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Writer's pictureMichelle Glenn-Dunn

True Knot Knowledge

Have you ever seen a true knot in an umbilical cord? Most birth workers see them quite often. They happen for about 1 in a 100 births. For some birth workers like me, it took a little over 7 years and 100 births before I seen one. So when this little guy was born on New Years Day, when I seen it, I said, "Is that what I think it is!?" I was the first to spot it and show mom!


You may be thinking, isn't that dangerous? The answer is yes and no. A true knot happens around 9 to 12 weeks gestation when your amniotic fluid is the highest and there is enough room for baby to dance and flip and move about freely. For many, a true knot will actually go noticed until delivery. Sometimes an ultrasound can detect a true knot. This is why keeping appointments with your provider is so important.


The umbilical cord contains a substance called Wharton's jelly. Wharton's Jelly is mainly connective tissue cells. The Wharton's Jelly protects these vessels from being compressed and restricting flow to and from your baby. In the umbilical cord there is one vein that carries nutrient rich, oxygenated blood to your baby, and two arteries that carry deoxygnated nutrient depleted blood away.


There can be some dangers with a true knot if the knot is pulled tight and blood flow is constricted, sometime this can be detected when monitoring during labor. Sometimes sudden decels in a babies heart rate may indicate a compressed cord. This is not always the case. There are a few variables that can cause a heart decel. Not all heart decels are alarming. Breath through those power surges and give your baby the most oxygen you can by staying calm and powering on.

Mom feels pulse in umbilical cord after birth.  Cord has a true knot.
True Knot after delivery
Baby snuggling on mother just after birth.  True Knot in Umbilical cord.
Waterbirth baby
Image of baby toes and umbilical cord with true knot.
True Knot in umbilical cord
Placenta
Placenta after birth with true knot in umbilical cord.

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