cord, so much would not be possible. It's one of the amazing first feats that are so critical to the baby's health later on.
14 Triple Threat
The umbilical cord sounds like one entity, but it is actually a combination of three blood vessels. Inside the cord, there are two arteries and one vein. Arteries take oxygenated blood from the mom to the baby, and the vein brings the blood that no longer has oxygen back to the mom to eventually go back to her heart and pick up its next batch of fresh air. That's a very important life function that wouldn't be possible without the special link providing blood through the umbilical cord.
The blood isn't just about circulation for the baby in the womb. Through the transmission of the blood in the umbilical cord, it also means that the baby gets oxygen. The baby can't breath until after the birth, so this is the only way that the air can get to all of the organs. Without those three special blood vessels, it could be bad news for the baby, and we'll get into that in just a moment.
13 Missing Part
For about 75 percent of pregnancies, the cord works just perfectly. But unfortunately, sometimes things can go wrong. The most common anatomical issue is that the cord is missing one of its arteries. That means only one blood vessel is in place to bring oxygen to the baby through the blood, and that leaves the baby at risk. The condition happens in about 1 in 100 singleton pregnancies, although it is more common for twins, and it happens in about 5 percent of those pregnancies.
While doctors don't know why single umbilical artery conditions happen, the truth is that about 20 percent of the time there is some other condition that is impacting the baby. Many times, that can include a genetic condition, or the baby could have issues with his heart, kidneys or digestion. In those cases, sometimes the umbilical issue can help diagnose another problem so that it can be fixed. Many times, babies can be born healthy even without the third vessel in place, but it can make the pregnancy high risk, and doctors will definitely keep an eye out for further problems.
12 Extra Vessel
Just as some pregnancies can end up with one less blood vessel in the umbilical cord, sometimes, there can be an extra one included. A four-vessel cord typically has two arteries and two veins, and that is usually an indication of other anatomical issues as well. Kids with that condition can have atrial septal defect, problems with the placenta, cleft lip or palate or other issues.
Other four-vessel cords can have an extra artery, but that doesn't necessarily indicate anything other than a knot in the cord that can redirect the blood flow. Very rarely, some cords can have four arteries and one vein. The arteries are smaller and they still carry about the same amount of blood as the usual two-artery variety.
In just about every case, the doctor is going to keep a close eye on the baby's development if the cord looks different than usual, but many babies can still be born healthy even with these conditions.
11 Wharton's Jelly
We just talked about how the umbilical cord is actually made of more than one blood vessel — usually three, although we've talked about many cases where there are more or less. But to make one cord, there has to be a substance that keeps everything together.
That substance is known as Wharton's Jelly. It's a kind of gelatinous substance that is kind of clear and can be bent and folded easily, allowing for the cords to have enough cushioning so that the blood can still flow even when the baby squeezes the cord or a knot develops. The jelly includes stem cells and develops within days of conception, but we'll get into that in a little bit. The Wharton's jelly is what most people think of when they visualize the clamped umbilical cord before it falls off a newborn. It's very important to cushion and protect the important substances inside.
10 The Long And The Short Of It
Most parents are shocked by the length of the umbilical cord, but there is a reason for why it is so long — on average about two feet long. Think about after the baby's birth, when the mother is holding her little one, but the placenta is still inside her body. The long cord allows the mother to be able to bond with her new baby and maybe even nurse before the placenta is delivered. While many doctors — or dads — cut the cord before the placenta comes out, it isn't necessary because of the length of the cord.
There are umbilical cords that are longer than two feet, and sometimes there are some that are shorter. Unfortunately, the shorter length has been linked to placenta retention issues, and it's also correlated with the need for a C-section. There can be issues with longer cords, as well, and we will get into that in the next section.
9 Tied In Knots
The umbilical cord is often baby's first toy. Ultrasound images show little ones having a good time with the only thing that they really have to occupy themselves in the womb. But in all that playing — along with the rolling and moving and all of the baby's usual antics — the cord can get tied up in knots. The longer the cord, the greater likelihood that it could get quite twisted in there.
Most of the time, fortunately, a knot in the umbilical cord isn't dangerous. It happens in at least 1 percent of pregnancies, and while it may be alarming to moms when they see it, cords can still function well when they are all tangled up. The cushioning provided by the Wharton's jelly can allow the blood to continue flowing even with a big knot in the middle, and thankfully, many doctors have taken photos of multiple knots in the cord that still resulted in a healthy delivery.
8 Neck Concerns
Another concern that mothers have about the baby's umbilical cord is a worry that the cord will be wrapped around the baby's neck at birth. That happens fairly often, but it's important for parents to know that most of the time the baby is just fine. Known as a nuchal cord, the condition happens in about one-third of births. In fact, many parents don't know that their baby had their cord around his neck because the doctor or midwife will unloop it after the baby crowns when the mom is still working to push the rest of the body out.
While there are some times when the birth does not go well, most of the time the nuchal cord isn't the main cause of the issue. The Wharton's jelly can protect the cord to allow the blood to continue to carry oxygen during the birth, and the baby doesn't have to breathe on his own until after he is out, which is when the cord is removed. The cord delivers oxygen up to two minutes after the birth, so even with a cord around the baby's neck, there is still a good chance that the baby can be born healthy.
7 Cord Prolapse
There is one cord birth issue that could be very concerning, and it may lead to a C-section. The condition is called a cord prolapse, and it is where the umbilical cord gets into the birth canal ahead of the baby. A prolapse is a danger when the cord is extra long, but there are other issues that can caught it as well, including when the baby is premature, at a low birthweight or breech. It also happens more often for twins and when the mom has an excess of amniotic fluid.
It's also especially a danger when the mom's water breaks early or when the doctor does a membrane sweep. That can allow for the cord to move into the birth canal before the baby does. As we've mentioned before, umbilical cords often have enough cushioning to allow it to be pinched for a while, but if the baby is deprived of oxygen, that could be detrimental to the baby's health. Sometimes the doctor can shift the baby into a more safe position, but many times doctors recommend a C-section to avoid the possibility of brain damage or death due to oxygen deprivation.
6 Toxic Substances
There is no doubt that the umbilical cord is important to the health and welfare of the baby. Therefore, it is important that the mom do what she can to keep the cord healthy. According to Belly Belly, maternal health is really important not only to the placenta but to the umbilical cord, and issues like poor nutrition and smoking can impact the entire umbilical system.
In addition, a research study showed that fertilizers and toxins have been found not only in the blood of pregnant women but in their baby's umbilical cord. The study is from Bali, where a midwife was named a "Hero of the Year" by CNN after she linked the large amount of GMO soy in the diet of Indonesians to an increase in umbilical cord deformities. Those same results haven't been determined in this part of the world yet, but GMO products remain a touchy issue for many in the United States.
5 Saving Cells
The umbilical cord isn't just a critical piece of keeping the baby alive during pregnancy. It also could provide life-saving nutrients after the birth Research shows that blood that is taken from the umbilical cord after the birth can be stored and used later to help a child who is diagnosed with disorders such as leukemia, sickle cell anemia and certain metabolic disorders. In fact, if a family has a history of those diseases, doctors may encourage cord blood banking.
The first use of cord blood to treat a disease came in 1998, and the procedure has improved in outcomes over the past decade. The cord blood doesn't just have to be used for the baby who it came from, as some public banks can match any child who is sick with a donation. It's also been used for siblings who are sick. It can be costly, although using a public bank can be free. Either way, it can be well worth it for families who are at worried about the health of their children.
4 Delayed Cord Clamping
We have mentioned the fact that the umbilical cord provides oxygen for a few minutes after the birth a couple of time because of the truth that it can help keep the blood and air flowing for a baby who might have a nuchal cord or other issue at birth. But lately some people have advocated for a delay in cutting the baby's cord even if the baby is born healthy.
According to advocates, a health care provider should delay any cutting or burning until the cord has stopped pulsing, allowing as much blood to go back to the baby before the tie is severed. It could increase the baby's blood volume by as much as one-third. It also can increase the baby's iron level, which is critical to brain development, but it can also put the baby at risk for greater levels of jaundice. Studies show that delaying the clamping is especially beneficial for preemies. The World Health Organization recommends waiting at least one to three minutes after birth, although some parents now choose to not cut the cord at all or at least wait until after the pulse ends
3 Cultural Connection
There are many ways to get rid of the umbilical cord, and it's interesting to consider all of the ways that society has created rituals surrounding the umbilical cord. In Japan, for example, a baby's umbilical cord stump is preserved in a special box, and many adults hold on to their own cords as long as they live as a symbolic connection to their mother. Some cultures believe that burying the placenta and cord are important, and some Hispanic cultures still believe that the cord should be covered to prevent air from getting in it.
In Tibet, women cut the umbilical cord with an unclean knife, but in the United States, it's become a rite of passage for dads — and it's usually their first act of fatherhood. A new trend is creating a gentler tradition, often getting the entire family together to burn the cord. It's taken from some cultural traditions, and it's become a symbolic connection for some families. For some, there is no more important aspect of the birth.
2 Cord Care
Keeping a baby fed and healthy and growing in the first few days of life are difficult, and knowing that you have to take care of the umbilical cord can be a daunting part of the job. The good news is that the cord pretty much takes care of itself, thanks to that magical Wharton's jelly.
Not long after the cord stops pulsing or is cut or burned, the blood vessels shrink up inside the jelly, and it hardens so that bacteria can't really get inside. The jelly starts out a sort of opaque-ish white, and it eventually fades to a darker brown before it falls off. There may be little bit of oozing blood at first, but if that doesn't heal up within a few days, it's important to talk to the doctor. The cord stump usually only sticks around for a couple of weeks, and the most important part of cord care is keeping it clean and dry during that time. It's not necessary to use an astringent — gently using wipes and clothes should do the trick — but parents should keep an eye out for the area to get red or puffy and call the doctor at any sign of infection. If all goes well, soon the umbilical cord will be gone, and all that will be left is a sweet little belly button.
1 Lotus Birth
Of course, you don't have to cut the umbilical cord. More and more people are choosing to keep that connection and carrying around the placenta. The cord falls off eventually, the same way that the stump does after it is cut, so they consider the practice of lotus birth to be more natural and gentle for the baby.
There are risks, though, and parents should know about that. The Royal College of Obstetricians and Gynaecologists have been warning parents that once the circulation of blood stops, the umbilical cord and placenta are dead tissue and they will begin to rot. The placenta, especially, can become infected, and that can easily spread to the vulnerable newborn. It can be smelly, and the extra organs can make it a little more difficult to care for the baby. People who are interested in Lotus Birth really need to do their research to make sure that the baby stays healthy. The cord has been an essential part of the baby's life, but there is a time when that must come to an end.
Sources: March of Dimes, What to Expect, Family Cord