What Is Shoulder Dystocia?
While every mother hopes that their childbirth experience will be smooth and safe, complications during pregnancy can still occur. Shoulder dystocia is one of the most common types of labor complications, occurring in 0.15 to 2% of deliveries.
Shoulder dystocia occurs when one of an infant’s shoulders gets caught behind a mother’s pelvis during delivery. This can cause complications when the baby’s head has already emerged, but the body hasn’t followed and requires timely and correct maneuvers to correct. Shoulder dystocia is more common in vaginal deliveries, but sometimes, shoulder dystocia may occur during a cesarean section.
What Causes Shoulder Dystocia?
Cephalopelvic disproportion, a condition that results when a baby is too big to pass through the birth canal, is the most common cause of shoulder dystocia. Shoulder dystocia may be hard to anticipate, but doctors and nurses should be mindful of several factors that can increase its likelihood:
- Previous experience of shoulder dystocia
- Overweight mother
- Maternal diabetes
- Use of labor-inducing interventions during childbirth
- Epidural use
- Late labor
- Overly quick or slow labor
- Multiple pregnancies
What Could I Expect If Shoulder Dystocia Occurs?
If your attending doctor and delivery team members suspect that you are experiencing shoulder dystocia during delivery, they will ask you to stop pushing. They will also call for help immediately since you and your baby may need specialized care.
Sometimes, doctors may be able to free the infant’s shoulder by simply having you change your position. Your delivery team may tell you to lie on your back and pull your knees back as far as you can. They may perform the McRobert’s maneuver, a technique that involves gentle pressure on your stomach to free your baby’s shoulder. Alternatively, you may have to assume a prone position on your hands and knees. If necessary, an attending physician may need to place his or her hands into your vagina to free your baby’s body.
If changing your position doesn’t work, a doctor may gently break the child’s collarbone to make the shoulders narrower so that your baby can be delivered more easily. In many cases, the collarbone will heal quickly without any problem. The last option is having a cesarean delivery under a general anesthetic. After the anesthetic has taken effect, your doctor will push your baby back into your uterus and deliver the baby through your abdomen.
What Are the Symptoms of Shoulder Dystocia?
Shoulder dystocia becomes noticeable when your baby’s shoulders become trapped in your pelvis after the head has completely emerged. The delivery process may result in a variety of birth injuries, including facial injuries and broken bones. Depending on whether your baby sustains any injury following shoulder dystocia, the following symptoms could result:
- Pain and permanent nerve damage in the injured area
- Paralysis in the affected limb
- Claw-like hand appearance
As a mother, you could be at risk of certain complications in the event of shoulder dystocia, including:
- Excessive bleeding
- Tearing of the vagina, rectum, and cervix
- Uterine rupture
Fortunately, many mothers and infants who experience shoulder dystocia may not always suffer from severe or long-term complications. If you or your baby sustains complications, your doctor can minimize or treat most of them.
Can Shoulder Dystocia Cause Neurological Conditions?
In an attempt to free your child’s shoulder, your doctor may tilt their head to the opposite side, stretching the brachial plexus nerves. In some cases, the nerves may be torn, completely detached, or moved, resulting in brachial plexus palsy. This condition could cause your baby to experience weakness or paralysis in certain parts of the arm.
Additionally, a delayed delivery due to shoulder dystocia may expose your baby to a period of reduced oxygen supply to your infant’s brain, which can potentially lead to brain damage and cerebral palsy. Cerebral palsy is a group of neurological disorders that can permanently undermine your child’s ability to properly perform simple tasks such as walking, talking, and eating.
How Can I Prevent Shoulder Dystocia?
Shoulder dystocia can be difficult to prevent. Nonetheless, you can take a few steps to reduce your chances of experiencing this complication, such as:
- Watching your weight during pregnancy
- Properly managing conditions such as diabetes
- Lying on your side or assuming a prone position during childbirth
- Opting for cesarean delivery
While relatively rare, shoulder dystocia may lead to long-term, debilitating conditions such as cerebral palsy. Sometimes, this complication could be the result of medical malpractice. If you think your child suffers from cerebral palsy because of medical malpractice, you may be able to claim compensation from the negligent party. Janet, Janet & Suggs, LLC has helped more than 30,000 families make educated choices about their medical malpractice cases. Contact us today to learn more.
Claire Surles, RN
Claire comes to JJS after a 10-year career as a labor and delivery nurse. She dedicated her hospital efforts to advocating for families, providing the safest birthing environment possible as Newborn Admission Nurse at UMMC St. Joseph Medical Center in Towson, Maryland. Her passion for helping those who experienced losses at any stage of gestation led to her appointment as Coordinator of the hospital’s ROOTS perinatal loss program. READ FULL BIO