Shoulder Dystocia occurs when a baby’s shoulder becomes stuck in the birth canal during delivery. This complicates the delivery, and can cause long-lasting complications for the mother and baby. Here are some important things you should know about this condition.
What is Shoulder Dystocia?
During a normal delivery, the baby’s head will emerge from the birth canal facing away from the mother’s pubic bone. After the head is out, the baby turns so the shoulders and rest of the body are born facing upward. This stage is where Dystocia occurs. During this turn, the baby’s shoulder may become lodged behind the mother’s pubic symphysis. This stops or delays a crucial part of the delivery. There is also a risk that the baby could be deprived of oxygen, which can result in brain injury.
Shoulder Dystocia occurs in about one out of every 150 births and is a condition that is difficult to predict. Here are some factors that can increase the risk of this condition:
- A larger than normal baby;
- The mother has diabetes, which may cause the baby to gain weight around the torso, increasing the chance of becoming stuck behind the pubic bone;
- The mother is overweight, or gained a significant amount of weight during pregnancy;
- The baby’s body is significantly larger than the head;
- Labor is induced; and
- The doctor used tools such as forceps to assist in the delivery.
Is a Birth Injury Caused by Shoulder Dystocia Medical Malpractice?
A doctor cannot usually prevent Shoulder Dystocia from happening. However, when a baby does become stuck, the standard of care requires that the doctor: 1) realize that this is happening and 2) take certain measures to help the baby out of the birth canal as quickly and safely as possible. If a doctor fails to do this, you may have a basis for a medical malpractice claim.
When the child’s birth is stopped by Shoulder Dystocia, there are several maneuvers that a doctor can use to help with the delivery, including:
- McRobert’s maneuver, pulling or pushing the mother’s legs towards her abdomen which is oftentimes used in conjunction with applying Suprapubic pressure, or pressure just above the mother’s pubic bone, attempting to manually dislodge the baby’s shoulder from behind the pubic symphysis;
- Woods Screw maneuver, manipulation of the baby’s shoulders so that the baby ends up facing towards the mother’s rectum;
- Zavanelli maneuver, during which the baby is pushed back into the birth canal, and a cesarean section performed.
What Problems Can Shoulder Dystocia Cause?
Fortunately, many babies affected by Shoulder Dystocia do not experience any lasting effects. However, in some cases nerve damage may occur in the baby’s shoulder and arm. If this occurs, the baby may develop a Brachial Plexus injury or an Erb’s Palsy. There can also be bone fractures as well. In the worst case scenario, a baby that gets stuck in the birth canal can be deprived of oxygen for any number of reasons, including a crushed umbilical cord. If the baby is deprived of oxygen for even a relatively short period of time, there is a serious risk of brain injury.
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