If you are a parent who has been told your newborn baby suffered an injury as a result of shoulder dystocia during delivery, you are probably experiencing many strong emotions, and have even more questions. The experienced medical malpractice attorneys at Wagner Reese are here to help give you the answers you need.

Although medical providers may try to make excuses for why your child’s injury occurred, the truth is that many birth injuries can be avoided with careful monitoring, planning, and swift action by the healthcare provider. When healthcare providers fail to act and cause harm, they can be held responsible for their negligence.

Wagner Reese provides free initial case consultations for parents of children affected by injuries from shoulder dystocia (distortion), because we believe you deserve to know the truth about your medical care.

What is Shoulder Dystocia?

Shoulder dystocia is a complication that occurs during delivery when one or both of the baby’s shoulders become stuck in the birth canal. When the baby’s shoulder becomes stuck, the rest of the baby’s delivery becomes more difficult. Baby shoulder dystocia is an obstetric emergency that can result in permanent injury to the baby and complications for the mother if immediate action isn’t taken.

What Are Warning Signs of Shoulder Dystocia?

While shoulder dystocia can’t always be predicted, there are several signs that may indicate a higher-than-average risk of shoulder dystocia occurring.

During Pregnancy

  • Mothers who have previously given birth to babies who suffered from shoulder dystocia
  • Babies weighing in the 90th percentile or higher
  • Delivering past the due date
  • Delivering multiples (twins, triplets, etc.)
  • Maternal diabetes
  • Maternal obesity
  • Induced labor

During Labor

  • Delayed or no progress in the baby’s descent, even with strong contractions and maternal pushing
  • “Turtle sign,” when the baby’s head appears, but then retracts again, like a turtle into its shell
  • No rotation of the baby’s head after it emerges

With these risk factors in place, doctors should take into consideration the risk of shoulder dystocia and order a cesarean delivery if necessary

It is a healthcare provider’s duty to watch for warning signs and take swift action to prevent harm to the baby and the mother as soon as a complication is recognized. Shoulder dystocia is always a medical emergency and needs to be treated with the urgency that entails.

Increased Risks for Shoulder Dystocia

There are several ways the risk for shoulder dystocia can be increased. These are:

  1. Fetal macrosomia: Fetal macrosomia or a clinically large fetus is by far the biggest risk factor for shoulder dystocia. The vast majority of dystocia cases occur in babies with an excessively large birth weight. More often than not, the large birth weight can be attributed to Gestational Diabetes in the mother. In fact, there is a fourfold increase in the risk of suffering a shoulder dystocia if you have GS.
  2. Induction, labor augmentation and instrumental delivery: All of these things, while sometimes necessary, tend to be drastically overused in the labor and delivery wards of our American hospitals. Having your birth interfered with by drugs or instrumentation often interferes with the natural process of the fetus’ descent into the birth canal. If interfered with, baby’s position can become misaligned, increasing the risk of shoulder dystocia.
  3. Maternal obesity: Shoulder dystocia occurs three times more often in obese or overweight women. If a mother gains excessive weight during pregnancy or is obese, it is likely that her birth will be more difficult, put more stress on her body, and can subsequently stress the baby.
  4. Birth Position: Lying flat on your back to deliver can significantly increase your risk of shoulder dystocia because it works against the natural flow of gravity in birth. When the mother lies flat on her back, the baby has to be pushed up through the birth canal, rather than an easier, downward position. The stress of pushing up can cause a malposition in the baby and sometimes cause a dystocia. Many hospitals encourage mothers to lie flat on their backs in the beds because it is easier to keep them on the monitors and much simpler for the doctors who are delivering the babies.
  5. Previous shoulder dystocia: There is a 15% chance of shoulder dystocia recurring if it has happened in a previous delivery. Once a shoulder dystocia has occurred, pursuing vaginal delivery again is possible, but options should be researched for ways to avoid this complication.

Shoulder dystocia is one of the most feared complications of a normal vaginal delivery. If you think that you or your infant has suffered due to medical negligence, then do not hesitate to contact one of our shoulder dystocia attorneys today. Our experienced team of personal injury lawyers can help you make up for your financial losses, however unique the medico-legal aspects of your case may be, by bringing your claims to justice.

How Does Infant Shoulder Dystocia Affect the Baby?

A birth complicated by shoulder dystocia can result in serious long-term effects for the baby. The major concern is a loss of oxygen while the baby is stuck in the birth canal, which can cause damage to the baby’s brain, or even death.

Oxygen deprivation can result in long term effects that will follow your child through life, including:

  • Epilepsy: A disorder that causes seizures
  • Attention deficit disorder (ADD): A condition that causes excessive difficulties with concentration, which often leads to problems in school and the workplace
  • Cerebral palsy: A motor condition that causes sufferers difficulty controlling their muscles, which often results in problems walking and speaking
  • Developmental, learning, and intellectual disabilities

While there is currently no cure for these conditions, medication, physical and occupational therapy, and mobility devices can help manage them. Unfortunately, the cost of treatment over the long term is often more than most families can handle without help.

The medical personnel attending the birth may also try to physically pull the baby out, and this may result in additional injuries. Commonly, infants suffer from:

  • Broken bones, especially the clavicle (collarbone) and humerus (upper arm)
  • Dislocated joints, especially the shoulder
  • Facial deformities
  • Erb’s palsy, a nerve injury that causes partial or full paralysis of the arm
  • Klumpke’s palsy, a nerve injury that causes paralysis of the lower arm and hand

Brachial plexus injuries like Erb’s palsy and Klumpke’s palsy often require surgery to treat. When injuries are permanent, the child will often require physical and occupational therapy.

How Does Infant Shoulder Dystocia Affect the Mother?

As a result of the doctor’s efforts to remove the baby, mothers may have lasting medical consequences.

Approximately 11% of all cases involving shoulder dystocia result in postpartum maternal bleeding. Severe tearing may occur as well. A more severe consequence is a uterine rupture, which can result in the mother becoming disabled or unable to carry another child. In extreme situations, uterine ruptures can result in the mother’s death.

How Does Infant Shoulder Dystocia Affect the Family?

Depending on the severity of the injury, one parent may even need to become a full-time caregiver or enlist the help of older siblings. This not only reduces income coming into the household, but it can also cause enormous emotional strain on families.

Can Shoulder Dystocia Cause Brain Damage?

The cost of treating an infant who suffers from oxygen deprivation-related brain damage because of shoulder dystocia can be high enough to significantly impact families. Even with insurance, parents of injured babies often have to make sacrifices in other areas of their lives. Some of these children will need continuing treatment and care for their entire lives.

The financial cost of these injuries is high, but the emotional cost is even higher. When the injury is the fault of a negligent delivering physician, families deserve compensation for the cost of care and the impact the injury has on their lives.

How Do Negligent Medical Professionals Cause Shoulder Dystocia?

Doctors, nurses, and midwives should be ready to act immediately if they diagnose or suspect shoulder dystocia. Any medical professional who works in labor and delivery should know all of the most effective and common methods for reducing the severity of the condition or lessening the severity of any injuries that may occur. Some of these techniques include:

  • Performing a C-section: In some cases, women may need to deliver their babies via C-section if they are at risk of shoulder dystocia.
  • Performing the McRoberts maneuver: This maneuver involves women in labor pressing their thighs against their bellies to rotate their pelvis and release pressure on their babies’ shoulders.
  • Performing an episiotomy: This procedure involves cutting the vagina to make more room for the baby and its shoulder during birth.
  • Performing a Rubin maneuver: This maneuver involves a healthcare provider physically turning the baby’s shoulder during labor to reduce the risk of serious injuries when shoulder dystocia is diagnosed.

These are just a few of the emergency procedures that can be performed to reduce damage and the risk of serious injuries associated with shoulder dystocia.

It’s up to labor and delivery healthcare providers to both diagnose shoulder dystocia and employ the safest and most effective method for delivering in a manner that reduces harm to both mother and child.

Wagner Reese Works Hard to Assist Families Hurt by Shoulder Dystocia

Although shoulder dystocia and other birth defects aren’t always someone’s fault, that changes if they are incorrectly treated or if treatment is delayed. That’s because birth complications should be both diagnosed before they cause serious problems, and appropriate interventions should always be attempted to keep mothers and babies as safe from harm as possible. Unfortunately, not all medical professionals are as attentive as they should be, and that can result in serious injuries.

The Indiana medical malpractice attorneys at Wagner Reese understand how traumatizing these birth experiences and the injuries that result can be for the family, especially when they could have been prevented or the harm reduced. In many cases, an experienced Indiana medical malpractice attorney can examine a case and help you decide if the severe injuries you or your child suffered as a result of shoulder dystocia are appropriate for a medical malpractice case. Contact Wagner Reese to discuss the specifics of your case today.

Originally published February 21, 2021.