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What Causes Shoulder Dystocia?

Michael Bereston

Imagine you just went through 12 hours of labor. Joyful that the birth is over, you look into the doctor’s eyes to find a look of concern. He says, “The trauma of birth has left your baby with a paralyzed arm.”

The technical term for your baby’s condition is “shoulder dystocia,” this birth injury happens when the baby gets stuck in the birth canal. Sometimes, the head makes it through, but the shoulders become trapped by the bones of the mother’s pelvis and the doctor needs to force the baby’s birth.

Shoulder dystocia is caused by nerve damage

When a doctor has to force a baby through the birth canal, injuries to the shoulder area can damage the nerves in the shoulder. These nerves pass through the shoulder to send signals from the brain to the arms. When the nerves rip or tear in these situations, it can cause the baby’s arm to go limp resulting in shoulder dystocia.

Sometimes shoulder dystocia is temporary and heals after birth. Other times, it’s a permanent, lifelong condition.

The size of your baby doesn’t matter

You might think that big babies have the highest risk for shoulder dystocia, but 50 percent of shoulder dystocia cases happen to small babies. What really causes shoulder dystocia is the baby’s failure to properly position him- or herself for exiting the womb through the birth canal.

Sometimes it’s also about the mother’s positioning. When the mother can reposition herself, the baby can sometimes better align to come out more easily through the pelvis.

Ultimately, obstetricians have training to determine when a baby is badly positioned. When an obstetrician recognizes the problem, he or she will direct the mother to reposition herself, or the doctor will try to reposition the baby. When the doctor cannot reposition the baby safely and allows the birth to proceed anyway, the baby can become obstructed, resulting in the danger of the baby losing oxygen. It’s in these emergency situations that a doctor could try to force the baby out and cause the shoulder damage.

Was your obstetrician negligent?

In many cases, obstetricians can detect when shoulder dystocia is likely. Then, they can order an emergency caesarian section to safely birth the baby. Failure to order a caesarian or failure to take other appropriate action to prevent shoulder dystocia could be an indication of medical malpractice on the part of a physician. If you suspect that your obstetrician’s negligence led to your baby’s shoulder dystocia, you might want to investigate your legal rights and options.

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Mother kissing her baby's feet