What Is Shoulder Dystocia?
Shoulder dystocia occurs when a baby's shoulder becomes lodged behind a mother's pubic bone, preventing normal delivery of the shoulders and body. It can cause serious long-term effects if the shoulder is not dislodged and the baby delivered in a timely manner.
Signs of shoulder dystocia are usually only noted by the attending physician and delivery nurses. After the delivery of the head, the shoulders should slide through the birth canal with little effort. However, if a baby is turned to the side, or the shoulders are too wide, a shoulder can become trapped behind the pubic bone. This will suck the head back and cause the cheeks to puff out. The pressure on the baby's head and neck can cause asphyxiation or pinch the nerves in the upper arm. Shoulder dystocia symptoms include paralysis of the arm and shoulder (brachial plexus injury) and permanent brain injury.
Other injuries resulting from shoulder dystocia include:
- Broken clavicle
- Fractured arm
- Contusions
- Erb's palsy
- Maternal injury, such as vaginal tearing and blood loss
Can Shoulder Dystocia Be Prevented?
Shoulder dystocia is most prevalent in women with smaller pubic bones or with larger than average babies. Knowing this, some efforts can be taken to prevent the complication from occurring. For example, women with gestational diabetes tend to have larger than average babies. A doctor may plan a C-section or induce labor early to avoid the struggles of delivering a large baby vaginally.
In many cases, however, shoulder dystocia is a natural complication of a vaginal birth. It is therefore, a doctor's responsibility to recognize the signs and take appropriate action to prevent further complications and injury.
Did Your Child Suffer Shoulder Dystocia?
There is some debate over when shoulder dystocia takes place. Is it whenever the shoulder is stuck? Does the shoulder need to be stuck for some time — usually, a minute a more? Or, is shoulder dystocia only measurable whenever the doctor needs to perform special procedures to maneuver the baby through the birth canal? The answer can make a big difference in determining liability, if any, if a birth injury ensued.
Because of this discrepancy, physicians may be reluctant to report a shoulder dystocia unless there was clear, undeniable evidence. If your baby suffers from an infant 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 mention anything about a stuck shoulder?
- Did anyone in the room mention any special procedures that were necessary to deliver your child?
Caring for a Child With a Shoulder Dystocia Injury
Some children will have no long-term effects of shoulder dystocia, while others will face a lifelong disability. It is difficult to pinpoint exactly what to expect as your child ages because of the range of disabilities and level of injuries that can occur. Surgery, therapy, special schooling and lifetime disability care are all possible matters you need to consider as a parent to give your child the best chance to live as normal a life as possible. Take some time to discuss these issues with your spouse, doctor, therapist and other experts in child care. Knowing what to expect can help you determine the resources you need to raise your child with a birth injury.
The Birth Injury Team is a subsidiary of Silvers, Langsam & Weitzman, P.C., made up of experienced attorneys and medical professionals. Our lawyers have more than 100 years of combined experience handling birth injury cases. We are dedicated to helping parents understand their child's condition and guiding them through the process of securing the care and support they need. Located in Philadelphia, we serve clients across the United States.
