Shoulder Dystocia Lawyer in Houston

What Is Shoulder Dystocia?

Shoulder dystocia occurs when one or both baby’s shoulders get stuck inside the mother’s pelvis during birth. It is a type of brachial plexus injury. Generally, most babies are born safely, even if their shoulders get stuck. Still, this type of birth trauma can cause serious issues for both mom and baby.

There are generally two forms of shoulder dystocia: posterior fetal shoulder dystocia and anterior fetal shoulder dystocia. Posterior and anterior shoulder dystocia are terms used to describe how the baby was positioned when the injury occurred.

How Common is Shoulder Dystocia?

Shoulder dystocia is fairly rare and only happens in 0.2-3% of pregnancies. Shoulder dystocia death is also very uncommon, happening in approximately 0.4% of birth traumas. According to data from Johns Hopkins Medicine, brachial plexus injuries, such as shoulder dystocia, only occur in 1 or 2 per 1,000 live births.

What Are the Risk Factors Associated with Shoulder Dystocia?

Shoulder dystocia can happen to any mother and baby. However, some women are more at risk for this type of birth trauma than others. A doctor must assess each vaginal delivery and determine if there is a risk of brachial plexus injuries or other birth injuries.

If there is any indication that the baby’s shoulder has gotten stuck before exiting the mother’s pubic bone, the doctor must address it immediately. Certain risk factors can increase the risk of brachial plexus injuries.

The most common risk factors associated with shoulder dystocia include:

• Macrosomia: This occurs when a baby weighs more than 8 pounds, 13 ounces. However, most vaginally born babies with macrosomia don’t have shoulder dystocia. This is because most cases of this type of birth trauma are associated with babies of normal weight. Still, macrosomia can raise risks, as mothers will have more trouble pushing larger babies.
• Diabetes: Having preexisting diabetes or gestational diabetes is also a risk factor for shoulder dystocia.
• Previous Shoulder Dystocia Injuries: having a child with shoulder dystocia in a previous pregnancy can raise your chances of having this kind of birth trauma in a later pregnancy.
• Carrying twins, triplets, or other multiples raises your chances of shoulder dystocia.
• Being overweight or gaining too much weight during pregnancy is another risk factor.

Labor Specific Conditions

Conditions that are specific to labor and birth can also raise your risk of shoulder dystocia.

These conditions include:

• Receiving oxytocin to induce labor can raise your risks of shoulder dystocia.
• Getting an epidural to reduce pain during labor can also raise the risk of shoulder dystocia.
• Having a very short or very long second stage of labor. This is the part of labor where a woman starts pushing to give birth.
• An assisted vaginal birth, also called an operative vaginal birth, can raise your chances of shoulder dystocia. In an assisted vaginal birth, a doctor will use tools such as forceps or a vacuum to pull a baby through the birth canal. With forceps, the doctor will put them around the baby’s head to guide it out of the vaginal canal. Meanwhile, a vacuum is a suction cup that goes around the baby’s head to guide it out of the vaginal canal.

Shoulder Dystocia Symptoms

The most common symptoms of shoulder dystocia include:

• When the baby’s shoulders don’t descend
• Difficulty in face and chin delivery
• Retracting difficulties
• Fetal head restitution failure
• Downward traction on the fetal head

What Are the Postpartum Side Effects of Shoulder Dystocia?

Most moms and babies fully recover from shoulder dystocia, but here are the most common problems they may face after this type of birth trauma.

Shoulder Dystocia Complications for Baby

• Collarbone and arm fractures are a common result of shoulder dystocia.
• Brachial plexus nerve damage, also known as Erb’s palsy. These nerves extend from the spinal cord in the neck and down the arm.
• Asphyxia is also known as a lack of oxygen in the body. In severe cases, this can cause injury or shoulder dystocia death. But asphyxia is very rare.
• Pneumothorax is a collection of gas between the chest wall and the lungs.

Shoulder Dystocia Complications for the Mother

• Postpartum hemorrhage, which is heavy bleeding after birth.
• Severe tearing of the perineum, which is the stretch of skin between the vagina and the rectum.
• Uterine or bladder rupture is a rare condition when the uterus or bladder tears during labor.
• Cervical tears, which is when the cervix tears during birth.
• Dislocation of the sacroiliac joint, which happens when both the anterior and the posterior columns of the pelvic ring are disrupted. When this happens, the hemipelvis rotates internally with vertical displacement.
• Symphyseal separation is the excessive movement of a part of the pelvis called the pubic symphysis.

How to Prevent Shoulder Dystocia

If your doctor thinks you may be at risk for shoulder dystocia, they can try several methods to move you and your baby into a better position during labor. Your doctor might try:

• The McRoberts maneuver, which is when you press your thighs against your belly.
• Suprapubic pressure, which is when your doctor presses on your lower belly above your pubic bone.
• Helping your baby’s arm out of the birth canal.
• Reaching into the vagina to attempt to turn the baby.
• Turning a mother onto all fours.
• Giving an episiotomy, which is a surgical cut at the vaginal opening during childbirth. This is generally not a routine method. It’s only done when a larger opening would be helpful during birth.
• Performing a Cesarean delivery to prevent the baby’s shoulders from getting stuck in the pelvis.

Treatment for Postpartum Shoulder Dystocia Side Effects

If shoulder dystocia isn’t resolved during labor, both mother and baby can suffer painful postpartum side effects. It is considered a medical emergency that must be addressed immediately. Without swift intervention, the mother and baby could both suffer injuries.

Treatment for the Baby

Because there are many possible side effects from shoulder dystocia, there are dozens of treatments available for mother and baby.