[coobabysmom]

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.

 

[yeahwhat]

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.

 

[laohaire]

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!).

 

[katt]

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.

 

[Robinna]

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

 

[AugustLia23]

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.

 

[Full Heart]

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.

 

[coobabysmom]

Quote:

Originally Posted by yeahwhat 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!

Quote:

Originally Posted by yeahwhat 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?

 

[coobabysmom]

Quote:

Originally Posted by laohaire 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)...

 

[coobabysmom]

Quote:

Originally Posted by katt 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.

 

[coobabysmom]

Quote:

Originally Posted by Robinna 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.

 

[coobabysmom]

Quote:

Originally Posted by AugustLia23 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.

 

[coobabysmom]

Quote:

Originally Posted by Full Heart 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?

 

[Full Heart]

Quote:

Originally Posted by coobabysmom 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.

 

[mwherbs]

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....

 

[coobabysmom]

Quote:

Originally Posted by mwherbs so maybe you felt something?

I'm not sure I know what you mean? I don't recall feeling anything....

Quote:

Originally Posted by mwherbs 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!

Quote:

Originally Posted by mwherbs 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...

 

[yeahwhat]

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.

 

[mwherbs]

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.

 

[2sweetboysmom]

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!!

 

[jenmidwife2b]

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.