What Is Shoulder Dystocia and How Can It Affect Your Baby?
First reported by medical practitioners in 1730, shoulder dystocia is a fairly rare complication during childbirth in which a child’s head is able to fit through the birth canal but its shoulders are too wide to pass beyond the pelvic bone. If one or both shoulders is impacted against the pelvic bone, a number of birth injuries can occur.
In addition to occurring when the baby’s body is disproportionately large compared to the mother’s birth canal (called cephalopelvic disproportion, or CPD), shoulder dystocia can also occur if a baby presents face-first, which is sometimes called “turtle syndrome”. In this case, the child may be pulled out of the mother face-first and/or at an odd angle, which can cause the shoulder to lodge against the pelvic bone, causing excessive stress on the neck and shoulder.
Problems Associated With Shoulder Dystocia
Shoulder dystocia occurs when the baby’s head is able to come out but the shoulders are stuck in the birth canal, held in place by the pelvic bone. The problem here occurs when the doctor does not recognize the situation and/or attempts to pull the baby out. This can cause a uterine rupture, lacerations, and/or hemorrhage in the mother, and it can be extremely dangerous for the baby, as well.
Shoulder dystocia can harm a baby in a number of ways, as well, including:
- Broken bones
- Pulled muscles
- Nerve damage (including brachial plexus injuries, such as Erb’s palsy and Klumpke’s palsy)
- Partial or total paralysis in one or both arms
- Problems with grip strength in one or both hands
- Oxygen deprivation
Shoulder Dystocia Can Cause Brachial Plexus Palsy
One of the most common birth injuries associated with shoulder dystocia is brachial plexus palsy. The brachial plexus is the nerve network near the neck that controls the movements and sensory nerves of the shoulder, arm, hand, and fingers.
If these nerves are damaged in any way, your baby could develop brachial plexus palsy, which takes on a few different forms. Damage to the upper nerves results in Erb’s palsy, while damage to the lower nerves causes Klumpke’s palsy. In either case, your baby will likely experience temporary or permanent symptoms, including partial or total paralysis of the affected arm, pain, numbness or tingling, reduced grip strength, and other disabilities.
Preventing Shoulder Dystocia
There are a number of known risk factors that can increase the likelihood of shoulder dystocia in childbirth, including:
- Use of an epidural
- Pregnancy with twins, triplets, etc.
- Maternal diabetes and/or obesity
- Delayed labor
- A family or personal history of shoulder dystocia
- Induced labor
A good doctor should be paying attention and looking out for these and other factors that could increase the risk of shoulder dystocia. If they see one or more of these factors, they can call for a cesarean section procedure to avoid the problem and prevent any birth injuries due to it.
Treatments Available for Shoulder Dystocia
As shown above, shoulder dystocia can result in a number of different birth injuries. In the case of nerve damage and brachial stretch injuries, the treatment will usually involve physical therapy and may require medication and/or surgery.
If the shoulder dystocia caused oxygen deprivation, your baby may develop cerebral palsy, for which there is no cure but there are a range of treatments to make life easier and to help your child’s health. These include physical therapy, occupational therapy, certain tools and devices to help with mobility and comfort, surgery, and medication.
If shoulder dystocia occurs, doctors will almost always attempt to take action to help safely pull the baby out without causing birth injuries. However, these injuries can almost always be prevented with foresight and by calling for a cesarean section procedure before the shoulder dystocia occurs.
If you or your child has suffered from injuries caused by shoulder dystocia, you may have a medical malpractice case. For more information on shoulder dystocia, brachial plexus palsy, and other birth injuries, contact us today at Birth Injury Center and schedule a free consultation.