Why Shoulder Dystocia Is a Medical Emergency

During labor and delivery, traumatic events can occur that may lead to serious consequences for both the mother and the baby. One specific complication that can arise is shoulder dystocia, where the baby’s shoulders become lodged during delivery. This can be a distressing and dangerous situation, potentially resulting in significant injuries.

Unfortunately, medical negligence can sometimes be a contributing factor in these situations. It is crucial for healthcare providers to properly manage and address these challenges to ensure the safety and well-being of both the mother and the baby. When medical negligence is involved, it can exacerbate the risks associated with labor and delivery trauma, potentially leading to long-term complications that could have been avoided.

What is shoulder dystocia?

During a normal vaginal delivery, the baby’s head typically emerges first, followed by the shoulders. Shoulder dystocia is a medical emergency that occurs during childbirth when the baby’s shoulders become stuck behind the mother’s pubic bone after the head has been delivered.

This condition poses significant risks to both the baby and the mother and requires immediate medical intervention. Shoulder dystocia can result in serious complications and potential birth and maternal injuries, including:

• Damage to the baby’s brachial plexus nerves
• Hypoxia (oxygen deprivation) caused by chest compression
• Umbilical compression
• Hypovolemic shock
• Damage to the mother’s bladder, anal sphincter, and/or rectum
• Postpartum hemorrhage

If not managed properly and effectively, both the mother and the baby’s lives could be at risk.

What are the causes of shoulder dystocia?

The exact cause of shoulder dystocia is not always clear, but some common contributing factors include:

• Fetal macrosomia. When a baby is significantly larger than average (a condition called macrosomia), it increases the risk of shoulder dystocia. Gestational diabetes, maternal obesity, or excessive weight gain during pregnancy can contribute to fetal macrosomia.
• Maternal pelvic anatomy. Certain pelvic abnormalities or narrowness of the birth canal can make it difficult for the baby’s shoulders to pass through, leading to shoulder dystocia.
• Maternal diabetes. Women with diabetes, particularly uncontrolled or poorly managed diabetes, have a higher risk of delivering larger babies, increasing the likelihood of shoulder dystocia.

How is shoulder dystocia treated?

When shoulder dystocia occurs, immediate action is crucial to prevent complications and ensure the safe delivery of the baby. The medical team should follow established protocols to manage the situation. Some common techniques used to resolve shoulder dystocia include:

• McRoberts Maneuver: This involves flexing the mother’s legs tightly against her abdomen, which helps to straighten the pelvic angle and release the trapped shoulders.
• Suprapubic pressure: Pressure is applied above the mother’s pubic bone to push the baby’s shoulder downward and free it from behind the bone. This pressure coupled with the McRoberts Maneuver can increase the effectiveness of the maneuver by 90%.
• Woods Corkscrew Maneuver: This technique involves rotating the baby’s posterior shoulder to release it from the pubic bone.
• Delivery of the posterior arm. If other methods are unsuccessful, the doctor may attempt to deliver the baby’s posterior arm to decrease the shoulder diameter and facilitate delivery.

In severe cases, when these maneuvers do not successfully resolve shoulder dystocia, more invasive techniques may be required, such as episiotomy, internal maneuvering of the baby’s shoulders, or even an emergency cesarean section.

How can medical malpractice lead to shoulder dystocia?

Medical malpractice can contribute to the occurrence of shoulder dystocia if healthcare providers fail to recognize the risk factors, properly manage the situation, or provide timely intervention. Negligence or errors during prenatal care, failure to monitor and detect fetal macrosomia, improper use of labor-inducing drugs, or incorrect handling of shoulder dystocia during delivery can all contribute to preventable complications and injuries.

Medical malpractice cases related to shoulder dystocia often involve allegations of:

• Failure to identify and address risk factors. Healthcare providers should identify and assess risk factors for shoulder dystocia during prenatal care, such as maternal diabetes or macrosomia, and develop appropriate management plans.
• Inadequate communication and preparation. Effective communication and coordination among the medical team are crucial in anticipating and preparing for potential shoulder dystocia scenarios. Failure to communicate or adequately prepare can lead to delays and errors in managing the emergency.
• Incorrect maneuvers or improper technique. Improper use of delivery techniques or applying excessive force during maneuvers can cause additional complications, including birth injuries.
• Delayed or inadequate response. Shoulder dystocia requires immediate action. Any delay in recognizing the condition or initiating appropriate interventions can lead to severe birth injuries, including brachial plexus injuries, fractures, or oxygen deprivation.

It’s important for healthcare providers to follow established guidelines and protocols for managing shoulder dystocia to minimize the risks associated with this obstetric emergency. By providing timely and appropriate care, healthcare professionals can improve outcomes and reduce the potential for long-term complications for both the baby and the mother. If you or your baby have been injured due to medical malpractice by your labor and delivery team, then you should reach out to a medical malpractice or birth injury attorney. They will guide you through the often complicated legal process to ensure that you are compensated for your pain, suffering, medical bills, and future treatments needed due to the injury.

Please contact Paulson & Nace, PLLC by calling our office or by filling out this contact form.