What is Shoulder Dystocia?
The birth of a baby is a joyful time, and so many births go without incident that when there is a problem, joy is rapidly replaced with worry and distress. One such situation is shoulder dystocia. As the name suggests, shoulder dystocia happens when, during labor, the baby’s head has passed through the birth canal, but its shoulder gets caught on the mother’s pelvis. When this happens, the infant cannot easily exit the birth canal. Often in shoulder dystocia cases, the baby’s head will emerge from the birth canal, then go back in, like a turtle retreating into its shell.
If this condition sounds painful for both mother and baby, it is, but pain is only the beginning of the problems shoulder dystocia can cause. A mother whose baby experiences shoulder dystocia can suffer tearing of the perineum, or serious postpartum hemorrhage and blood loss. Rarely, a mother experiences uterine rupture in these cases. And the outcome may be even more severe for the baby.
If not properly managed, shoulder dystocia can result in devastating birth injuries, severe and life-long impairments, or the infant’s death. Some of the injuries associated with shoulder dystocia include:
- Erb’s palsy
- Brachial plexus injuries
- Klumpke’s palsy (involving nerve damage in the forearm)
- Fractured shoulder bones, including the clavicle or humerus
- Birth asphyxia (oxygen deprivation)
- Hypoxic ischemic encephalopathy
Oxygen deprivation due to shoulder dystocia can lead to permanent brain damage or death. Because the consequences of this condition can be so devastating, obstetricians should be aware of the earliest warning signs of shoulder dystocia, and act decisively to manage it.
Signs and Risk Factors in Shoulder Dystocia
Unfortunately, there is no way to know that shoulder dystocia will happen until it is happening. The telltale indicator is the “turtle sign” described above, when the baby’s head emerges from the birth canal, then retracts.
There are, however, a number of factors that should alert medical professionals that a mother may be at risk of having an infant with shoulder dystocia. Risk factors for shoulder dystocia include:
- Obesity in the mother
- Mother experienced gestational diabetes
- Mother gained over 35 pounds during the pregnancy
- Mother is of short stature
- Mother has had a previous labor with shoulder dystocia
- Baby with a birth weight exceeding 8 lbs., 13 oz. (macrosomia)
Even with multiple risk factors, shoulder dystocia may not be present in a birth; by the same token, a pregnancy with no risk factors may end in a birth involving shoulder dystocia. So, while it is wise for medical staff to be aware of the risk for certain women, they should be prepared to address shoulder dystocia in any labor and delivery. Failure to properly manage the condition could be medical malpractice.
Medical Malpractice in Shoulder Dystocia Cases
Shoulder dystocia happens in about one out of every 150 vaginal births, or about 0.7% of cases. It is not terribly common, therefore, but it is common enough that every obstetrician is likely to encounter it and should know how to respond.
If a woman is at risk of having an infant with shoulder dystocia, her obstetrician should explain her risk factors and identify options to prevent problems with the birth. One option is to schedule a c-section, especially if the mother has gestational diabetes and/or the baby is expected to be large. An obstetrician may also induce labor somewhat early, so that the baby is likely to be smaller, in an effort to prevent shoulder dystocia.
If a mother is in labor and shoulder dystocia has been identified, there are a number of things medical staff can do to reposition the mother and baby. These maneuvers can help open the woman’s pelvis wider and move the baby’s shoulders from the problematic position. If these efforts are unsuccessful, an emergency c-section may need to be performed.
Like any medical malpractice case, a shoulder dystocia case requires proving that the medical professional had a duty of care to the patient; that he or she breached that duty; that the patient or her baby suffered injury; and that that injury was a result of the breached duty of care.
Unless the doctor or medical team’s actions were egregious, it may not be immediately obvious that medical malpractice took place. But if you experienced a birth involving shoulder dystocia, and you or your baby suffered a serious injury, it is likely medical malpractice played a part. Particularly if your baby suffered serious or permanent injury, you need to think about the possibility of seeking compensation for their injuries, as you may need it to provide your child with proper care.
Unfortunately, you have only a limited time in which to file a medical malpractice claim. It makes sense to schedule a consultation with an experienced Oregon medical malpractice attorney to evaluate whether it would be worthwhile to pursue a malpractice claim against your doctor or medical team. We invite you to contact Huegli Fraser to discuss your concerns.
The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact a qualified medical malpractice attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with a competent medical malpractice attorney licensed to practice in your jurisdiction.