What is shoulder dystocia?
Shoulder dystocia is an emergency situation that can occur unexpectedly during vaginal birth when the infant’s head delivers, but the baby's shoulders become stuck behind 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, RN
Registered Nurse for 20+ Years
Causes of shoulder dystocia
While shoulder dystocia is unpredictable, there are several causes and risk factors that put mothers at increased risk.
- 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, occurring only during pregnancy)
- 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.
- 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.
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:
- Turtling, or turtle signs, which is when delivery of the head retracts back toward the perineum (area between vagina and anus)
- Fetal elbow, when one of the baby's arms is delivered, but the posterior arm (back) remains trapped in the birth canal
- Lack of rotation of the baby’s head after delivery
- Slow descent of the baby during the second stage of labor (protracted descent)
- 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:
- Performing a cesarean delivery (C-section) after pushing the baby’s head back in (Zavanelli maneuver)
- Using the HELPERR mnemonic:
- H: Call for help, the delivery team must promptly seek additional assistance from other medical staff
- E: Consider an episiotomy, when a cut is made to the tissue that 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)
- Breaking the baby’s collarbone (clavicular fracture) to help them pass through the canal
- 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.
- 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 $962 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.
