If there is a rest between the birth of the head and the birth of the shoulders, feel for the cord around the baby's neck.

If the cord is wrapped loosely around the neck, loosen it so it can slip over the baby's head or shoulders.
If the cord is very tight, or if it is wrapped around the neck more than once, try to loosen it and slip it over the head.
If you cannot loosen the cord, and if the cord is preventing the baby from coming out, you may have to clamp and cut it.

If you can, use medical hemostats (clamps) and blunt-tipped scissors for clamping and cutting the cord in this situation. If you do not have them, use clean string and a new razor. Clamp or tie in two places and cut in between (Figure 5.9). Be very careful not to cut the mother or the baby's neck.

If you cut the cord before the birth of the baby, the mother must push hard and get the baby out fast. Without the cord, the baby cannot get any oxygen until he or she begins to breathe.

Figure 5.9 Cutting the cord when it is wrapped around the baby's neck.