# Nuchal Hand question



## coobabysmom (Nov 16, 2005)

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 (Feb 10, 2007)

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 (Nov 2, 2005)

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 (Nov 29, 2001)

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 (Aug 11, 2003)

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 (Mar 18, 2004)

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 (Apr 27, 2004)

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 (Nov 16, 2005)

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 (Nov 16, 2005)

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 (Nov 16, 2005)

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 (Nov 16, 2005)

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 (Nov 16, 2005)

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 (Nov 16, 2005)

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 (Apr 27, 2004)

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 (Oct 24, 2004)

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 (Nov 16, 2005)

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 (Feb 10, 2007)

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 (Oct 24, 2004)

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 (Aug 1, 2006)

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 (Jan 2, 2007)

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.


----------



## laohaire (Nov 2, 2005)

Quote:


Originally Posted by *coobabysmom* 
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.


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *Full Heart* 
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?


----------



## kerikadi (Nov 22, 2001)

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.

Keri


----------



## Robinna (Aug 11, 2003)

Quote:


Originally Posted by *coobabysmom* 
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.


----------



## Jster (Apr 22, 2003)

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.


----------



## Spark (Nov 21, 2001)

Quote:


Originally Posted by *Jster* 
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.


----------



## stacyann21 (Oct 21, 2006)

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.


----------



## Peppamint (Oct 19, 2002)

I posted in your other thread but I wanted to post and subscribe here, I like all the shared stories.









Quote:


Originally Posted by *busybusymomma* 
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.


----------



## ~Yola (Sep 2, 2006)

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)


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *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. .

What an amazing thing to witness! WOW!!!! While I was pg, I always thought ds would be born in th caul!

Quote:


Originally Posted by *jenmidwife2b* 
Mom did have tearing along an old episiotomy line with her birth.

Do you think this had to do with arm?


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *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.

The Arom/nuchal hand connection didn't occur to me until many months later.

I felt very centered and tuned in to my body & baby during labor at home, and was really clear all was well without any sensation of tickling or scratching as other posters describe. Contrax were super irregular and I always thought it was because I self-induced with the cohoshes and I was a first timer.

I actually didn't know until about the "hand" until a few days after ds was born when I went back to the midwives' office for bright blood (popped stitches) and severe pain then I was told.


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *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!!

To feel him scratching at your cervix just blows my mind!


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *kerikadi* 
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.

Keri

It feels good to hear many women citing only skidmarks or less. Sounds like you had a nice birth experience.


----------



## Belle (Feb 6, 2005)

My dd had a nuchal hand. I had AROM at 9+cm. I think it was already up there and the AROM didn't have much to do with it.


----------



## KWenn (Jun 13, 2006)

DD was born with a nuchal hand. I had a few tears on the inside that needed a few stitches. When her head came out, I saw the splash of bright red blood and knew _something_ had happened









I had SROM @ almost 10 cm while sitting on the birth stool. Some back labor as well--didn't know this was from her hand being up there?

This is an interesting thread!


----------



## jenmidwife2b (Jan 2, 2007)

I was so privileged to be there, it was my first "catch" on my own. I really feel that since that first catch was a caul baby I am doubly blessed.

Quote:


Originally Posted by *coobabysmom* 
Do you think this had to do with arm?

I think it was twofold, one, the hand/arm and also her position. Initially she was on her side pushing but was clamping her legs together everytime she pushed so I asked her if she'd like to try a different position so she could open up. She chose squatting. Squatting opens up a pelvis just wonderfully, but also puts more pressure on the perineal area since this makes it tighter. So, I think it was the squat position and that lovely hand.


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *KWenn* 
DD was born with a nuchal hand. I had a few tears on the inside that needed a few stitches. When her head came out, I saw the splash of bright red blood and knew _something_ had happened









I had SROM @ almost 10 cm while sitting on the birth stool. Some back labor as well--didn't know this was from her hand being up there?

This is an interesting thread!

Again, I am seeing a pattern here with us mamas of "nuchal hands/arms".

I too was on a birth stool and a splash of brith red blood came out with his head/hand.


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *busybusymomma* 
I posted in your other thread but I wanted to post and subscribe here, I like all the shared stories.










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.

Finger sucker!







So cute.

Yes the *descent was excrutiating* for me too. While pushing I actually wondered when the relief was going to come as I had read in a number of books and hear from others! Early and Active labor was pretty manageable compared to the pushing...

The shared stories mean a lot to me. Thanks to all and I hope they keep coming.


----------



## coobabysmom (Nov 16, 2005)

Quote:


Originally Posted by *jenmidwife2b* 
I was so privileged to be there, it was my first "catch" on my own. I really feel that since that first catch was a caul baby I am doubly blessed.

You're kidding! That seems like a great omen to the start of your midwifery career and dare I say it highlights your trust in the female body to do it's work without intervention.

Quote:


Originally Posted by *jenmidwife2b* 
I think it was twofold, one, the hand/arm and also her position. Initially she was on her side pushing but was clamping her legs together everytime she pushed so I asked her if she'd like to try a different position so she could open up. She chose squatting. Squatting opens up a pelvis just wonderfully, but also puts more pressure on the perineal area since this makes it tighter. So, I think it was the squat position and that lovely hand.

This gives me a lot to think about actually...


----------



## Full Heart (Apr 27, 2004)

Quote:


Originally Posted by *coobabysmom* 
Awesome. Do you feel the pushing stage was affected by the nurchal arm?

Nope. I hate pushing, I panic. But it very quick and I let my body do all the work. Doesn't seem to matter where the hand is - all hurts the same lol.

I gave birth 2 days ago, now no one actually saw the birth cause I was on hands and knees in the pool facing away from everyone but I am pretty sure there was no hand or arm and I again had SROM to start off labor.


----------



## Peppamint (Oct 19, 2002)

Quote:


Originally Posted by *coobabysmom* 
Awesome. Do you feel the pushing stage was affected by the nurchal arm?

I had to push hard and give an extra push. My previous babe (1oz bigger) had practically fallen out because I had that ejection reflex going.







I still had the reflex feeling with my nuchal hand baby too, but she didn't come out as easily.

It definitely changed the pushing stage and I think it could have caused some probs if my pelvis wasn't so roomy, and if I hadn't already given birth twice. Who knows though.


----------



## attachedmamaof3 (Dec 2, 2006)

My first and second both had nuchal hands (and were both posterior strangely enough)...the first I believe was because we had to do an internal version since he was coming out shoulder/arm first...the second had 2 nuchal hands/arms and was posterior. His bag broke on it's own when he crowned. I had no tearing (with any of mine) and a 1.5 hr labor...so I think (in my experience anyway) that the nuchal hands are already there but an AROM may cause it to 'stick' for lack of a better word...


----------



## 2Sweeties1Angel (Jan 30, 2006)

Saffron's had was up by her face at my 38 weeks US. I just assumed she'd move it before birth but no, she didn't. I had SROM a few hours before she was born and she came out with the nuchal hand. That didn't feel so good.


----------



## yeahwhat (Feb 10, 2007)

It definitely did not effect pushing for me. Once srom happened, I got an overwhelming urge to push on the next contraction and baby girl arrived in one long push.

I'd never thought to connect the terrible back pain I had during the last 30 minutes or so with the position of her elbow. I guess that's a possible explanation.


----------



## MyCalling (Sep 1, 2004)

My first was a nuchal arm and I had srom at 7cm that had nothing to do with it. His cord was wrapped under his arm pit and around the other side of his neck holding it up there. His fingers where the first thing to crown and his arm had to be crossed over and pulled through before he would fit out.

I felt everything and have a huge fear of pushing each birth because of it. On the side with the elbow, I tore from front to back along the inside and up the center of my labia and swelled like I had elephantiasis on the opposite side.


----------



## loraxc (Aug 14, 2003)

I'm bumping this because I'd love to hear more from mamas who birthed babies with nuchal hands. I am almost 36 weeks and my MWs have felt a nuchal hand at my last 3 appointments; babe is also very low, so I think this critter has its mind made up. I'm nervous about tearing and long labor (my first labor was 34 hours!)


----------



## wendy1221 (Feb 9, 2004)

My first had a nuchal hand. My doc didn't break my water until after I had been pushing for over an hour. I don't think her breaking my water had anything to do with it. I do think it's the reason I had to push for 2.5 hours, though.


----------



## Queen of my Castle (Nov 11, 2005)

Interesting thread!
Dd had a nuchal hand, and I too felt her tickling me with her fingers way down low a week or so before. It was so weird, a new sensation. I remember thinking to myself, 'don't tell me this baby is going to come out with a nuchal hand'!
Ds didn't and I had arom _right_ before birth and dd _did_ have the nuchal hand and my water broke between push 1 and 2 (of total 3). I didn't tear, pushing was extrememly fast, but also very furious. (3 min) I laughed when my mw told me later that she had a nuchal hand, I said, 'I knew it!'. She was 8lb4 oz, for the record, and my ds was only 6lb 9oz.
A


----------



## langdonslady (Dec 7, 2007)

My 10 lb 2 oz baby boy born at home after previous caesarean, was born 'en caul' (the membranes never ruptured and his head was born with the sac around it) yet he was also born with nuchal hand. And only 1st degree tears (happy proud dance)!
But at least from my experience, you can have the amniotic sac completely unbroken until the head delivers right into it (the bag bulged out first, yet still didn't break), but still have a nuchal hand.


----------



## langdonslady (Dec 7, 2007)

You mean you think the rupture of membranes was why you pushed so long? Oh right! The membrane smooths things along, so to speak! My 10+ lb HBAC (which had nuchal hand too... ) was born en caul, ... the sac never broke until his head emerged into it, and I think that's why I only pushed for 41 minutes. Man, I can't imagine how I could have kept that up for 2 hours! HUGS!


----------



## langdonslady (Dec 7, 2007)

Quote:


Originally Posted by *yeahwhat* 
It definitely did not effect pushing for me. Once srom happened, I got an overwhelming urge to push on the next contraction and baby girl arrived in one long push.

I'd never thought to connect the terrible back pain I had during the last 30 minutes or so with the position of her elbow. I guess that's a possible explanation.

You know, I had forgotten all about that part! Yes, the nuchal arm was what caused me to have pain and pressure in the rectum with each contraction and push! Since I had had back labor in the previous breech c/sec, I was no stranger to this pain, because I had had the rectal pain and pressure then too. I was just grateful this time that the pain went away between contractions, unlike last time. The HBAC went well all things considered, and between the big head, and the nuchal arm, maybe I got off easy with skidmarks and 1st degree tears. And yes, I was in the hands/knees squat. Didn't know it put more pressure on the perineum. Not that it would have mattered; I just felt I HAD to be in that position.


----------



## langdonslady (Dec 7, 2007)

Quote:


Originally Posted by *busybusymomma* 
I had to push hard and give an extra push. My previous babe (1oz bigger) had practically fallen out because I had that ejection reflex going.







I still had the reflex feeling with my nuchal hand baby too, but she didn't come out as easily.

It definitely changed the pushing stage and I think it could have caused some probs if my pelvis wasn't so roomy, and if I hadn't already given birth twice. Who knows though.

Omigosh! Thank you for the link to what an ejection reflex is! That described exactly what happened when I had DS. It was absolutely not something I could have stopped, or done on purpose. It was more like the feeling you get when you projectile vomit... your body takes completely over, and you are at the mercy of events, and have to ride through it come what may. That's how the pushing was! And I wasn't aware of my midwives, the doula, or DH, or anything at that point. Hope I am not posting too many replies. This has been quite an education.


----------



## 3cuties (Mar 4, 2006)

I didn't have AROM for my last delivery and my daughter was born with a nuchal hand. My first two I did have AROM and no nuchal hand. So I don't see any relation. Additionally, my daughter still sleeps with her hand like that.


----------



## MiaMama (Jul 21, 2007)

Quote:


Originally Posted by *Spark* 
My posterior nuchal hand baby was my smallest (most room to get all turned around?) and my most painful and odd process of labor









I only have one baby, but she was very small, and had a nuchal hand. She was delivered over an intact perineum, but since she was posterior, I believe her hand/arm is what tore my labia. He little fist was right under her chin and I didn't even realize it until I saw the pictures that her daddy took of her crowning. It only took one stitch to repair, so it wasn't that bad of a tear. I had SROM after 16+ hours of labor. It was a gentle, long labor, until the OB decided I needed pit. It was shortly after the pit started that my water broke, then I convinced them to turn it off and I finished the rest of the way on my own.


----------



## Banana731 (Aug 4, 2006)

Quote:


Originally Posted by *langdonslady* 
But at least from my experience, you can have the amniotic sac completely unbroken until the head delivers right into it (the bag bulged out first, yet still didn't break), but still have a nuchal hand.

nak

that is what happened with dd2. i felt her hand tickling me right above my clitoris, but on the inside for a week or 2 prior to labor. my water broke on the last push(i pushed for about 1 1/2 hrs). her entire body came out in that one push, and i believe that she would have been born in the caul and that i wouldn't have torn if i had pushed her out slower. i was tired, and afraid that i wouldn't make it much longer. i had a small tear down( i uc'ed, so no stitches) my husband said it just looked like the skin tore, and also something happened to my labia, because i could feel it-both healed in a couple days though, so it couldn't have been that bad.

also, FWIW, my labor pattern was all over the place, no consistency at all. i almost went to the hospital when i my body started to push because i thought there was no was i could be complete. no break in ctx, no discernable transition. luckily a wonderful MW talked me down via VIOP! (i live overseas)


----------



## coobabysmom (Nov 16, 2005)

Oh! I like seeing this thread resurrected.

I no longer think my AROM (at 9.5cm) caused ds nuchal hand at birth. I now am assuming his hand was just there prior to & during labor and probably wouldn't have moved even if I didn't have the AROM.

Banana731

Quote:

also, FWIW, my labor pattern was all over the place, no consistency at all. i almost went to the hospital when i my body started to push because i thought there was no was i could be complete. no break in ctx, no discernable transition. luckily a wonderful MW talked me down via VIOP! (i live overseas)
Interesting... My entire labor pattern was also all over the place-no consistency of length between contrx or lenght of contrx ever during the whole 24hrs of it. However I did have breaks between contrx and about 2 minutes of tears and fears over going to the hospital, which I assume was transition.

Does anyone think nuchal hands/arms have something to do with this kind of labor?

I do believe the pushing stage was more difficult due to the nuchal hand- it probably took longer, hurt more than labor and I did tear. Healing took 9mos., but I now feel great, um, down there!


----------



## Peppamint (Oct 19, 2002)

Quote:


Originally Posted by *coobabysmom* 
Does anyone think nuchal hands/arms have something to do with this kind of labor?

I do!







It seems like malpresentations and nuchal extremeties can, and often do, cause odd labor patterns and they also seem to affect pushing urges. Ya know, the mom will say something like "Wow, this just doesn't feel as effective as last time [previous birth]", comments like that.


----------

