How Umbilical Cord Knots Form and What They Mean

BySamradni Pradhan
Updated: 10 Dec 2025, 8:00 am

When you hear about knots in the umbilical cord, it can sound worrying, but they aren’t always dangerous. These knots usually form when your baby moves around in the womb. Most of the time, they don’t cause any harm. However, in some cases, they can affect your baby’s blood and oxygen supply. This blog explains how umbilical cord knots form, what they mean for your baby’s health, the signs to look out for, and how your doctor can help ensure a safe pregnancy and delivery.

Pregatips
During pregnancy, you’ll come across many new medical terms that can spark both curiosity and concern. One such term is “umbilical cord knots.” The phrase itself might sound alarming, as it seems to suggest potential danger to your baby. However, understanding what these knots are and how they form can help ease your worries. By learning more about their nature, you can feel more informed, calm, and confident throughout your pregnancy.
In this article:


What Is an Umbilical Cord Knot?


The umbilical cord is the lifeline of your baby, giving oxygen and nourishment and taking away the waste. A knot on this cord merely indicates that a portion has been twisted into a loop, just as a knot on a rope.

There are two main types:

  • True knots: A true knot is created by the baby passing through a loop in the cord.
  • False knots: A bulge in the cord due to the folding of a blood vessel, or to the addition of Wharton jelly (a protective material). These are harmless.


How Do Umbilical Cord Knots Form?


It normally occurs in the early months of your pregnancy when the baby is small and has a lot of space to move freely. Here are common causes:

  1. Active baby movements: When your baby skips or turns over, they can get caught in a cord loop.
  2. Excess amniotic fluid (polyhydramnios): The more fluid there is, the more space your baby has to move, and the more possibilities of knots.
  3. Long umbilical cord: A cord that is more than 60 cm can lead to an excessive risk of knotting.
  4. Twin or multiple pregnancies: The movement of babies may lead to knots or entanglement.
  5. Small baby size: The baby is smaller, which means that it has more space to move, which is why it sometimes causes knots.


Are Umbilical Cord Knots Dangerous?


Not all knots are harmful. Actually, most of them do not tighten and do not affect your baby. This worry occurs when a knot is tight, particularly in labour contractions. A very tight knot can decrease blood and oxygen flow, causing distress.

According to the statistics, cord knot complications occur in less than 1 per cent of all births. Doctors closely monitor pregnancies to minimise risks.


What Are the Signs of a Cord Knot?


Unfortunately, you cannot feel a cord knot forming. However, some signs may indicate a problem:

  • Sudden decrease in the baby’s movements
  • Irregular heart rate of the baby (detected during scans or monitoring)
  • Stress signs during labour
Note that these symptoms do not necessarily imply the presence of a knot, but they are indicators that you should visit your doctor as soon as possible.


Can Umbilical Cord Knots Be Detected During Pregnancy?


Yes, in some cases. Sophisticated ultrasound methods such as colour Doppler imaging can be used to identify knots. However, it’s not always easy to identify them, as the umbilical cord naturally loops and twists. In fact, many knots are only discovered after the baby is born.


What Should You Do If a Cord Knot Is Suspected?


You will be closely monitored when your doctor suspects a knot. Here’s what you can expect:

  • Non-stress tests (NST) are used to check the heart rate of your baby.
  • Keep a kick count tracking at home by noting your baby’s movements daily.
When your doctor thinks the knot is reducing the blood flow, they might advise an early birth or C-section to save your baby.


How Can You Keep Your Baby Safe?


You can not avoid knot formation, but you can take precautionary steps so that you can observe any warning signs at an early age.

Checklist for Parents-to-Be:

  • Track your baby’s kicks daily.
  • Inform your doctor immediately if the movements decrease in frequency or intensity.
  • Attend all scheduled scans and monitoring sessions as scheduled.
  • Stay calm, most knots do not cause harm.
  • Prepare emotionally by talking to your partner and doctor about birth plans.


Emotional and Social Aspects


Knowledge of umbilical cord knots can be stressful. It’s natural to feel anxious, but remember, you’re not alone, and support is always available:

  • Partner involvement: Communicate your concerns and share them with your partner. This will create confidence and relieve your emotional burden.
  • Mental health support: Feeling anxious during pregnancy is completely normal. Talking to a counsellor or joining a prenatal support group can often help you feel more reassured and supported.
  • Bonding with your baby: Focus on secure activities, such as counting the number of kicks your baby makes and speaking to them in a low tone, which will give you a sense of safety.
While hearing about umbilical cord knots can be unsettling, most of them are harmless and do not affect your baby’s well-being. These knots often form naturally as your baby moves in the womb and rarely cause complications. Staying aware of your baby’s movements and attending regular check-ups can provide reassurance and peace of mind. Along with proper medical care, emotional support from your partner and loved ones can help you maintain a calm, balanced, and healthy approach throughout your pregnancy.

Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.

FAQs on How Umbilical Cord Knots Form and What They Mean

  1. Can I prevent umbilical cord knots during pregnancy?
    No, you cannot prevent them. The knots appear naturally as the baby moves. Nevertheless, regular check-ups and monitoring of baby movements can help keep you and your baby safe.
  2. Are umbilical cord knots common in twins?
    Yes, knots and entanglements are more prevalent in twin or multiple pregnancies because babies are in close contact, and cords may overlap.
  3. Do cord knots always require a C-section?
    Not always. Some children born with knots are actually safely delivered following a normal delivery. C-section is typically recommended in cases when the knot is painful or when there is a lack of blood flow.
Disclaimer: Medically approved by Dr Ritu Hinduja, Clinical Director & Senior Fertility Consultant at Cloudnine Group of Hospitals, Mumbai, Malad

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