Shoulder dystocia is a birth injury where one or both shoulders of a newborn baby become stuck behind the mother’s pubic bone during delivery. Although the type of traumatic birth injury caused by shoulder dystocia generally takes between 6 and 12 months to heal, some injuries may turn into a permanent disability.
Birth injury attorneys work with families whose children were delivered with traumatic birth injuries and can help you if you believe that those injuries were the result of substandard medical care. Call 1-800-222-9529 to connect with an attorney in your state.
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Infant Shoulder Dystocia Lawsuits & Injury Cases
In order to bring an infant shoulder dystocia lawsuit, the plaintiff must prove medical malpractice occurred during childbirth. This will require the plaintiff to establish the standard of care was not met, that negligence occurred, and that recoverable damages were suffered as a result. These lawsuits must also be filed within the statute of limitations, which varies from state to state.
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Infant Shoulder Dystocia Types
Following deliveries that involved shoulder dystocia, approximately 20 percent of affected babies will suffer a temporary or permanent injury. Shoulder dystocia occurs in about 1 of every 200 births. The most common injury is damage to the brachial plexus nerves, bone fractures, contusions and lacerations, birth asphyxia, and fractured clavicles.
The two types of brachial plexus injuries are Erb’s palsy and Klumpke palsy. Erb’s palsy is paralysis of the arm caused by an injury to the group of the arm’s main nerves which form part of the brachial plexus. This can cause arm weakness and loss of movement. Klumpke palsy is a neuropathy that involves an injury to the nerves of the brachial plexus that affect the lower arm and hand.
Infant Shoulder Dystocia Causes
Shoulder dystocia is a complication that can happen during a baby’s birth if the baby’s shoulders are stuck in the mother’s pelvic area after the head has already come out. One reason for this may be that the baby is too big for the birth canal, called CPD or cephalopelvic disorder. Another cause may be if the baby is born face first and the physician pulls the baby out during delivery by the face, which causes stress on the baby’s neck. If a baby is born feet first, this can also create stress on the shoulder and neck area.
There are risk factors associated with the birth of an infant with shoulder dystocia, including:
- Maternal gestational diabetes
- Maternal obesity
- Use of an epidural
- Labor that was induced
- Prior deliveries complicated by shoulder dystocia
- A late labor and delivery
- Pregnancy with more than one baby
- A newborn baby that is significantly larger than average (also known as fetal macrosomia)
Infant Shoulder Dystocia Symptoms
Physicians can identify shoulder dystocia when they notice that the baby’s head is out of the birth canal, but the rest of the body isn’t able to be delivered.
If your baby sustained an injury after delivery due to shoulder dystocia, he or she may be experiencing nerve damage. You may also notice that the baby’s hand seems claw-like and there may be some paralysis of the affected limb.
Infant Shoulder Dystocia Diagnosis and Treatment
If the doctor who is delivering the baby sees that although the head is out of the birth canal, the body is not following and seems stuck, they should take specific actions to make the delivery easier and will diagnose shoulder dystocia. Long-term complications can occur in these births, including:
- The mother experiencing excessive bleeding during the delivery.
- The mother experiencing tearing of the cervix, rectum, uterus, or vagina.
- A loss of oxygen to the baby’s brain, which can result in brain damage.
- Injuries to the baby’s shoulders, arms, and hands.
If shoulder dystocia is suspected during delivery, the physician may:
- Ask for help from other medical staff
- Recommend an episiotomy, which is an incision in the perineum between the anus and the vagina
- Ask the mother to pull her legs up toward her stomach to flatten her pelvis
- Put pressure on an area of the mother’s pelvis to help your baby’s shoulders to rotate
- Rotate the baby internally
- Free one of the baby’s arms from the birth canal
- Suggest that the mother gets on her hands and knees to make the delivery easier
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Infant Shoulder Dystocia Frequently Asked Questions
How Do I Know If My Baby Has Infant Shoulder Dystocia?
If the baby’s shoulder becomes stuck behind the mother’s pelvis, the nerves in the baby’s head can become stretched, resulting in a brachial plexus injury. This can cause the baby’s arm to be paralyzed. In many cases, this is temporary and resolves within a few hours or days. In a small number of cases, the injury can be permanent. If the baby has pain or redness in their arms or hands, a fracture may have occurred.
If your baby misses their developmental milestones, has bruising, difficulty breathing or eating, drools excessively, seems to favor one side of their body, or has any behavior that seems out of the ordinary, they may have suffered birth injuries. If a baby did not get enough oxygen during delivery, also known as severe asphyxia, they may have some degree of brain damage.
Can Infant Shoulder Dystocia Be Fatal?
If the shoulder dystocia takes more than five minutes to resolve, some babies will need resuscitation. If the baby is not getting enough oxygen, also known as severe asphyxia, they may have some degree of brain damage. Without enough oxygen, the baby will die.
Who Is Liable for Infant Shoulder Dystocia?
Doctors, hospitals, and other healthcare providers are responsible for providing a safe environment for both the mother and the child during labor and delivery. Some birth injuries and deaths may result from medical negligence or medical malpractice. Your attorney will demonstrate that the healthcare team was negligent during labor and delivery and that the negligence resulted in infant shoulder dystocia.
What Is the Statute of Limitations for Infant Shoulder Dystocia?
The time period in which you can file your birth injury claim, or statute of limitations, for infant shoulder dystocia varies from state to state. The wrongful death statute of limitations also varies from state to state. The statute may be tolled, or paused, but this varies from state to state. Speak with a lawyer familiar with the laws in your state to learn more.
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Infant Shoulder Dystocia Glossary Terms
What Is Fetal Macrosomia?
Fetal macrosomia describes a newborn that is significantly larger than the average. Generally, the baby will weigh more than 8 pounds, 13 ounces at birth. Genetics may be responsible for a larger than average (LGA) baby but a larger baby can also stem from how much weight a mother gains during her pregnancy. If the mother has gestational maternal diabetes, the baby may be bigger than average.
What Is Maternal Diabetes Mellitus?
Maternal diabetes mellitus is a condition where a hormone made by the placenta prevents the body from using insulin effectively which causes glucose to build up in the blood. Approximately 3 to 8 percent of all pregnant women in the U.S. are diagnosed with diabetes mellitus during pregnancy.
What Is Suprapubic Pressure?
Suprapubic pressure is a technique that a doctor may use when delivering a baby with shoulder dystocia which involves putting pressure on the baby’s shoulder in a direction intended to facilitate the birth.
Call 1-800-222-9529 for Help With an Infant Shoulder Dystocia Lawsuit
If you think that your child may have been injured during their delivery, call the Birth Injury Lawyers Group at 1-800-222-9529 to connect with an attorney practicing in your state. No matter the circumstances of your case, your lawyer will fight for you to make sure you receive the compensation you deserve for your child.
Infant Shoulder Dystocia News
Washington Doctor Sued For Using Wrong Techniques For Shoulder Dystocia
A Washington doctor is going to trial for accusations of causing a brachial plexus injury while delivering a baby. Yaktrinews.com reported on the matter.
The lawsuit claims that Dr. Kevin Harrington failed to adjust his method of delivery when he noticed a baby was at risk for shoulder dystocia. The birth happened in 2013 and parents filed suit in 2015 claiming that permanent damage to their baby’s brachial plexus happened due to the doctor’s methods.
The suit claims that Dr. Harrington should have offered a cesarean section, however, after she went into labor, he “negligently proceeded with a vaginal delivery” and failed to tell the mother of the risks of delivering a baby vaginally at risk for shoulder dystocia.
It also claims that had she known of the risks she would have asked for a C-section. The doctor pulled too hard on the baby’s head and neck to free his stuck shoulders from the cervix. This is what lead to the injury.
The baby has had limited use of his left shoulder and elbow, despite surgeries and other medical treatments. There is also an allegation that this doctor has caused the same kind of injury in three other children.
The doctor and his practice have denied all of the accusations.
Lost Hospital Notes Cause Doctors To Ignore Shoulder Dystocia History
If a baby experiences shoulder dystocia during birth, the odds are good that any future children from that mother will experience the same issue. Doctors can take steps to prepare for it.
However, that did not happen to one mother in England. She just won a £5.8m payout for the hospital’s negligence. BBC reports.
When the woman had her second child, it became stuck due to shoulder dystocia, a condition that happens when the baby’s shoulder gets stuck on the pelvis of the mother. This happened with her first child too, but doctors were able to free the child unharmed. That did not happen with the second child.
The child couldn’t breathe and suffered disability due to oxygen starvation. He has cerebral palsy and cannot talk or use the bathroom six years after his birth. Walking is also difficult.
Why did it happen? The hospital did not have notes on the previous birth and the mother was not warned of any risks that her second child could experience the same issue.
The hospital has apologized and said they have taken steps to prevent a similar case in the future. In addition to the lump payment, he will also receive ongoing payments throughout his life for his medical needs.
If you ever feel that your doctors are ignoring your medical history, speak up. You could be saving your life or the life of your baby.
Mother Wins $9 Million Judgment In Shoulder Dystocia Case After Midwife Ignored Complaints
Shoulder dystocia is a condition that only happens in 0.2-0.3% of pregnancies. What happens is that the baby’s shoulders get stuck against the mother’s pelvis during delivery. This can cause a number of side effects to both the baby and the mother that require serious treatment.
One of the major risk factors for shoulder dystocia is if your baby is too large before birth. If doctors detect this, they may advise that you undergo a C-section to avoid the possibility of trauma. But sometimes this warning doesn’t come fast enough or isn’t given at all. That’s what happened to one Minnesota mother.
A jury awarded $8.9 million dollars to a mother in Minnesota according to the Star Tribune. According to the suit, an Allina Health nurse-midwife ignored concerns about the size of the baby. The baby was born with a broken right arm and severe nerve damage. The mother had been pregnant before and told the nurse-midwife that her son felt larger than her previous child. But the nurse-midwife said that the boy would weigh around six pounds. The average birth weight in the U.S. is 7.7 pounds.
When the 10.5-pound boy was delivered, shoulder dystocia occurred. The suit claimed that the midwife “grasped the baby’s head with excessive force” to free the child. The doctor had to step in and make an incision to complete the birth. The child required intensive care to repair function to the arm, but complications remain.
The hospital plans to appeal the case and the family has agreed to mediate a settlement.
Shoulder Dystocia Maneuvers
Shoulder dystocia is a condition that happens during birth when the baby’s shoulder gets stuck on the mother’s pelvis. Fixing this position can lead to birth injuries like Erb’s palsy, but it can be necessary to save the life of the child. Business Insider discussed some of the things doctors can do to free a stuck baby.
First, if the risk factors for it are too high, doctors may recommend a C-section instead of a vaginal birth. C-sections have their own issues, but it can be the safest method depending on the circumstances.
If shoulder dystocia happens during birth, there are several things doctor’s can try. The first is an episiotomy, which is an incision in the pelvic muscle. This creates more space for the child, but can cause side effects for the mother after birth.
McRobert’s maneuver involves grasping the legs of the mother and pushing them back against the abdomen to create space and pressure. Doctors can also provide pressure externally on the pubic bone to push on the shoulder.
Another maneuver, the corkscrew maneuver, involves reaching up into the vagina and rotating the baby’s shoulder. If done incorrectly, this can stretch the brachial nerves and cause Erb’s palsy.
The last-resort maneuver is the Zavanelli maneuver. It is literally pushing the baby by the head back into the womb and performing a C-section as soon as possible.
Any of the treatments involving pressure can cause bone fractures, possible brain damage, or injuries to the brachial nerves. Fortunately, shoulder dystocia is quite rare.
Antidepressant Usage May Lead To Shoulder Dystocia In Babies
A new study performed in Quebec found a strong link between antidepressant usage and gestational diabetes, one of the risk factors for shoulder dystocia in babies. Sky Statement has the story.
The researchers looked at every birth in Quebec between 1998 and 2015. The study found that mothers who took antidepressants during pregnancy had a 19% greater likelihood of gestational diabetes. This was an observational study.
One of the side effects of gestational diabetes is increased birth weight. If a baby gets too large, their shoulder or limbs could get trapped during labor. The pressure from birth or the impact of a doctor’s intervention can cause conditions like shoulder dystocia.
Two drugs in particular caused a spike in gestational diabetes. Elavil caused a 52% increase in risk. Efexor XL caused a 27% increased risk. However, common SSRIs like Prozac did not cause a risk. Furthermore, the researchers stated that severely depressed pregnant women on these drugs should continue taking them because of the dangers of stopping.
The speculated reason for why these drugs cause weight gain is that they control serotonin. Serotonin is involved in the processing of sugar in the body. An absence of serotonin can affect insulin levels and cause diabetes.
While most cases of gestational diabetes clear up soon after birth, during pregnancy women should eat a healthy diet and stay active to counter the effects. Fetal weight should also be monitored so doctors can be ready if a baby grows too large.
Girl With Shoulder Dystocia Awarded Settlement
Sometimes the full reality of a birth injury doesn’t appear until later in life. What may seem minor and recoverable at first might not turn out that way. In some cases, families can still seek compensation well after birth once the full problem becomes apparent.
One case in Ireland proves this. The Irish Times reports on a settlement over a case of shoulder dystocia. She was granted €425,000 (~$464,700.)
The girl, who is now 14, had difficulty riding a bicycle and carrying a backpack due to her shoulder injury. She also lost the ability to play sports. Along with the shoulder dystocia, she also was diagnosed with Erb’s Palsy after her birth. The suit claimed that the pregnancy was managed poorly and that the most experienced obstetrician on staff wasn’t consulted when the shoulder dystocia was suspected.
A further claim that the child should have been delivered by C-section was denied. But the court agreed that the child was unable to participate in sports and that it was the result of the injuries sustained.
Note that due to differences in the statute of limitations, you may not be able to sue for a past birth injury if too much time has passed. It all depends on the circumstances. If you feel like you deserve compensation for a birth injury, speak with a birth injury lawyer about the matter so you can learn the facts for your jurisdiction.
Episiotomies Are Still Happening, Sometimes Without Consent
The New York Times reported on the current state of a procedure called episiotomy. It is an incision made between the vagina and the anus to help control vaginal tearing during birth. It used to be a common procedure, but now it’s use isn’t recommended. Yet it is still common in some hospitals to make the “snip”, sometimes without the mother’s consent.
Large babies and long labor times put too much pressure on the vagina and can cause it to tear. These tears take a long time to heal and can become infected. The theory behind the procedure is that if you pre-tear the tissue with a clean incision, you can reduce the chances of additional tearing and have a faster delivery.
If a baby is experiencing shoulder dystocia or is stuck in the canal, this can save a baby’s life. One of the danger signs during birth is a dropping fetal heart rate. If doctors detect this, they may perform the procedure to hasten the baby’s delivery and save its life.
However, some doctors still do the procedure as a matter of course, despite the dangers and long recovery time. A study in the Journal of Reproductive Medicine found that older obstetricians are more likely to make the cut than ones with later training. Considering that this procedure used to be done in over 60% of births in the U.S., that’s not surprising. Today, the rate is about 8%.
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