Shoulder Dystocia

Shoulder dystocia occurs after an infant's head has already been delivered and the shoulders become stuck behind the mother's pelvis. Dystocia is defined as a slow or difficult birth or delivery. This complication is difficult to predict prior to labor. Adjustments usually need to be made on the spot once the complication is discovered.

Newborn infants are extremely delicate, so this situation calls for extreme care.  Sometimes, the healthcare professional responsible for the delivery may cause injuries due to improper technique or negligence.

Do I Have A Case?

Unless you're a medical professional yourself, you may be uncertain if medical negligence caused injuries which resulted from shoulder dystocia. But if you're concerned that these injuries were preventable and the product of malpractice, we recommend speaking with an experienced birth injury attorney. He or she can analyze the details of your situation and consult with medical experts to determine if your case is viable.

Be aware that Pennsylvania has a two-year statute of limitations for medical malpractice lawsuits. If you suspect that something went wrong, don't hesitate to pursue the case.

If your healthcare professional is found liable for malpractice, you may recover damages for:

• Medical expenses
• Lost wages
• Pain and suffering
• Loss of quality of life

Common Medical Mistakes

Shoulder dystocia can be a difficult issue to navigate for healthcare professionals.  In some cases, injuries may be unavoidable. But many could have been prevented and may have been caused by medical negligence.

Excessive Force

The deliverer must be careful when attempting to dislodge the baby's shoulders. Sometimes, he or she may pull too hard on the infant's head or shoulders. This can cause nerve damage, often leading to serious injuries. In fact, excessive force during shoulder dystocia is the most common cause of Erb's palsy.

Lack Of Planning

There are certain risk factors which make shoulder dystocia more likely. If the prospective mother has multiple risk factors, it may be prudent to schedule a cesarean section. These risk factors include:

• Very large fetus
• Diabetes
• Pregnant with two or more babies
• Obesity in mother
• Late delivery
• Previous history of large babies or shoulder dystocia
• Induced labor
• Epidural during labor
• Operative vaginal birth (use of tools such as forceps or vacuum)

Plenty of women with none of these risk factors also encounter shoulder dystocia. But if there are several risk factors at play, your healthcare professional may be found negligent for failure to anticipate complications and schedule a c-section.

Instrumental Delivery

Studies have shown that deliveries requiring the instrumental assistance (e.g. vacuums and forceps) are at a higher risk of shoulder dystocia. Additionally, inexperienced personnel may improperly use these tools and consequently cause an injury while attempting to dislodge the shoulders.

Common Injuries

About 20% of babies are injured in shoulder dystocia deliveries.

Brachial Plexus Injuries

The brachial plexus is a nerve network, consisting of spinal cord nerve roots in the shoulders, neck, arms, and hands. Roughly 10% of shoulder dystocia cases result in a brachial plexus injury. There are two common brachial plexus injuries which may be caused by this complication:

• Erb's palsy - The more common of the two injuries. The upper portion of the brachial plexus is injured, which is localized in the upper arm. Infants with Erb's palsy may experience numbness, partial or full paralysis, and general weakness in this region.
• Klumpke's palsy - This condition is similar to Erb's palsy, but affects the lower region of the brachial plexus. Symptoms include hand deformities and paralysis of hand muscles.

If you struggled with shoulder dystocia in your delivery and your child acquired one of these conditions, medical negligence may be to blame. Consider consulting with an experienced birth injury lawyer to discuss your options.

Fractures

Fractures are the second most common injury type resulting from shoulder dystocia deliveries. Specifically, the clavicles and humerus are affected. Clavicle fractures are actually a necessary component of many such deliveries. They reduce chest diameter and make delivery easier. 4% of these cases result in humerus fractures, which tend to heal quickly.

Fetal Asphyxia

It's important to act quickly in these deliveries. Longer intervals between the delivery of the head and the rest of the body can cause serious problems. After the head has emerged, the umbilical cord may become compressed between the infant and the mother's birth canal. This compression will decrease or completely eliminate blood flow. If this isn't addressed promptly, fetal asphyxia (a lack of oxygen) may occur. This can lead to brain damage, cerebral palsy, or even death.

Relevant Birth Injury Pages

• Comprehensive birth injury guide
• Questions after a birth injury?
• Info on cerebral palsy
• About Erb's palsy