Shoulder dystocia in a newborn is a complication that occurs during labor, turning the delivery into a medical emergency. Shoulder dystocia refers to when the baby’s head delivers normally, but the shoulders become stuck in the birth canal behind the mother’s pubic bone. Since the shoulders are behind bone, simply performing an episiotomy will not free the baby.
Shoulder dystocia creates an immediate risk to the baby because it often compresses the umbilical cord. This compression can limit blood flow, and thus prevent oxygen from reaching the baby’s organs and brain. If the doctor does not respond quickly, the baby may experience lasting, life-altering brain injuries within about five minutes.
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Large Babies Are Most At-Risk for Shoulder Dystocia
According to a study from the medical journal Obstetrics & Gynecology, between .6% and 1.4% of vaginal births involve shoulder dystocia. There are a few risk factors for shoulder dystocia that the doctor must monitor before and during delivery. If the risk factors are too great, the doctor should consider planning a C-section delivery.
Planning ahead is preferred in any case when there is a good chance that an emergency C-section may be necessary. Planned surgical births are much safer than emergency operations for both the mother and the child.
The risk factors for shoulder dystocia generally center on signs that the mother may struggle to give birth vaginally. They include when the mother:
- The baby has grown larger than expected by the delivery.
- Has an unusually-shaped birth canal or a small pelvis.
- Had a previous vaginal birth that involved shoulder dystocia or required assistance with birth tools.
- Has diabetes or experiences extreme weight gain in pregnancy.
Fetal macrosomia can also increase the risk of shoulder dystocia. This refers to when a baby is larger than average at the time of delivery, making vaginal birth more difficult.
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Recognizing and Treating Shoulder Dystocia
Shoulder dystocia in a newborn requires immediate recognition and quick action from the medical team delivering the baby. As soon as the baby’s shoulders do not deliver, the doctor may call in an anesthesiologist in the event that a C-section becomes necessary. Then, the team will generally attempt the McRoberts’ maneuver. This involves the following steps:
- Breaking down the foot of the bed
- Moving the mother to the end of the bed
- Lifting the mother’s bent legs as close to her chest as possible
- Applying suprapubic pressure to try to free the baby’s shoulder
Doctors often attempt this maneuver first because it is generally safe when done correctly, and it is often effective. The American Journal of Obstetrics & Gynecology published a study suggesting this maneuver was successful in 42% of cases. There are also other maneuvers, including the Jacquemier maneuver and the Letellier maneuver that doctors may try.
Since there are only about five minutes before brain damage may occur, doctors may order an emergency C-section during this time. This requires them to push the baby back into the birth canal to release the pressure on the umbilical cord and deliver the baby surgically.
Even without lasting brain injury, shoulder dystocia can cause other injuries. The likelihood of a baby getting delivered without any type of injury following shoulder dystonia depends on how the doctor in charge responds to the complication. If the doctor can identify the risks of shoulder dystocia in advance, a scheduled C-section is often the best route.
Shoulder Dystonia as Medical Negligence
In some cases, shoulder dystonia and the resulting complications may support a birth injury case. It may constitute medical malpractice if the doctor failed to recognize and diagnose any risk factors for shoulder dystocia before the delivery. Medical malpractice can also apply if the doctor failed to act quickly enough or caused more harm to the baby when shoulder dystocia occurred.
Complications that may occur as a result of shoulder dystocia and further support a birth injury case include:
- Hypoxic brain injuries.
- Cerebral palsy.
- Brachial plexus injuries, such as Erb’s palsy.
You may be able to recover damages to pay for your child’s current and future medical needs and other losses, including:
- Expenses for initial treatment.
- Ongoing care costs.
- Time you have to take away from work.
- Related out-of-pocket expenses.
- Pain and suffering damages.
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A medical malpractice lawyer who pursues birth injury cases in your state can evaluate your child’s injuries and offer legal advice based on the specifics of your claim. From there, a lawyer may help you:
- Understand how quickly you need to act based on the statute of limitations in your state.
- Assign liability in your case based on the evidence available.
- Build your birth injury claim.
- Identify medical experts who can support your claim.
- Pursue compensation based on the cost of your child’s medical treatment and other losses.
You can get help with your legal case today by reaching out to the Birth Injury Lawyers Group. You can speak with a member of our team about your child’s birth injury for free by calling (800) 222-9529.