Shoulder Dystocia, also known as stuck shoulder, occurs during labor and delivery when the baby's shoulder is trapped behind the mother's pubic bone (which is the most common) or when the shoulder becomes trapped in the hollow of the mother's tailbone. Stuck shoulder is present in nearly one half of one percent of all deliveries in the United States. That averages out to nearly twenty thousand women suffering this complication at delivery.
While shoulder dystocia itself is serious, it unfortunately cannot be predicted with any degree of accuracy and also cannot be prevented by any specific strategies or maneuvers during pregnancy. However, this injury is an obstetric emergency requiring immediate action by medical teams in order to avoid serious complications. If the shoulder is unable to be freed up within a few minutes the baby may suffer irreversible brain damage or death.
Complications of shoulder dystocia include Brachial Plexus Injury (BPI) and Erb’s Palsy. These injuries are most often caused when a health care provider uses excessive force during delivery in response to the stuck shoulder.
Brachial Plexus Injury (BPI)
Although most Brachial Plexus Injuries resolve themselves within six months, close to ten percent are permanent and devastating. There are four types of brachial plexus injury:
- Avulsion is the most severe, occurring when the nerve roots are torn from the spine.
- Rupture is the torn nerver, which is still attached to the spine.
- Neuroma is when the nerve tears and heals improperly, causing scar tissue.
- Neuropraxia is the stretching of the nerve, which is painful but the least severe.
Erb’s palsy is an injury of nerves in the arm, which is attached to the nerve group near the neck and shoulders known as the Brachial Plexus. Because Erb’s palsy is an injury caused at birth, signs are visible immediately. However, depending on the extent of the damage to the baby’s nerves, it may not present itself until months later. One way to judge the severity of muscle injury is to perform the Moro reflex test. Newborn babies, when startled, will naturally throw their arms out to the side with palms facing up. In newborns with Erb’s palsy, they will hold the affected arm tight to their bodies, and show little use or movement on that side.
Additional things to look out for after a birth involving shoulder dystocia include:
- A baby that is slow to start and may require assistance with breathing.
- Fractures of the baby's collar bone (clavicle) or humerus.
- Repairs for episiotomy or tearing done during the birth.
- Maternal hemorrhage.
- Uterine rupture.
If you think that you or a loved one have lost a baby or have a baby suffering from complications due to delayed or improper handling of shoulder dystocia, you may have a medical malpractice or medical negligence case. Contact the lawyers at Sweeney Law Firm to help you determine your rights. Remember, there is never a fee unless a recovery is made for you.