United Brachial Plexus Network, Inc.

My husband told me today that his friend and business associate told him that his brother and sister in law's baby has a BPI. She's 8 months old and has a pretty severe injury. It's amazing to me how common this thing is considering no one's ever heard of it. It made me so sad to hear this news...I wish there were some way to make it stop!

IT is a common injury however, I think a lot of times people are afraid to ask if you or someone else has a BPI. This injury occurs too much, It needs to be stopped !!! GAYLE

Hello everyone

Your so right this injury has been around long enough and every obstetric doctor is aware of the risks......hopefully when our children are grown this will be something un heard of......

I was shocked when I found out I was not one of the very few with this "rare" birth injury.

I am 66 and still can't believe that we can put men on the Moon and a baby can't be delivered safely.
I was so scared when my daughter had her children.
I know my family all have big babies even if we gain only a few pounds when pregnant.

My OB/GYN spoke to me about it and said he feels that every birth should be approached as if it's a possible SD delivery.
He delivered three of my grandchildren all over 9 lbs. safely. The last one was 9 lb. 9 oz.

Kath ( adult/robpi)

Hello all,
I'm 68 & still am shocked at the enormenity of this "rare" Injury. I believe there is more "Awareness" every day, now.
HUGS,
Carolyn J
LOBPI

I guess I just need to chime in on this one, too. I'm 57 years old. Until last year I was the only person I knew with a BPI. I didn't even know the term BPI, although I knew the term Erb's Palsy, having learned that when I was 17.

When I first came to UBPN I was moved to tears that I wasn't alone anymore. There are other adults who were injured at birth, as I was. However, I was shocked that babies were still being injured this way. After all these years, OB/GYNs still seem to think that this injury is no big deal. It will heal itself in a few months. With that attitude on the part of the OB/GYNs, no wonder so many babies are still being injured!

This is why UBPN is so important. In numbers, there is strength. Together we can reach out and teach doctors and pregnant women the risk factors for shoulder dystocia and Brachial Plexus injury. Hopefully, in the future, the incidence of babies being injured this way will decline until NO more babies are injured this way.

Joanie

P.S. Sorry if this post sounds a bit angry. I guess I am a bit angry.

Joanie
You don't sound angry!

I was about to give you a round of applause!

I always knew I had Erb's Palsy and how it happened.
I was told the doctor pulled too hard and severed a nerve in my shoulder.
I was also told he did it to save both our lives...
There was never a time when I did not know the doctor made a mistake.
It was not a secret because people did not sue when I was a baby so why hide it?

I get upset when I think about all the children and how unnecessary it is.

Kath (robpi/adult 66 )

Kath,

I'll take that round of applause. Thank you.

My parents were also told that the doctor saved both our lives. I think the doctor told them that to insure that they would not sue him. However, you are also right that people didn't sue so much back then. I don't think it would have entered my parents' minds to sue.

Joanie

I think that the dr's do pull on the baby to save the life of the baby; however I just don't understand how a professional could let a situation get to that point! I know people say a lot of dr's do too many c-sections...but I personally would prefer to err of the of caution, rather than push something to the point where lives are even at stake! I would love to know if this condition is discussed and taught about in med school or in the training of OBs. Why don't they know what it is? Or do they and just don't say anything to cover their own ____? Mine never told me what it was....my pediatrician thank goodness knew what it was. He knew, unfortunately b/c there is another boy that he sees that has BPI....
Joanie...I say GET ANGRY! We should be angry...

They do learn about it in medical school, but usually only from textbooks or theory. I think the vast majority of OB/GYNs have never seen a severe shoulder dystocia at all, and except in the busiest hospitals it's unlikely that they ever saw one during training, nevermind got "hands on" experience in resolving it.

There is no other branch of medicine where a doctor is expected to be able to deal with a severely time-dependent, lifethreatening emergency with virtually no hands-on training or practice! Can you imagine if all the doctors working an emergency room only knew about CPR from a book and maybe a powerpoint presentation?? How crazy would that be?? And yet today's OB/GYNs are expected to handle an even worse emergency with little or no practical training.

What gives me the most hope is these new, high-tech birth/SD simulators that various groups are making and distributing to training programs. They aren't perfect, but its a really big start. At the SD/BPI conference last May, I met an MBA who was there to learn about the new simulators in order to implement them as part of training to handle SDs in the OB/GYN residency at Northwestern. Hurray for progress!!

C-sections are not the answer. Don't forget... there are many, many babies who don't have any advance risk factors for SD. Sometimes it does happen very suddenly and without warning. Hopefully, as more and more programs realize that there *are* maneuvers that can be effective (but need a certain comfort level and advanced training to implement) these shoulder dystocias will be resolved quickly and without injury.

Until very recently, the general opinion among even BPI specialists was that this injury resolves "completely" 90% of the time. This statistic was published by various centers as recently 1998 (including a TCH publication)! Now that the real long-term disability rate is becoming clear, the pressure is on for doctors to not only save the life of the mother and child (of course their first priority) but to do it without disabling the child for life.

For so long OB/GYNs have believed that the risk of ill effects from BPI is so very small, it is nothing compared to saving the child's life. Now they are starting to realize that not only will correct maneuvers possibly save the child from a lifetime of disability from BPI, but *also* have a better chance of saving the child's life by resolving the shoulder dystocia effectively! The problem with "just haul on the baby's head" to get them out is that it doesn't always work! Many times, yes, it does get the baby out, but with injury. But for really bad shoulder dystocia, it doesn't even work and can make the child even more stuck. The key to solving the OBPI problem is in recognizing that maneuvers which help protect from BPI are *also* more effective at resolving shoulder dystocia and get the baby out safer, period. It is not necessary to choose saving the child's life over sacrificing their arm. With proper preparation and training, that choice need never be made at all.

Kate