Compound Presentation (babies hand up by head)

[EntropyReversed]

Hi all,
I'm currently 36 + 4 with my third, had a midwife appointment today and baby is 3/5 engaged, which is great, but unfortunately his little hand is up by his head.
My midwife briefly mentioned how it's called compound presentation and that might mean additional trauma down below for me when I give birth but that's about it.
Anyway, since coming home from the appointment I've googled it and, well, I've terrified myself!

I'm all set for a home birth, but this compound presentation seems to increase the risk of shoulder dystocia and the umbilical cord getting trapped around the neck etc, not to mention it's highly likely I'll end up with a third degree tear!!

Does anyone have any experience with this compound presentation??

I had that with the homebiirth of DS1 although not diagnosed until his head was out. The midwife was feeling for the cord and found fingers which he then pushed out up his face giving her a very rude gesture for such a new human. She got me to pant a bit whilst she delivered the arm and he came out superman style. We'd have never known beforehand as he was such an unstable lie and it was only chance that he was even head down for labour.

I'd talk with your midwife about the issue with you specifically and not rely on stats and worst cases. But then I'm happy with my decisions and can't (and wouldn't) make them for anyone else. You need to make the choice that will make you most comfortable.

I had this. I was induced at 38 +4 for GD she took 3 days to finally come out she was so comfy that all induction methods failed until they broke my waters. I was in the delivery room they decided to check how far I was and the midwife suddenly called another midwife and said the cord was around her neck. Turned out it was actually her arm (she has chubby little arms) I was still only 5 cms at this point they didn't panic. She came out like super. man literally and she sleeps in that position now. All in all I ended up with a second almost 3rd degree tear. I believe this is only because my first came so quickly that she literally almost tore me front to back and my second just tore along the same scar tissue not helped by her arm up by her head. They stitched me up and that's that really.

It sounds dramatic but the midwifes deal with this sort of thing all the time, they know what they are doing and as long as you relax and listen to them you can do it! If you're worried you could have your baby at the hospital. I'd speak to your midwife about it. every birth is different, good luck Xx

It probably doesn’t mean much at this stage OP - baby will still be changing position potentially for another few weeks, and they even change in labour. I think chat with your midwife more, and perhaps if you’re still worried you could have a lower threshold for examination in labour to make sure the wee hand has moved? Even if they can feel the hand presenting in labour it can often be pushed back out of the way - sometimes a wee tickle of babies fingers will get them to move their hand away :)

My ds was born hand first. The labour was more painful than dd but that could have just been a normal variation.
I did have a couple of grazes on the cervix and somewhere else I can't remember because of his hand. Other than that it was fine. Just confusing when the mw said she could see a hand before I had actually pushed him out.

If you're worried is it to the extent you think it might concern you badly once in labour? I was breech with one of mine and chose CS on the basis I couldn't bear the risk of something going wrong and thought if that was on my mind all the time my labour was likely to be very stressful. I'm pretty risk averse though so this might just be me. If you're worried but not too worried perhaps switch to midwife led birth centre?

I didn't know in advance, but my first came out like that- hand up. She also came out VERY fast- precipitate labour and only two contractions of pushing, so I don't know how much that contributed. I ripped internally but not through to my bowel, and one labia got a little mangled. They thought initially that I might have to go to theatre and have a spinal for them to fix me, but thankfully when the dr came in she was able to stitch me up in the room with just gas and air because it wasn't as bad as it looked.

Do you live far away from the hospital? Be prepared that you might have to go in to get a bit more stitching, but stay calm and I'm sure it will be fine.

I gave birth last week and my baby had BOTH hands on his face when he was born. I didn't know at the time but the midwives instructed me how to deliver him slowly, panting him out etc. I delivered him using only gas and air and I received a second degree tear. I'm still quite uncomfortable now but I wouldn't say the experience was bad. I think if I'd goggled it before I would've been terrified but the reality was absolutely fine. Best of luck!

I had a 'superman' baby too, I didn't know beforehand but all was fine.i had a waterbirth. No problems came because of the hand although DS ear looked swollen for first couple if weeks (he's now 4 with no issues). This was my first baby so no idea if it was more painful. It didn't feel painful. I had stitches from tear but again that's nothing out of the ordinary anyway.