Shoulder dystocia is an obstetrical emergency that occurs when a baby’s shoulder becomes lodged behind the mother’s pubic bone, preventing a routine delivery of the shoulders and body. During a normal delivery, a baby’s shoulders should slide through the birth canal with little effort. However, if a baby is large, turned to the side, or the shoulders are too wide, a shoulder can become trapped behind the pubic bone. If the shoulder is not dislodged in a timely manner, it can cause serious long-term effects.
Physicians should anticipate risk factors for shoulder dystocia such as whether the baby is over 8 pounds or the mother diabetic and, if necessary, plan for a c-section delivery. When a shoulder dystocia does present during delivery, doctors can perform a variety of maneuvers to ensure safe delivery of the baby. Serious, life-altering injuries can occur when the doctor either fails to deliver the baby timely or applies too much force in performing the various maneuvers.
Once the shoulder dystocia becomes apparent, the umbilical is compressed and unable to oxygenate the baby effectively. To prevent asphyxiation and permanent brain damage, the baby must be delivered quickly. In delivering the baby, the health care provider must pay careful attention to the force used in applying the various maneuvers to deliver the child. Applying too much force can permanently damage the nerves that control the baby’s arm and shoulder and result in permanent paralysis of the arm and shoulder (brachial plexus injury).
Did Your Child Experience Shoulder Dystocia?
There is some debate over the definition of shoulder dystocia. Does this condition apply whenever the shoulder is stuck or does the shoulder need to be stuck for some period of time –usually a minute or more? Is it only “shoulder dystocia” when the doctor needs to perform a special maneuver to deliver the baby? Many physicians are reluctant to report shoulder dystocia unless there is clear, undeniable evidence.
If your baby suffers from a brain injury, cerebral palsy, Erb’s palsy or another brachial plexus injury, ask yourself these questions:
- Did delivering your baby take longer than expected after the head was out?
- Did a nurse or doctor express any sign of concern when delivering your baby?
- Did the doctor or nurses mention anything about a stuck shoulder?
- Did anyone in the room mention any special procedures that were necessary to deliver your child?