What Causes Shoulder Dystocia?

doctor pulling a baby through the birth canal

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.”

Shoulder dystocia can cause nerve damage

Shoulder dystocia can cause nerve damage, often happening when a baby gets stuck in the birth canal during delivery. When a doctor has to force a baby through the birth canal it 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 permanent nerve injury. Sometimes an injury 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.

Other Causes of Shoulder Dystocia

It would be misleading to assume that the infant or the mother is always to blame for shoulder dystocia. Positioning and the baby’s size are not the only risk factors for this type of birth injury. There are a few other factors that can increase the risk of shoulder dystocia and that doctors need to pay close attention to when delivering a child.

Three other causes of dystocia are:

  • Heavier newborns: Regardless of positioning or the baby's height, heavier newborns have a higher risk of shoulder dystocia and other birth injuries caused by pulling, tearing, or displacement. Babies born at the average healthy weight – approximately 7.5 pounds – have about a 1% chance of being born with shoulder dystocia. On the other hand, newborns who weigh about 10 pounds or more are about 7 times more likely to be born with shoulder dystocia, so there is a clear correlation between weight and this type of birth injury.
  • Incorrect use of birthing tools: During some deliveries, doctors and nurses will rely on birthing tools like vacuum extractors and forceps to complete the delivery. However, incorrectly using these pieces of medical equipment can exert too much force on the child, pulling them forcibly and damaging their shoulder. Forceps and vacuum extractor misuse can also cause facial and cranial scarring to the infant.
  • Diabetes: Some studies have shown babies born to mothers with diabetes are more likely to suffer shoulder dystocia during delivery. The exact cause of this correlation is not yet fully understood. Although, it is believed that maternal diabetes causes different subcutaneous fat growths in unborn children, which can result in unusual shoulder diameter at birth. The wider the child’s shoulders, the more likely they are to be contorted in the birth canal and suffer shoulder dystocia.

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.

If you believe your child is a victim of medical malpractice,
contact our firm for a free, no-obligation consultation today.

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