St. Louis Medical Malpractice Attorneys

Birth Injuries | Shoulder Dystocia

Shoulder dystocia can be one of the scariest moments for would-be parents during childbirth. In a normal delivery, after the head emerges, the rest of the baby will soon follow amidst jubilation, and cheers. Imagine the confusion and fear if the baby’s neck were to suddenly slip back into the mother, causing the baby’s cheeks to puff up. This happens because the baby’s anterior (front) shoulder has lodged on the mother’s pubic bone. If this situation is not quickly addressed and remedied, this could spell imminent danger for the baby and the mother.

Statistics show approximately 20,000 deliveries annually in the United States experience shoulder dystocia. When shoulder dystocia occurs during the birth process, one of the most serious complications is a brachial plexus injury, also commonly known as Erb’s palsy. A brachial plexus injury is characterized as damage to nerves on the shoulder that control the arm and hand. Depending on severity of the injury, this could mean permanent damage, lack of muscle tone in the affected hand, and even paralysis.

During a normal vaginal delivery, the soft bones of a baby’s head can mold and overlap to fit through the mother’s pelvis. The baby’s shoulders, will then follow, at an angle, which gives the baby enough room to descend. If the baby’s shoulders were straight instead of at an angle, the baby may not have enough room, and may get caught on the mother’s pubic bone.

Risk factors that can result in shoulder dystocia

• A prior birth where the infant experienced shoulder dystocia, even if it did not result in Erb’s Palsy
• Larger babies, especially those born to mothers with diabetes or gestational diabetes
• Babies with above average birth weight, or a birth weight of 8lb 13 oz or higher
• Smaller mothers, particularly those with smaller pelvises
• Labors where the second stage of labor (when the mother starts to push) lasts longer than 2 hours
• Breech position births

With time and medical advances, improved delivery techniques have helped prevent many injuries of this nature. At present, if shoulder dystocia should occur during delivery, there are specific actions that the obstetrician can take to remedy this situation without causing injury to the infant.

Techniques to prevent shoulder injuries include:

• Gaskin Maneuver
  By placing the birth mother on her hands and knees, the diameter of the pelvis is changed and may make delivery easier. This may not be possible if the mother has received an epidural.
• McRobert’s Maneuver
  Mother’s knees are pushed back and down to open the pelvis even more. This procedure may reduce shoulder dystocia in half.
• Woods Maneuver
  Also called the corkscrew, two fingers are placed on the baby’s shoulders and pushed in 180 degrees.
• Rubin Maneuver
  Similar to the Woods maneuver where two fingers are placed on the baby’s shoulders. The fingers are pushed in the direction of the baby’s eyes instead.
• Suprapubic pressure
  Instead of putting pressure on the uterus, pressure is placed on the pubic bone to allow the infant to exit the birth canal.
• Zavanelli Maneuver
  Normally used if the baby presents in a breech position, this can be a dangerous maneuver. The baby is pushed back into the vagina, and a cesarean is performed to remove the baby.

Steps to prevent shoulder dystocia include:

• Maintain good health care during pregnancy.
• If you have diabetes or gestational diabetes, be vigilant to maintain proper blood sugar levels through diet and medication. Maintaining proper blood sugar levels will prevent your infant from gaining too much weight.
• Be informed of the risks that could lead to shoulder dystocia. Should you know your infant is at risk of shoulder dystocia, begin exploring options with your obstetrician such as planned cesarean, or an induced delivery.

After the baby is born

If shoulder dystocia is experienced by the baby during delivery, there are several things a physician will monitor for:

• A baby that may not be breathing on his or her own.
• The baby’s collar bone (clavicle) or arm bone (humerus) has sustained a fracture during delivery.
• Signs of a brachial plexus injury.
• Maternal hemorrhage due to a uterine rupture

Millikan Wright LLC has experience in complex medical malpractice cases. Our results demonstrate our committment to helping families recover and heal from an injury or wrongful death. We work only on a contingency fee basis, which means no cost to you until we secure a financial settlement. If we do not win the case, we absorb the entire cost. To arrange a no-cost consultation and learn how you may be entitled to compensation, contact us online or call our personal injury lawyers at 877.621.0622 (314.621.0622 in St. Louis).

The Missouri Injury Attorneys of Millikan Wright LLC focus serving the needs of the greater St. Louis Metropolitan area. On the Missouri side, our lawyers represent people injured in St. Louis city, St. Louis county, Jefferson county, Franklin county, St. Charles county, and Lincoln county. On the Illinois side, our attorneys represent people hurt in Madison county, St. Clair county and Monroe county.