Birth Injury Detection: Understanding and Identifying a Shoulder Dystocia

shoulder dystocia

Shoulder dystocia occurs in 0.3 percent to 1.5 percent of births. While the birth injury isn’t as common as others, it’s still one parents, and future parents, need to understand.

As mentioned above, shoulder dystocia is a birth injury (sometimes called birth trauma). It occurs if one or both of a baby’s shoulders become lodged in the mother’s pelvis while giving.

Usually, babies suffering from shoulder dystocia are born safely. However, it can cause issues for mom and baby. The word “dystocia” translates to difficult or slow birth or labor. Keep reading to learn more. 

Risk Factors for Shoulder Dystocia

Some women are at a higher risk of experiencing shoulder dystocia than others. Some of the women who are at a higher risk of this condition include those who:

  • Are pregnant with multiples
  • Have gestational diabetes or diabetes
  • Have an operative vaginal birth (when vacuum or forceps are used)
  • Have a history of shoulder dystocia
  • Go past the due date
  • Are obese
  • Have an induced labor

However, women may have a baby with shoulder dystocia without ever experiencing any of the above risk factors.

How Do Doctors Diagnose Shoulder Dystocia?

Shoulder dystocia is diagnosed by a doctor when they can see the baby’s head, but their body is unable to be delivered. This occurs even after certain maneuvers are made.

If your doctor observes the trunk of your baby isn’t coming out easily, and they have to take certain actions, shoulder dystocia is diagnosed. If this diagnosis is made, the doctor will work quickly to help correct the issue and deliver the baby safely.

Most babies and moms recover easily from issues caused by shoulder dystocia. However, some issues can occur.

Common Long-Term Problems Caused by Shoulder Dystocia for Babies

It is important to note that doctors can minimize and treat most of the complications that occur to reduce the likelihood of long-term issues. In fact, under 10 percent of babies with injuries after shoulder dystocia have permanent problems.

Some of the most common issues for babies who experience shoulder dystocia include:

Fractures

A baby’s arm(s) or collarbone may be fractured during the delivery. This is one of the most common issues that occur.  

Brachial Plexus Nerve Damage

The Brachial Plexus nerves start in the baby’s neck, travel through the spinal cord, and into their arm and hand. They are responsible for providing movement and feeling in the hand, arm, and shoulder.

If damage occurs, it can cause paralysis or weakness in the shoulder or arm. Paralysis is if you are unable to move or feel part of the body.

Asphyxia

If the baby has a lack of oxygen during delivery, asphyxia may occur. In severe situations, this can cause serious brain injury or death. It is extremely rare for this to occur.

Common Long-Term Problems Caused by Shoulder Dystocia for Moms

Some of the issues that may occur for a new mom-related to shoulder dystocia include:

Postpartum Hemorrhage

This is also referred to as just PPH. It is a condition that causes extremely severe bleeding after giving birth.

Severe Tearing

Shoulder dystocia can also cause severe tearing of the perineum, which is the area between the rectum and vagina. If the tear is severe enough, it may require surgery to repair the damage.

Uterine Rupture

This occurs when the uterus tears while giving birth. It’s extremely rare.

Can Shoulder Dystocia be Prevented?

In most situations, shoulder dystocia can be prevented. A doctor must monitor and detect any fetal distress to schedule a C-section before injuries occur. Also, babies with higher birth weights or cephalopelvic disorder should be delivered via C-section.

It’s usually a physician’s decision regarding if a C-section will be done to reduce the possibility of shoulder dystocia.

Treatment Options for Shoulder Dystocia

Treatment for shoulder dystocia is dependent on the injuries that occur. Sometimes, the baby can be delivered successfully without causing harm to the brachial plexus nerves or without damaging any other part of the body.

This means treatment is going to coincide with the injuries sustained. For example, with a brachial plexus injury, a baby may need massaging, physical therapy, and for serious conditions, surgery.

Usually, doctors are going to attempt medical maneuvers to help remove the baby safely and prevent injuries. Some of the most common maneuvers used by doctors to prevent shoulder dystocia include:

The McRoberts Maneuver

With this method, your doctor will press your thighs up against your belly. This is done to help get the baby better positioned for delivery.

Suprapubic Pressure

With this maneuver, the doctor will press on your lower belly, right above your pubic bone.

Internal Rotation

Internal rotation is used for several birth-related issues, including shoulder dystocia. During this process, your doctor will reach into the birth canal to turn the baby.

Surgery

A doctor may opt for surgery. Common procedures used to handle cases of shoulder dystocia include breaking the baby’s collarbone to release the shoulders or a c-section. These are only used as last resorts when other methods are ineffective.

Some or all of these will be used by a doctor to help prevent shoulder dystocia during labor and delivery.

Shoulder Dystocia: Who’s to Blame?

Unfortunately, shoulder dystocia occurs even when preventative measures are taken. However, there are some situations where the doctor may have been negligent and not taking the proper steps to prevent this condition.

If you believe that your baby suffered shoulder dystocia due to your doctor’s negligence, you may be able to recover compensation. For more information, visit our resource page discussing shoulder dystocia and your rights.