What is Shoulder Dystocia?

Shoulder dystocia is a condition during delivery in childbirth where the head has been delivered but due to a complication, the infant's shoulders are stuck in the birth canal and natural delivery becomes unlikely. Complication of this condition can lead to fetal injury or even fetal death, and as a result it is important that medical personnel performing child deliveries understand both the risk factors as well as the appropriate management of this condition.

The most common concern for an infant whose delivery involves shoulder dystocia is damage to the nerves of the upper branchial plexus, which run from the spine through the neck, armpit, and into the arm. Lesions or other damage to these nerves can cause severe functional impairment, including:

1.Erb's palsy: this is a paralysis of the arm, most commonly caused by dystocia during childbirth. The condition can require physical therapy or surgery to correct

2.Klumpke paralysis: similar to Erb's, this is a paralysis of the forearm and hand, commonly resulting from dystocia

3.Fetal hypoxia: resulting from a shortage of oxygen supply to parts of the body, this severe condition can lead to cerebral palsy in the infant, or even to fetal death

Shoulder dystocia can be caused by a number of different situations. If the delivering doctor notices a delay during delivery of the child's shoulders, even a natural delay, she may panic and apply unnecessary lateral traction to the baby's neck, which can serve to worsen the dystocia. It can also occur when the doctor improperly rotates the child's shoulders to align them properly with the head in the birthing canal. Shoulder dystocia can be encouraged by improper administration of an epidural anesthetic, resulting in an impacted shoulder as the fetus descends unnaturally into the canal. Additionally, improper use of medical instruments during the birthing procedure, including forceps and vacuum extractors, can lead to or worsen shoulder dystocia.

Fortunately, these factors can easily be prevented if doctors make use of standardized birth maneuvers and their medical equipment with diligence. The fact that so many causes of shoulder dystocia are preventable provides a strong incentive for those whose delivery has resulted in a complication due to shoulder dystocia to consult an attorney.