Nuchal Hand question - Mothering Forums

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Old 03-16-2007, 05:40 PM - Thread Starter
 
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Is there any validity to an AROM during active labor contributing to a nuchal hand?

I can't seem to find any info on this but feel, possibly incorrectly, that this caused ds to be born with a nuchal hand.
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Old 03-16-2007, 07:39 PM
 
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Maybe if his hand was already up by his head it might get it stuck there without water to move around in.

My older dd was born with a nuchal arm with srom 3 minutes before her birth. I'd had a prenatal appt earlier in the day and my midwife had been able to feel her hand up by her head then. She got her to move it, but I guess dd liked having her hand up there.
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Old 03-16-2007, 07:48 PM
 
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I don't see why not.

FWIW, I believe I had AROM (that is, my MW was not trying to rupture them but she had just a few hours before done my first pelvic exam, and it was definitely PROM since labor did not start, and only started 2 days later after cohosh) and DD came out with hand on chin (ouch!).

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Old 03-16-2007, 09:30 PM
 
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my sister had AROM during both labours and both kids had a hand up by their head... however, AROM wasn't performed until she was at 9+ and, at least with the first one, he always had his hand up by his face during the US.
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Old 03-16-2007, 09:30 PM
 
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I have no idea... my ds was born with a nuchal hand, but I know it was up by his face all the time anyway becuase I could feel his fingers tickling waaay down low a lot. My waters broke on their own before I started labour.

xo robin
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Old 03-16-2007, 09:44 PM
 
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My 1st son was born with a nuchal hand and spontaneous ROM. My partner, who carried him, said she felt his hand up by his face for a while though, so I would vote no for us.

I, on the other hand, had AROM(at 8cm) and no nuchal hand.

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Old 03-16-2007, 11:48 PM
 
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I think it could have something to do with a roomy pelvis.

My 1st was born with her hand by her face she was srom at onset of labor.

My 2nd had a nuchal arm (whole thing came out with her head) and had arom at crowning.

My 3rd had his hand by his face, arom to start labor.

My 4th had the same nuchal arm my 2nd did and his was srom.

My 5th and 6th didn't have either and one was born in the caul and the other was srom.

FWIW my kids are thumb suckers. Even the last 2. My 2nd had a callous on her thumb at birth from sucking it so much. So I think between my roomy pelvis and their oral fixation my kids tend to come out that way.

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Old 03-17-2007, 12:22 AM - Thread Starter
 
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Maybe if his hand was already up by his head it might get it stuck there without water to move around in.
This was my conclusion too!

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My older dd was born with a nuchal arm with srom 3 minutes before her birth. I'd had a prenatal appt earlier in the day and my midwife had been able to feel her hand up by her head then. She got her to move it, but I guess dd liked having her hand up there.
Did you midwife feel her hand by her head through a VE or externally?
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Old 03-17-2007, 12:26 AM - Thread Starter
 
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I don't see why not.

FWIW, I believe I had AROM (that is, my MW was not trying to rupture them but she had just a few hours before done my first pelvic exam, and it was definitely PROM since labor did not start, and only started 2 days later after cohosh) and DD came out with hand on chin (ouch!).
Interesting. I used the cohoshes too to get labor started because of post dates and I live in IL (that's for another thread).

Nuchal hands/arms=ouch, in a big way! This leads me to wonder if everyone tore badly too (multiple 3rds here)...
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Old 03-17-2007, 12:28 AM - Thread Starter
 
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my sister had AROM during both labours and both kids had a hand up by their head... however, AROM wasn't performed until she was at 9+ and, at least with the first one, he always had his hand up by his face during the US.
YES! That was my experience. I was somewhere between 9 1/2 and complete when I agreed to the AROM.
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Old 03-17-2007, 12:29 AM - Thread Starter
 
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Originally Posted by Robinna View Post
I have no idea... my ds was born with a nuchal hand, but I know it was up by his face all the time anyway becuase I could feel his fingers tickling waaay down low a lot. My waters broke on their own before I started labour.

xo robin
Robin- that is wild! You could feel fingers tickling you.
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Old 03-17-2007, 12:31 AM - Thread Starter
 
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My 1st son was born with a nuchal hand and spontaneous ROM. My partner, who carried him, said she felt his hand up by his face for a while though, so I would vote no for us.

I, on the other hand, had AROM(at 8cm) and no nuchal hand.
Interesting, I had no sense or feeling of a hand near his face.
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Old 03-17-2007, 12:41 AM - Thread Starter
 
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I think it could have something to do with a roomy pelvis.

My 1st was born with her hand by her face she was srom at onset of labor.

My 2nd had a nuchal arm (whole thing came out with her head) and had arom at crowning.

My 3rd had his hand by his face, arom to start labor.

My 4th had the same nuchal arm my 2nd did and his was srom.

My 5th and 6th didn't have either and one was born in the caul and the other was srom.

FWIW my kids are thumb suckers. Even the last 2. My 2nd had a callous on her thumb at birth from sucking it so much. So I think between my roomy pelvis and their oral fixation my kids tend to come out that way.

What is a roomy pelvis exactly? Pelvis bones that are wider apart (comparatively) or shaped differently (rounder interior)?

Interesting conclusion that gravity would pull more than just the head downward in a larger space with the idea that the hand was already posed in way (near the mouth) to predispose it toward a nuchal presentation.

Btw, was there tearing? And with each child was there tearing, less or more?
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Old 03-17-2007, 12:41 AM
 
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Interesting. I used the cohoshes too to get labor started because of post dates and I live in IL (that's for another thread).

Nuchal hands/arms=ouch, in a big way! This leads me to wonder if everyone tore badly too (multiple 3rds here)...
I never tore. Well I had a skid mark but thats it.

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Old 03-17-2007, 12:51 AM
 
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so maybe you felt something?

In all the old textbooks nuchal hand or arm was a RARE even but I have seen it a lot and I think it is probably we are bigger people with ample room- as opposed to the old days where contracted pelvis was a possibility from rickets --
AROM has a higher incidence of cord prolapse- but a cord would flow with the water but a hand/arm is muscular and a healthy baby would have a reflex to pull arms in --- so if it started to flow I would think that the baby would pull back just like we see when we are holding babies....
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Old 03-17-2007, 01:24 AM - Thread Starter
 
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so maybe you felt something?
I'm not sure I know what you mean? I don't recall feeling anything....

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In all the old textbooks nuchal hand or arm was a RARE even but I have seen it a lot and I think it is probably we are bigger people with ample room- as opposed to the old days where contracted pelvis was a possibility from rickets --
I am a big, healthy girl!


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AROM has a higher incidence of cord prolapse- but a cord would flow with the water but a hand/arm is muscular and a healthy baby would have a reflex to pull arms in --- so if it started to flow I would think that the baby would pull back just like we see when we are holding babies....
This is exactly why I put no AROM in my birth plan! But I trusted my mw and when she suggested it, I did it because I just wanted that baby out...
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Old 03-17-2007, 01:29 AM
 
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I had no tearing with dd's nuchal arm. But I've never had more than small tears with any of my kids (well, so far). Dd's arm did get bruised, either from my pelvis or from the second midwife seeing her hand coming out and holding her hand tight to her head. She had a smallish head though was the same weight/length my first two babes. It was a quick labour and birth, and I'd never have known if I hadn't been told and seen the bruise on her arm.
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Old 03-17-2007, 02:36 AM
 
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since you think that this might have been the cause -- I wondered if your intuition about it was also something you sensed- had a physical feeling- or a mental image when it happened.
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Old 03-17-2007, 03:59 AM
 
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I was born with a nuchal arm/hand, my mom said her labor started with srom (at k-mart : ) Her labor with me was 6 hours.
My first was 7lb 9oz nuchal hand (I had felt him "scratching" my cervix with his fingers for a couple of weeks beforehand) He was arom + pit to induce (pre-e) 6hr labor.
My second was 8lb8oz and had a nuchal hand too. arom 7 hr labor.
Both my boys curled into a position with their hand over their head for weeks after birth so I'm just glad it was only a nuchal hand!!

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Old 03-17-2007, 04:05 AM
 
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AROM can cause a nuchal hand to get "stuck" that way, but most likely the hand was already there.

Completely anecdotaly, I caught a waterbaby in the caul that had a nuchal hand. I felt her little fingers flex against the bag of waters as she was being born and saw them through the bag holding her ear just before I broke the bag after she was born. It was the coolest thing. Mom did have tearing along an old episiotomy line with her birth.

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Old 03-17-2007, 10:23 AM
 
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Nuchal hands/arms=ouch, in a big way! This leads me to wonder if everyone tore badly too (multiple 3rds here)...
I tore. I was told I had a second degree tear, so that wasn't so bad. But I think it must have been one heck of a LONG tear. It took over an hour to be stitched up (went to the ER and the OB attending stitched me, so it wasn't inexperience... plus I felt him put in a LOT of stitches).

Also, it took me 6 hours to push her out. She was my first, but I really feel the hand really kind of got us stuck a bit for a few hours. When I finally pushed her out, I did it on purpose - I was draining, and I was worried about my poor baby's head going through all that, and I psyched myself up (and announced to everyone that the next push was going to be "the one"), and the next contraction I kept pushing even after the contraction, and harder than the contraction was pushing on its own. I realize you're not "supposed" to do that, and no doubt that's when I tore, but I have never regretted it; baby and I were getting tired.

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Old 03-17-2007, 11:01 AM - Thread Starter
 
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I never tore. Well I had a skid mark but thats it.
Awesome. Do you feel the pushing stage was affected by the nurchal arm?
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Old 03-17-2007, 12:43 PM
 
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My water broke on it's own while sitting on a birth stool about 5.5 hours into labor, my DD was born minutes later in our bathtub with a nuchal hand.
Oh, and we just had a skidmark as well, she was 8lbs 8oz.

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Old 03-17-2007, 02:18 PM
 
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Nuchal hands/arms=ouch, in a big way! This leads me to wonder if everyone tore badly too (multiple 3rds here)...
actually it was no big deal. he was 8lbs 6oz, 20 minutes of pushing (1st baby), and all I had was a skid mark.
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Old 03-18-2007, 02:01 AM
 
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Nuchal hand here! And I felt her tickling my cervix as well, and we had an u/s the day before birth (going on 42 weeks) and she had her hand up there. The video of her birth is funny, she's coming out, and my sister says, "Oh! There's that hand!"

I did tear...but only 1st degree, it was just a funny shape, so it took a while to stitch. My mw was actually concerned that the tissue wouldn't reattach, because it was quite a flap, and I'm convinced it was her hand that did it. Also, her descent through my birth canal was excruciatingly painful, I just kept feeling this burning and pain, and knew something was up. I begged the mw to break the bag of waters right before pushing, at 9.5cm+, because I wasn't quite complete, but baby and my uterus were pushing her out and it really was painful. She was born about 20 minutes later.

I'm impressed with the nuchal hands/arms and no tearing, wow! Did anyone else experience a really painful descent?

Oh, dd2 w/ nuchal hand was 9lbs, dd1 had been 7lb 11oz, so a big size difference as well.
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Old 03-18-2007, 01:27 PM
 
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I'm impressed with the nuchal hands/arms and no tearing, wow! Did anyone else experience a really painful descent?
I had nuchal hand with my first. No tearing. I *did* say at one point, "Hot Compresses NOW!" And, he was posterior, too. I pushed him out sunnyside up with his hand beside his head. I remember thinking when I got his head out that all the books would say I'd feel relief since only his neck resting in my perenium... but his elbow was there, too, so it was just as big as his head was. I felt a little misled by the book at that moment.

I did have really painful descent, but I'm not sure if that was nuchal hand stuff or posterior stuff.

My posterior nuchal hand baby was my smallest (most room to get all turned around?) and my most painful and odd process of labor (reverse dilation, stops & starts galore, pain). I swore by www.spinningbabies.com after that though and my other 2 babies were perfectly positioned.

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Old 03-18-2007, 01:28 PM
 
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My ds was born with a nuchal hand wrapped in the cord! I didn't have AROM. My water broke naturally at about 10 cm.

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Old 03-18-2007, 05:20 PM
 
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I posted in your other thread but I wanted to post and subscribe here, I like all the shared stories.

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dd2 (#3) had nuchal hand... the problem for me was getting active labor going... at five days post-dates I had my first VE and was 4cm/stretchy to 8cm. My bp was rising, so my mw stripped my membranes and noticed fingers at dd's scalp (and my cervix). That explained the very weird feelings I'd been having at my cervix and possibly why I'd had so much prodromal labor without turning into active labor.

Once active labor began it was very quick and intense (~2 hours). I had awful, awful back labor, I'm presuming it was her arm pressing on something. My waters ruptured spontaneously and I threw down at that time. Her arm being up did require an extra push whereas my previous baby had just shot out without me pushing. No tears or repairs needed, I caught.
In my above post, I forgot to say that the week before my midwife felt fingers in the VE, the midwife's apprentice said she felt an arm up by baby's head when she did palpations.

Descent WAS excrutiating. I'm glad my labor was fast because the back labor was awful and I'm glad she came pretty quick once I started pushing. I have a roomy pelvis, so I'm hoping if we have #4 that he/she won't decide to be a finger sucker too.

To this day, dd sucks her two middle fingers on her right hand, she's 10mo now.
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Old 03-18-2007, 05:37 PM
 
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My Dd was born with a nuchal arm and hand, one elbow was in front of her nose and pushing against my spine...talk about bad back labour!The other hand was holding her ear.

I did tear with her (the only birth were I've torn) right when her elbow was comming out,it was an awfully tight fit, lol.
I'm only 5'3" and barely 100lb when not pregnant...so I don't think it's a matter of my pelvis being very large..

It wasn't a bad tear however, 1st degree..I belive I got 3 stitches..hmmm, maybe 5..

Oh, and my waters ruptured spontaniously about 2 hours before she was born, at home, and the hospital was a 30min drive away, which I believe influenced the length of my labour (I've promised myself I will never get in a car well in labour again, lol)
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Old 03-18-2007, 09:52 PM - Thread Starter
 
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AROM can cause a nuchal hand to get "stuck" that way, but most likely the hand was already there.

Completely anecdotaly, I caught a waterbaby in the caul that had a nuchal hand. I felt her little fingers flex against the bag of waters as she was being born and saw them through the bag holding her ear just before I broke the bag after she was born. It was the coolest thing. .
What an amazing thing to witness! WOW!!!! While I was pg, I always thought ds would be born in th caul!

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Mom did have tearing along an old episiotomy line with her birth.
Do you think this had to do with arm?
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