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Compound Presentation Repeats

25 January 2009 510 views 2 Comments

compoundpresentationBoth of my children have so far been born with nuchal hands, a type of compound presentation (head + other part, such as arm, hand, or elbow). When it occurred the first time, at the birth of my son, I really didn’t think much about it. I luckily avoided tearing, which seems to be more common during a compound presentation.

When I was pregnant with my daughter, we ended up having several ultrasounds after the screening scan due to a possible heart problem. During several of the scans, I noticed that she was holding one of her hands up by her head. During those scans, I was silently wondering to myself whether my daughter would come out with hand-on-head, just like her brother. But I pushed it out of my head, and I never verbally brought it up to my midwife or husband.

At J’s birth, dilation in the later stages of labor was very slow. I was surprised that this birth wasn’t really going much faster than my first. (First was about 24 hours, second was about 19 hours.  I was sort of expecting things to move more quickly the second time around.) Transition lasted quite some time. SROM happened sometime close to transition. When J finally joined us, she came out in one furious push or two, very quickly at the end. No tears this time either, despite the presentation. The first thing the midwife said was something like, “Oh! No wonder she was taking so long! She’s coming out with her hand along her head!” Then Arp says, in a voice of comical chastisement, “Oh! M did that too!” (Luckily, no tearing again, despite the compound presentation!)

What is the chance that baby #3 will be compound too? As a pregnant woman, I like to obsess a lot, and this question has been on my mind a lot. I’m not planning to have any ultrasounds this pregnancy, so I’ll have no clues like I did with J.  Although I am reading that some women feel the fingers tickling down below in late pregnancy (I noticed this a lot with J, though I didn’t think anything of it at the time).  I asked my current midwife about this, and she sort of laughed it off.  But part of me wonders if I am just destined to have children with hands-on-head.

I found several message boards with women saying they have also had multiple children with nuchal hands (see here and here).  Evidently, I am not alone.  What’s the chance it will happen again?


  • Nava said:

    I’m actually hoping this one presents the same as my first; textbook perfect presentation and everything! fingers crossed over here.
    I do think that it’s pretty common that babies to the same mom seem to present the same way; I was right-transverse breach, so the midwife scooted me around during labour and I wound up “sunny-side up” as my mom put it (ouch!) My sisters weren’t breach presentation, so they didn’t have any manipulation to be born, but they were also face up. sooo…maybe another nuchal hand? Then again, maybe not. I’m also wondering if there have been any studies on this.

  • sara said:

    I’m currently preg with baby no. 2 and trying not to become too obsessive about whether this one will be compound like my first. I didn’t realize how lucky I was to have avoided more issues with the compound presentation- besides my labor being very long and very painful, and having some tearing- the research i’ve done seems to suggest that c-section is often used if the baby is known to be compound. One more reason I’m glad we used a midwife! I see that your 3rd baby was not compound- do you think you did anything different in that pregnancy as far as positioning? I would love to hear if you think there’s anything that can help. I’m so glad I found your blog- when I was looking for images of compound birth and read your blog post- my first thought was– wait—is this the couple from Orgasmic Birth- then when I saw the about us page I knew it was. I watched your birth before and after my son was born and that was the only mention I’ve found I’d ever heard of a compound presentation during that time period. Anyway- thanks for the post!