Once your egg cell is fertilized, a small miracle begins in your belly. In the first weeks of pregnancy, the umbilical cord also begins to form, creating the first strong connection between you and your growing baby—making the moment of separation often all the more emotional. In this article, learn more about the functions of the umbilical cord during pregnancy, which complications can occur, and what you should consider about your umbilical cord before birth.

Structure and Functions of the Umbilical Cord

You can think of the umbilical cord as a spiral-wound rope that connects your Placenta with your baby. The advantage of this shape is that it can adapt wonderfully by stretching or contracting. This way, it still has enough space in the uterus even at full length, and your baby does not get entangled in it. To ensure it remains especially flexible and does not bend or break under stress, it is made of a gelatinous connective tissue. It is surrounded by a thin, transparent membrane called the amnion—you might also know it as the “sheep’s membrane.” While the umbilical cord is only about 15 millimeters long in the first few weeks, it grows with your baby and, by the end of pregnancy, is about 50 to 60 centimeters long and has a diameter of 1.5 to 2 centimeters.

The formation of the umbilical cord begins in Week 4 of pregnancy . When your baby’s heart starts beating—approximately in the 6th week of pregnancy —the umbilical cord begins its main function: caring for your growing child. An umbilical vein carries blood—and therefore oxygen and important nutrients—from the placenta to your baby. Conversely, two umbilical arteries transport waste products such as carbon dioxide and nutrient-poor blood from the embryo to the placenta. Additionally, the umbilical cord acts as a kind of filter that separates the maternal and fetal circulations. This is ensured by a membrane in the placenta, the so-called placental barrier, which prevents, for example, viruses or bacteria from reaching your baby.

Starting from the 8th week of pregnancy , the umbilical cord also fulfills an important protective function : from now on, you transfer antibodies to your child that can recognize pathogens and protect your little explorer from early infections. And incidentally, this wondrous umbilical cord is also something like your baby’s first toy , as many ultrasound images show. Starting from about Week 14 , your baby begins exploring its surroundings, and grabbing the umbilical cord is not only a great activity but also an early exercise for the important grasp reflex it is born with. :)

Umbilical cord complications

Sometimes, the umbilical cord is positioned unfavorably or is simply too long, which can cause harmless or serious complications. Usually, you won’t notice any clear symptoms yourself, but your doctor may detect an altered heart rate in your baby during an examination. Some umbilical cord complications occur during pregnancy, while others occur only during or after birth:

• Umbilical cord presentation : In this case, during pregnancy , part of the umbilical cord has been pushed into the birth canal and is positioned in front of your baby’s head. As long as the amniotic sac has not yet ruptured, this can sometimes be corrected—for example, by elevating your pelvis—so that a vaginal delivery may still be possible under certain circumstances. Otherwise, the care of your baby during birth could be at risk.

• Umbilical cord prolapse : Unlike umbilical cord presentation, after the water breaks a loop of umbilical cord slips ahead of your baby into the birth canal. If your doctor detects the pulsating umbilical cord in your vagina during delivery, a Cesarean section often needs to be initiated, as your baby would otherwise receive too little oxygen and nutrients. Fortunately, this is a very rare complication.

• Umbilical cord entanglements : If your child can still move around a lot in the womb, the umbilical cord may become wrapped around the neck, arms, or torso, which can sometimes already be seen during Ultraschalluntersuchungen . You don’t need to worry that your child will choke on it. In most cases, a simple umbilical cord wrap is harmless and occurs in approximately every fifth pregnancy—in Multiple pregnancies even more frequently. Your baby will then be monitored especially closely during birth. If an umbilical cord entanglement causes supply issues during the Ejektionsphase , your midwife or doctor can intervene quickly.

• Node: There are harmless “false” knots , which can be explained, for example, by a curvature or thickening of the umbilical cord sheath. Nodules can sometimes be detected during ultrasound examinations in pregnancy, but often they are only found incidentally after birth. Very rarely, a “real” knot forms in the umbilical cord, caused by your baby’s movements. These true knots can impair blood flow in the umbilical cord and may prevent your baby from receiving enough oxygen. If a true knot is detected during pregnancy, your doctor will regularly monitor your baby with the CTG and, if necessary, initiate an early delivery by cesarean section.

• Umbilical cord hernia: In this rare complication, your child’s intestines and liver protrude outward and are covered by a transparent wall of the expanded umbilical cord. An umbilical cord hernia can often be detected by ultrasound during a Preventive examination , as it usually develops before the 12th week of pregnancy . After birth, surgery is usually performed to reposition the organs back into your child’s abdominal cavity.

• Umbilical hernia: Unlike an umbilical cord hernia, an umbilical hernia is often harmless and occurs in 5 to 10 percent of all infants. In this case, a herniation develops. gap in the abdominal connective tissue at the navel , through which the umbilical cord was guided, as it scars only slowly. You can recognize an umbilical hernia by the fact that the navel visibly protrudes outward—but this is not associated with pain for your little explorer and often recedes within the first years of life.

The cutting of the umbilical cord

During your entire pregnancy, your body supplied your baby through the umbilical cord, connecting you in an incomparable way. Cutting the umbilical cord after birth therefore also carries great emotional and symbolic significance: your baby takes its first independent breaths and is finally part of this big, wide world. Many expectant parents find it meaningful to be involved in this moment for their little explorer—so it’s best to discuss with your partner before the birth whether he or she would like to cut the umbilical cord, and also ask the medical staff on site whether this is possible. When the time comes, the umbilical cord is clamped a few centimeters from your baby’s abdomen and again a bit further along. This section can then be cut by your partner with scissors or a knife. Many people are surprised by how much strength this requires. If the birth was too exhausting—who doesn’t know the image of fainting fathers in the delivery room :)—or if you are alone, someone from the birth team will, of course, take over this task.

You should also consider, before the birth, when the umbilical cord should be cut and discuss this with your midwife and doctor. In hospitals , it is common to clamp the umbilical cord 1 to 5 minutes after birth or after the pulsation has ceased. If you decide on delayed cord clamping , you wait to separate the cord until there is no longer a pulse and all the blood from the placenta has reached your baby—this can take between 3 and 10 minutes. Delayed clamping has the advantage that your child may have improved iron stores, even six months after birth. In contrast, with early clamping , the umbilical cord is cut immediately after birth. This is done when there are complications, such as umbilical cord loops around your baby’s neck, or when the newborn requires medical care—for example, when it comes into the world as a Preemie . With a Lotus Birth , cutting is avoided completely after birth. Instead, the baby and placenta remain connected until the umbilical cord naturally falls off after a few days.

The use of umbilical cord blood

If the umbilical cord is clamped early after delivery and does not continue to pulsate, blood remains in it. Valuable stem cells can be obtained from this umbilical cord blood, which you can store for your child or donate —which benefits, for example, leukemia patients. To make a donation, you only need to fill out a questionnaire and provide written consent, and you must be of legal age and healthy. To verify this, blood will be drawn from you before and after the birth. Collecting umbilical cord blood is not possible in every hospital—so it’s best to inform yourself in advance and ask your midwife if you plan to store your umbilical cord blood.

To access the blood, the umbilical cord is punctured. This is completely painless, so neither you nor your baby will notice anything. Afterwards, your donation is frozen at -186 degrees Celsius and stored in a public umbilical cord blood bank. Private companies also offer to store your umbilical cord blood for a fee if you want to reserve the stem cells for your child. The idea behind this is that if your child, for example, develops leukemia, type-1 diabetes, or a heart defect, it can be treated with its own stem cells. However, a lot of research is currently being conducted on this, and no definitive statements can yet be made about whether therapies using one’s own stem cells are promising.

The umbilical cord stump after birth

After birth, a few centimeters of umbilical cord still remain attached to your baby’s belly and are clamped with a small closure. Most of the time, this umbilical cord stump falls off on its own after about 2 to 5 days. To ensure that neither the wound nor the clamp is covered, our in sizes 1 and 2 have a cut-out at the waistband and are therefore designed for sensitive baby belly buttons. Especially in the first two weeks after birth, your little explorer’s navel needs special attention. All the information you need to know about care can be found in our article " ".

The connection between you and your child is something very special from the very beginning: the physical separation marks the start of an exciting and intense time with your baby, and your emotional bond will last a lifetime. We wish you a wonderful pregnancy and your little explorer a great start in life!