Question to UBPN!!!!? Prevention.?

[Phillyking87]

I was wondering how can brachial plexus palsy be prevented? how can doctors know before hand, that the baby is over weigh? Is there a way of preventing BPI? Or is this network just to inform people about BPI?

[njbirk]

You should find these pages on our website helpful in answering these questions:

http://ubpn.org/prevention/

How's your report coming?

Nancy Birk
UBPN President

[admin]

only around half of bpi babies are large. The factors most have in common are that the mother labors on her back or tailbone and has other interventions such as epidural, pitocin etc. All of these factors increase the risks of SD and ultimately birth injury. It isn't always easy to predict a baby's weight, it is relatively much easier to explain the risks of the other interventions so that parents make an informed choice when opting for them.

[Phillyking87]

my report is coming along great... i'm just wraping up on my conclusion. but i ask the question because i'm still wondering if there are any preventions. i'll send it to you when i'm done.

[lizzyb]

I can thouroughly recommend contacting Karen Hillyer the chairperson of the U.K. Erb's Palsy Group about this subject.

The Erb's Palsy Group have been very active these past ten + years in preventing OBPI from happening at birth by having annual midwife training days, and educating obs on safer birthing methods.

They have had great results by using this approach. I am sure she would be more than willing to share some of the groups' ideas about this.

Karen's email is info@erbspalsygroup.com

Lizzy F

[Karen HillyerUk]

Hi everyone
sorry to have been missing in action from these boards for a while- but there are only so many hours in a day and currently, I seem to be working about 18 of them on bpi related issues, and haven't been checking in here at UBPN so much!
Our group here in the Uk has been established for 14 years now and for the last 12 of them we have been running an annual study day for health care professionals educating them about the long term effects of a brachial plexus palsy on a child and it's family.
For many years (about 8) we concentrated on Midwives and Obstetricians - training them in methods to overcome a shoulder dystocia, without injuring a child - or in some severe SD cases, by lessening the degree of injury to the baby ( and hopefully Mother too).
Since the inception of our training courses for Midwives ( at which over 800 have been trained) the incidence rate of BPi's has lessened.
The British Paediatric Surveillance Unit completed a survey with Paediatricians on the incidence rate of BPi - and found that it had reduced from 1 in 1000 live births 10 years ago to the current rate of 1 in 1800 live births.
We feel that there will ALWAYS be ladies who will suffer a birth complicated by SD and that it is important for clinicians dealing with such a delivery can use accepted safe methods to overcome the emergency.
We are also aware that there are many other methods of reducing the incidence rate - such as changing the position Mothers give birth in and so on - however as a small group of volunteers ( we have 5 people on our board, with only 2 regular day to day workers on a voluntary basis) we simply cannot deal with each and every eventuality that MIGHT occur in labour- so we find that concentrating on dealing with the SD once it has actually occurred was the best method for our group and our children.
Through our training courses, we have forged good relationships with medical professionals and have facilitated new training methods for Doctors, with a finacial contribution towards a fully poseable, lifelike Mannequin which is already in use in a number of hospitals in the UK.
We have tried to get our Government to intervene and to keep statistical information on the incidence of this injury - but to be honest the effort we and our many members put into the whole effort was futile- that's why we decided to "do it ourselves" and train people in better methods.
We work extremely hard on this topic - as does the BOD of UBPN - it is a project that is never far from our thoughts- how to stop these children from being injured in the first place, but the work takes us down a very long, twisty and rough road and will be ongoing for many years I feel.
We are about to run our annual training day in May of this year - we are training therapists about when children should be referred, how to help the parents with therapy and how the psychological effects spread far and wide amongst the whole family.
We have woked for the last 2 years on therapists- but for 2007 we are already planning to revert to training Midwives and Obstetricians again - we are always thinking ahead - if we could afford the money and had the manpower to run these events - we would and could have two events per year - but it's just not feasible for us.

[admin]

(((((((((((((Karen))))))))))))
Havent see you (read you?) in ages!

Like liz, Karen and the other annon poster all suggest;
O BPIs are a result of labor mismanagement
NOT large babies,
sure, labors are more challenging to manage when you have a large baby but many injuries could be avoided,
and I don't mean by cutting the mother open for birth by cesarean causing her 3x greater mortality risk amoung other things (such as future reproductive life),
but simply by positional changes during labour, and birth, which, by the way, are extremely difficult to accomplish when your legs have been unnaturally numbed or your head is swimming with stadol...
I believe the last issue of OUTREACH spoke towrds this subject also,
I hope you will ppost your paper when its done
~Mary Rainer
mom
CCBE and birth ssistant
Fort Pierce, FL