What can we help you find?
Top searches

Shoulder dystocia

Shoulder dystocia occurs during vaginal delivery when a baby's shoulders get stuck in the mother's pelvis. It is a rare but serious condition that often happens without warning, making it hard to predict. Shoulder dystocia can cause significant harm, including Erb’s palsy, brain damage, or even death. Learn more about complications and what to do if your child was harmed.

Did you know?

About 7 birth injuries occur for every 1,000 children born in the United States. Was your child one of them?

Free case review

What is shoulder dystocia?

A newborn receives care in a delivery room, with arm raised and wrapped in medical tape connected to monitoring equipment.Shoulder dystocia is an emergency situation that can occur unexpectedly during vaginal birth when a baby's shoulders become lodged in the mother's pelvis (body part that includes pubic bones). This situation requires immediate attention to prevent complications.

Some cases may result from the baby's size or position, making delivery difficult, while others may stem from the mother's pelvic shape.

Shoulder dystocia affects 5% to 9% of babies born weighing more than 8 pounds, 13 ounces, according to Cleveland Clinic.

Many babies make a full recovery, while more severe cases may result in brachial plexus injuries, like Erb’s palsy, and require ongoing treatment.

Despite the significant risks, effective management is possible with prompt and expert medical care. However, there are times when delivery teams fail to provide the necessary care, putting the safety of both mother and child at risk.

If you believe your child's complications from shoulder dystocia could have been prevented by your delivery team, you probably have questions.

Connect with one of our labor and delivery nurses right now to talk through your concerns.

kristin proctor registered nurse

Kristin Proctor, RN

Registered Nurse for 20+ Years

kristin proctor registered nurse

Talk to a Nurse Now

Call or chat with a caring, experienced nurse right now — we’re standing by to get you help and answers.

Causes of shoulder dystocia

While shoulder dystocia is unpredictable, there are several causes and risk factors that put mothers at increased risk.

These are some situations that increase the risk of shoulder dystocia:
  • Abnormally shaped or small maternal pelvis
  • Advanced maternal age (35 years or older)
  • Delivery past the due date
  • Excessive weight gain during pregnancy or maternal obesity
  • Fetal macrosomia (birth weight of 8 pounds, 13 ounces or more)
  • Maternal diabetes (pre-existing or gestational diabetes)
  • Multiple births (twins, triplets, or more)
  • Previous shoulder dystocia births

Since it is a medical emergency, health care professionals must act swiftly to prevent birth injuries from occurring. When harm could have been prevented with proper care, medical malpractice may have played a role.

Shoulder dystocia and medical malpractice

When shoulder dystocia occurs, it requires immediate and expert care from the delivery team. If the situation is not managed properly, it can result in lasting harm or even death.

Medical negligence that can lead to birth injuries may include:

  • Allowing a baby to remain stuck in the birth canal for too long
  • Misusing assisted delivery tools, like vacuum extractors or forceps
  • Using excessive force to pull the baby from the mother’s pelvis

In a tragic 2023 case, a baby born at a Georgia hospital was decapitated during delivery due to excessive traction applied to his head and neck.

The parents found out about the details of their baby's death from the funeral home, not the hospital. This is when they knew something wasn’t right. With the help of a personal injury lawyer, the family filed a birth injury lawsuit against the hospital and delivery team.

The lawsuit alleges that the health care providers caused the baby’s death and went to great lengths to cover up their mistakes.

Sadly, medical professionals may try to minimize their role when things go wrong. This is why it is so important to get help immediately if your baby was injured during childbirth.

Cerebral Palsy Guide works with top birth injury law firms that help families in all 50 states.

Call us right now at (855) 220-1101 or Click to Live Chat if you think something may have gone wrong when your baby was born.

Shoulder dystocia birth injuries

Delivery teams must make lightning-fast decisions to prevent complications from occurring. When proper care is not taken, it can lead to birth injuries that could have been avoided.

Potential birth injuries in newborns include:
  • Asphyxia (lack of oxygen)
  • Brachial plexus injury, such as Erb’s palsy
  • Brain damage
  • Broken collarbone (clavicle)
  • Broken or fractured upper arm (humerus)
  • Cerebral palsy caused by brain damage
  • Compressed umbilical cord (trapped between the pelvic bone and baby's arm, cutting off blood/oxygen flow)
  • Horner’s syndrome (nerve damage disorder affecting the face and eyes)
  • Hypoxic-ischemic encephalopathy (HIE)
  • Other serious birth injuries

If your baby suffered from any of these injuries after shoulder dystocia during childbirth, you may have legal options. This could lead to financial compensation to provide top-quality care for your child.

Even if your delivery team made you believe nothing could have been done differently, that is not always the case. An experienced birth injury lawyer can help you get to the bottom of what happened.

Get a free legal case review right now if you have any concerns.

Was your child injured at birth?

Find out how we can help you cover the cost of your child’s treatment.

Free case review

Signs of shoulder dystocia

Unfortunately, there’s no way to predict whether the situation will happen, but there are a few signs to watch out for during vaginal deliveries.

Here are 5 signs that shoulder dystocia may be occurring:

  1. Turtling, or turtle signs, which is when delivery of the head retracts back toward the perineum (area between vagina and anus)
  2. Fetal elbow, when one of the baby's arms is delivered, but the posterior arm (back) remains trapped in the birth canal
  3. Lack of rotation of the baby’s head after delivery
  4. Slow descent of the baby during the second stage of labor (protracted descent)
  5. Fetal shoulder can be seen or felt lodged behind the mother’s pubic bone

Any of these signs can signal the need for immediate medical attention. Doctors are trained to spot these signs and deliver emergency care if detected. Spotting them and taking immediate action can potentially reduce risks to both the baby and mother.

Responding to shoulder dystocia during delivery

Proper management during delivery involves prompt and coordinated actions by the medical team to safely maneuver the baby through the birth canal and minimize potential complications.

Here are the common methods used:

  1. Performing a cesarean delivery (C-section) after pushing the baby’s head back in (Zavanelli maneuver)
  2. Using the HELPERR mnemonic:
    • H: Call for help, the delivery team must promptly seek additional assistance from other medical staff
    • E: Consider an episiotomy, which opens the vaginal area to make room for more rotation
    • L: Flex the mother’s legs upward toward her abdomen, rotating the pelvis and opening the sacrum (McRoberts maneuver)
    • P: Use suprapubic pressure to press down above the pubic bone to rotate the baby’s front or anterior shoulder
    • E: Use enter maneuvers by reaching inside the vagina to perform internal rotation of the baby
    • R: Gently remove one of the baby’s arms from the birth canal to make room for their shoulders (Jacquemier’s maneuver)
    • R: Roll the mother to hands and knees (Gaskin maneuver)
  3. Breaking the baby’s collarbone (clavicular fracture) to help them pass through the canal
  4. Symphysiotomy, or making an incision between the pubic bones (symphysis pubis) to open the pelvis further

Treatment for shoulder dystocia complications

Treatment options for babies harmed in childbirth depend on the complications or injuries they endured.

Here are some common treatments for different complications:
  • Brain damage: Depends on the extent, but physical, speech, and occupational therapies may help
  • Broken collarbone or arm: Time to heal, medical monitoring
  • Cerebral palsy: Tailored to each child and may require specialized cerebral palsy care
  • Erb’s palsy or brachial plexus palsy: Physical therapy or surgery in severe cases

Get legal help for shoulder dystocia birth injuries

When medical malpractice is the cause of birth injuries, you may have legal options. Mistakes made by delivery teams during childbirth can leave children with lifelong physical and intellectual disabilities.

Working with an experienced birth injury attorney can help your family pursue justice and hold the health care providers that delivered your child accountable for their negligent care.

Cerebral Palsy Guide partners with a network of top birth injury lawyers and law firms across the country. Together, they have helped recover over $862 million for families affected by birth injuries.

If you feel the health care team that delivered your child was negligent, your family may be entitled to financial compensation.

Call (855) 220-1101 or fill out this form for a free case review right now to find out if we can connect you with a top birth injury law firm near you.

Shoulder dystocia FAQs

What is shoulder dystocia?

Shoulder dystocia is an obstetric emergency in vaginal deliveries when one or both of a baby's shoulders get stuck during delivery after the head is delivered.

The situation is unpredictable and can place both the mother and baby at risk of injury, according to the American College of Obstetricians and Gynecologists (ACOG).

Can babies survive shoulder dystocia?

Yes, babies can survive shoulder dystocia. With immediate and proper medical intervention, most infants affected are born safely, though some may require treatment for complications.

Do babies recover from shoulder dystocia?

Yes, most babies recover, especially with prompt medical care. While some newborns may experience temporary issues like nerve damage, most regain full function without long-term effects.

However, sometimes, complications can lead to Erb’s palsy, brain damage, and even death. If your child was harmed during childbirth, you may be able to access financial compensation to help with their care.

Get a free case review right now to find out if you may have legal options.

What are two distinct signs of shoulder dystocia being present?

Two signs of shoulder dystocia include:

  1. The "turtle sign," where the baby's head retracts back into the birth canal
  2. Failure of the shoulders to emerge after the head has been delivered

Can you avoid shoulder dystocia?

While it is unavoidable in some cases, proper management of shoulder dystocia can prevent serious complications.

If the back shoulder (posterior) and arm are freed, and the baby is safely delivered in a timely manner, birth injuries can be prevented. This is often done by using gentle downward traction to guide the baby out of the birth canal.

When posterior shoulder impaction (being stuck) is not swiftly addressed, complications may occur that lead to effects on the fetal head, such as lacerations, lack of oxygen, brain damage, and more.

If you suspect complications that harmed your child could have been avoided, don’t suffer in silence. We have labor and delivery nurses on staff who can listen to the details of your child’s birth and help you figure out your options.

Call (855) 220-1101 to speak with a member of our team.

What causes shoulder dystocia during delivery?

Shoulder dystocia during delivery is caused by one or both of the baby's shoulders getting stuck behind the mother's pelvic bone. It is often due to the baby's size, the mother's pelvic shape, or the baby's position during childbirth.

Cerebral Palsy Guide was founded upon the goal of educating families about cerebral palsy, raising awareness, and providing support for children, parents, and caregivers affected by the condition. Our easy-to-use website offers simple, straightforward information that provides families with medical and legal solutions. We are devoted to helping parents and children access the tools they need to live a life full of happiness

  1. American College of Obstetricians and Gynecologists. (2017, May). Shoulder dystocia. Retrieved February 15, 2024, from https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/05/shoulder-dystocia
  2. Cleveland Clinic. (2022, May 31). McRoberts Maneuver. Retrieved February 15, 2024, from https://my.clevelandclinic.org/health/treatments/23155-mcroberts-maneuver
  3. Cleveland Clinic. (2022, January 23). Shoulder dystocia. Retrieved February 15, 2024, from https://my.clevelandclinic.org/health/diseases/22311-shoulder-dystocia
  4. Davis D.D., et al. (2023, September 20). Shoulder dystocia. Retrieved February 15, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK470427/
  5. Tamsett, M. (et al). (2024, February 7). Parents seek justice for baby who was decapitated during delivery at a Georgia hospital. Retrieved February 15, 2024, from https://www.cnn.com/2024/02/06/us/babys-head-detached-during-delivery-ruled-homicide/index.html