In a normal vaginal delivery, your baby’s head emerges first and is soon followed by the shoulders, chest and the rest of the baby’s torso.  The delivery of your baby should be smooth and steady.  Shoulder dystocia is diagnosed when the shoulders fail to delivery shortly after the head.  When shoulder dystocia occurs, the baby’s shoulder gets stuck on the mother’s pubic bone, known as the symphysis pubis.  After the delivery of the head of the baby, the shoulder of the baby cannot pass below the symphysis pubis. If this happens, the rest of the baby does not follow the head easily out of the vagina.

Shoulder dystocia is an obstetrical emergency, and the baby can die if he/she is not delivered due to compression of the umbilical cord within the birth canal.  The other major concern with shoulder dystocia is damage to the upper brachial plexus nerves.  These are the nerves that supply the sensory and motor components of the shoulder, arm, and hands.  Excessive tension in the brachial plexus nerves during the delivery can cause permanent damage, known as Erb’s Palsy.

If you or a loved one have been affected by shoulder dystocia, please contact one of our Kingston shoulder dystocia lawyers today to discuss whether you have the basis for filing an injury claim. Our experienced birth injury attorneys can assist in walking you through the claims process and answer whatever questions you might have.

How to Handle Shoulder Dystocia

First, the obstetrician or nurse-midwife must stay informed of the time that has elapsed since delivery of the baby’s head.  The obstetrician or nurse midwife has roughly seven minutes after the delivery of the baby’s head to deliver the rest of the body before the baby will sustain brain damage.  It is critical that the obstetrician keep track of the amount of time that it takes to
deliver the baby, as every second counts once shoulder dystocia is encountered.

Second, the mother’s legs should be hyperflexed against her abdomen.  This widens the pelvic opening thus allowing for easier passage of the baby.  This is known as the McRobert’s Maneuver and it is successful in delivering the baby in about 40% of all cases.

A third step that is often used for shoulder dystocia is “supra-pubic pressure”, which is the application of force against the mother’s lower abdomen in an attempt to dislodge the stuck shoulder. A nurse or obstetrician will put his/her fist just above the mother’s pubic bone (lower part of the abdomen) and push the baby’s shoulder in one direction or the other. Many obstetricians will use the McRobert’s Maneuver and suprapubic pressure at the same time.

If these maneuvers do not dislodge the baby’s shoulder and time is running out, another option is to push the baby back up the birth canal and perform an emergency Cesarean Section.  This is typically a last resort.  However, by pushing the baby back up the birth canal, the doctor has bought more time to deliver the baby since the umbilical cord is no longer compressed by the mother’s pelvic bones.

Contact a Kingston Shoulder Dystocia Today

If you are at risk of having a “big baby” and you want a normal vaginal delivery, you should discuss with your obstetrician how he/she intends to manage shoulder dystocia if it is encountered. You should make sure that you are familiar with the management of shoulder dystocia and what you can expect as a patient. It is important to contact an experienced Kingston shoulder dystocia attorney to have more of an understanding of the risks.