An umbilical cord around the neck, also called a nuchal cord, occurs in roughly 25 percent of vaginal childbirth deliveries. While a terrifying thought to many parents, most umbilical cord complications such as a nuchal cord do not affect the health of the baby nor the mother. When the baby's head has "crowned" and emerges from the birth canal, the medical professional routinely checks for an umbilical cord around the neck. In most cases, the cord is loose enough to slip over the baby's head before the body of the baby is delivered. While complications do occur, most are extremely rare or easily resolved.

Fetal death from an umbilical cord around the neck is very rare, and may be caused by the presence of other complications. Cord stricture, in which the umbilical cord is knotted tightly enough to prevent oxygen and nutrients to the baby, may be caused by a deficiency in the protective jelly covering. Prenatal technology such as ultrasound are incapable of diagnosing such complications, and in such cases the baby is stillborn. Cord stricture is responsible for an estimated 19 percent of fetal deaths.

In the rare cases where the cord is wrapped tightly around the neck or knotted, a doctor clamps the cord in two places and cuts the cord between the clamps. Delivery of the baby should commence immediately, as the baby no longer receives oxygen once the umbilical cord is cut. In extreme cases, the baby is injured during the clamping or cutting procedure. Overall, removing an umbilical cord from around the neck is generally a standard and safe procedure.

The umbilical cord vein and artery are covered by a thick, jelly-like protective sheath called Wharton's jelly. This slippery sheath reduces friction and prevents the cord from compression should the cord become entangled around the baby's neck or twisted into an umbilical cord knot. Obstetricians have created two types of classification for an umbilical cord around the neck. Type A is a cord wrapped around the infant's neck 360 degrees; type B is a cord wrapped around the neck in a firm knot.

Some medical practitioners use Doppler ultrasound technology to detect a prenatal nuchal cord. While ultrasound may be a good indicator of an umbilical cord around the neck, it is not an accurate predictor of a safe birth. Moreover, as the baby grows larger in the womb he or she becomes more active, and the possibility of an umbilical cord around the neck increases. Doctors are trained to detect the presence of a nuchal cord during delivery.