The risk of the umbilical cord presenting before the baby is small but noteworthy. The best way to avoid a prolapsed cord is to keep the labor normal and keep curious fingers out of the vagina unless the mother is prompted to check herself.
Hurrying birth along increases the risk of the head not settling in to the pelvis before the water breaks and "washing" the cord into the birth canal. Avoid all induction techniques (except maybe sex; semen is a fine source of certain prostaglandins).
If the cord DOES prolapse: The standard protocol is to transport with the woman in a hands and knees position with the midwife's hand holding the head off of the cord. I might ask my husband (in the absence of a midwife) to check and see if there was any chance of normalizing the situation but this is a rare scenario where I wouldn't take my chances at home.
Of course, the scenario is rare enough that it doesn't bother me either.
If the prolapse is not discovered until the pushing stage, the urge to push is present and strong and a Cesarean is not immediately available, the best thing to do is probably to push with everything you've got. This tip is from a mother who lost her baby due to waiting in exactly that situation. Usually, the prolapse will be discovered early on and this won't be an issue, but I'd hate for this community to lose any more precious little ones due to waiting when there is no time to waste.
For extra protection from a prolapsed cord you can make sure you get enough zinc in your pregnancy diet, it toughens the amniotic sac, making the odds of it breaking before the head is engaged even slimmer...
cbirth archives on prolapsed cords
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