Shoulder dystocia happens when a baby’s shoulder becomes stuck behind the mother’s pelvic bone during delivery. While it can occur without warning, many cases involve risk factors and labor signals that a trained delivery team should recognize and respond to quickly.
Childbirth is unpredictable, but it’s rarely without warning signs. Risk factors often appear well before delivery, and labor itself can send clear signals that something isn’t progressing as it should.
When a delivery team notices and responds to those signals, most complications can be managed safely. When those signs are missed or ignored, a manageable situation might turn into a lifelong injury. Let’s talk through the normal procedure so you can make sure your family is taken care of.
What Is Shoulder Dystocia?
This complication is when a baby’s head delivers normally, but one or both shoulders become lodged behind the mother’s pelvic bone. It’s considered an obstetric emergency because every second matters once the head is out. Here’s what’s important to understand about this situation:
- Gentle downward traction fails to deliver the shoulders
- Oxygen to the baby can become compromised the longer delivery is delayed
- Resolving the issue requires specific, coordinated maneuvers, not added force
Prenatal Risk Factors the Care Team Should Identify
Doctors and nurses know signs that can signal a higher chance of complications and shoulder dystocia. Recognizing these factors ahead of time allows the care team to plan appropriately and discuss delivery options with the mother.
Baby-related factors can include:
- Suspected fetal macrosomia (a larger-than-average baby) seen on ultrasound or physical exam
- Post-term pregnancy, meaning the baby is born after 42 weeks
Mother-related factors can include:
- Gestational or pre-existing diabetes
- Maternal obesity or significant weight gain during pregnancy
- A history of this complication in a previous delivery
When these risk factors are present, they should prompt a conversation about delivery options, including whether a cesarean section may be safer than a vaginal delivery.
Warning Signs During Labor and Delivery
Labor itself also often provides clues that a complication may be developing. An attentive delivery team should be watching for:
- A prolonged second stage of labor, or a stall in the baby’s descent
- The need for vacuum or forceps assistance when the baby is already suspected to be large
- The “turtle sign,” where the baby’s head delivers and then pulls back tightly against the mother’s body
- The baby’s head failing to rotate naturally after it emerges
How a Delivery Team Should Respond
When the warning signs of shoulder dystocia appear, a well-trained team should act quickly and deliberately.
Call for Help Immediately
This means bringing in additional support right away, including another obstetrician, anesthesia, pediatrics, and extra nursing staff.
Use Recognized Maneuvers in Sequence
Proven techniques, like the McRoberts maneuver, suprapubic pressure, delivery of the posterior arm, and rotational maneuvers, are designed to safely reposition the baby.
Avoid Harmful Actions
The entire care team should avoid excessive pulling on the baby’s head and fundal pressure (pushing on the top of the uterus).
Document Everything Accurately
Careful notes on timing, which maneuvers were used, and who performed them are essential for both safety and accountability.
Injuries That Can Result When Warning Signs Are Missed
When this complication isn’t handled correctly, the consequences can be serious and sometimes lifelong. There may be one or multiple of the following injuries:
- Brachial plexus injuries, including Erb’s palsy
- A fractured clavicle or humerus
- Oxygen deprivation that can lead to brain injury or cerebral palsy
- Maternal injuries, such as severe tearing or postpartum hemorrhage
When Shoulder Dystocia Becomes Medical Malpractice
It’s important to understand that this complication itself is not always a sign of negligence. Medical malpractice refers to when the delivery team doesn’t respond in the best way they can. Common failures include:
- Not recognizing or acting on known risk factors
- Failing to offer a cesarean section when the risk was clearly elevated
- Using excessive traction or improper maneuvers during delivery
- A delayed response or a lack of trained staff in the delivery room
Medical records and fetal monitoring strips will almost always tell the real story of what happened during delivery, which is why reviewing them closely matters so much.
Shoulder Dystocia Claims in Utah
If you suspect that your care team missed warning signs or incorrectly handled your delivery, you may have the grounds for a medical malpractice claim. Utah law requires a prelitigation review before a medical malpractice suit can be filed, which adds a necessary but time-sensitive step to the process. Statute of limitations rules also apply to birth injury claims; you’ll need to act quickly.
Because these cases are medically complex, a thorough expert review by obstetric specialists is essential to evaluate whether the standard of care was met.
Frequently Asked Questions
Q: How common is shoulder dystocia?
A: It occurs in a small percentage of vaginal births, around 1%, but the risk rises significantly when certain factors, like a larger baby or maternal diabetes, are present.
Q: Can shoulder dystocia be prevented?
A: Not always, but many cases can be anticipated ahead of time, and with proper handling, the resulting injury can often be avoided.
Q: Will my child’s brachial plexus injury heal on its own?
A: Some mild cases improve over time, but others result in permanent weakness and require ongoing therapy or even surgery.
Q: What records should I request after a difficult delivery?
A: Ask for the full labor and delivery records, fetal monitoring strips, and the delivery note describing which maneuvers were used.
Q: How much does it cost to talk to a birth injury lawyer?
A: Consultations are free, and attorneys typically work on contingency, meaning you pay no legal fee unless your case recovers compensation.
Get Answers About Your Delivery
If your delivery didn’t go as expected and you’re left with questions, you deserve clear answers from someone who understands the medical and legal details involved.
The attorneys at G. Eric Nielson & Associates have spent over 30 years focused exclusively on medical malpractice cases, including birth injuries, and we know how to evaluate whether warning signs were missed. Contact us today to review your delivery records and find out whether the warning signs in your case were missed.