Shoulder Dystocia Lawyers in Pittsburgh, PA | Edgar Snyder

Shoulder Dystocia

The birth process is complicated and sometimes unpredictable, not always going as planned. Though the vast majority of births occur without injury to the mother or baby, there are still instances when something goes "wrong," and the consequences can be tragic.

Healthcare providers have a responsibility to closely monitor the labor and delivery process, making on-the-spot decisions about what is best for their patients. Shoulder dystocia is one of the conditions that, if not handled properly, can lead to serious complications for both the mother and child.

If you think that you could have a birth injury malpractice case for shoulder dystocia, you should contact a shoulder dystocia lawyer right away. There are important deadlines called statutes of limitations that have to be met. We are available for free legal consultations 24/7 at 1-866-943-3427.

What is Shoulder Dystocia in a Newborn?

Newborn shoulder dystocia occurs when the baby's head passes through the mother's pelvis but the shoulders become stuck – preventing the birth of the baby's body. A shoulder dystocia birth can occur in any vaginal delivery (and even some Caesarean sections), and is diagnosed when the shoulders aren't delivered shortly after the baby's head.

This condition is considered an obstetric emergency, as it can lead to obstructed and/or prolonged labor and be fatal due to compression of the umbilical cord.

What Are the Causes of Obstructed Labor?

Obstructed labor occurs when the baby doesn't progress through the mother's pelvis even though the uterus is contracting normally.

This lack of progression is caused by a physical factor – either the presenting part of the baby is too large or abnormally positioned, the mother's pelvis is too small, there are problems with the birth canal, etc.

Though it appears as though certain factors such as maternal height and previous difficult labor may increase the likelihood of obstructed labor, they aren't useful screening tools. It is almost impossible to predict obstructed labor until the onset of the labor process, so careful monitoring is essential.

What Are the Causes of Prolonged Labor?

Prolonged labor, also called failure to progress, refers to the amount of time labor takes. It is defined as labor that lasts for 20 hours or more if you are a first-time mother and 14 hours or more if you have previously given birth.

There are a number of different causes of prolonged labor – some of which also result in obstructed labor. These include:

  • Slow effacement (thinning) of the cervix
  • Large fetal size
  • Small maternal pelvis
  • Small birth canal
  • Carrying multiples
  • Weak uterine contractions
  • Incorrect position of the baby
  • Certain pain medications that weaken or slow contractions

Some research has shown that psychological factors such as stress and fear can also prolong labor.

What Are the Risk Factors for Shoulder Dystocia?

There are a few shoulder dystocia risk factors that make the condition more likely to occur:

  • History of shoulder dystocia in a prior delivery
  • Maternal diabetes/impaired glucose tolerance (a false-positive on a glucose screening test)
  • Fetal macrosomia (when the baby's body is disproportionately large compared to its head)
  • A rapid second stage of labor (less than 20 minutes)
  • A prolonged second stage of labor
    • Without regional anesthesia: longer than two hours for first-time mothers, longer than one hour for women who have previously had a child
    • With anesthesia: longer than three hours for first-time mothers, longer than two hours for women who have previously had a child
  • Vaginal delivery that includes vacuum, forceps, or both

Despite these risk factors, shoulder dystocia is generally impossible to predict in individual patients and is diagnosed during delivery.

What is the Cause of Shoulder Dystocia?

Shoulder dystocia occurs for "mechanical" reasons. Some shoulder dystocia causes include:

  • The baby's head being too large or the mother's pelvis too narrow (or both) to allow the baby's shoulders to rotate enough to pass through the pelvis
  • The baby descending feet first, creating stress on the shoulder and neck area
  • The baby descending face first, causing stress on the neck

What Happens When the Baby's Shoulders Get Stuck?

If a baby experiences shoulder dystocia during delivery, there are a few steps that can be taken:

  • The mother may be repositioned in an attempt to widen the birth canal
  • The mother's stomach may be pressed above the pelvic bone to free the shoulder
  • The baby may be moved within the birth canal
  • A healthcare provider may make a cut (episiotomy) to widen the vaginal opening

If none of these techniques work during a shoulder dystocia delivery, an emergency Caesarean section may be performed.

What Are Shoulder Dystocia Complications?

Your healthcare provider should monitor you and your baby carefully, as shoulder dystocia can cause some complications. Shoulder dystocia treatment in newborns depends on the type and severity of injury the baby experiences.

Risks for the Baby

  • In rare cases, babies can experience brain damage if he or she didn't receive enough oxygen during birth.
  • Brachial plexus injury: When the baby's shoulders are stuck, the nerves in the baby's neck – called the brachial plexus – can become stretched. Approximately one in 10 babies who experience shoulder dystocia have brachial plexus injury. It can cause temporary paralysis, and about one in 100 babies who have shoulder dystocia will suffer permanent damage.
  • Fractures to the baby's arm or shoulder

Risks for the Mother

  • Heavy bleeding, also called postpartum hemorrhage, which may require additional treatment and/or a blood transfusion
  • Vaginal tears
  • Emotional trauma

Filing a Shoulder Dystocia Lawsuit

In Pennsylvania, you have a set amount of time – called a statute of limitations – during which you can file a medical malpractice claim. Generally speaking, the statute of limitations is two years from the time the malpractice occurred, though there are some exceptions that extend that deadline.

It's best to reach out to an attorney as soon as you suspect that you or your baby may be a victim of medical malpractice. An experienced attorney will be able to get to work right away, gathering evidence and helping to determine what your options are.

In addition, the faster an attorney can get to work, the faster you will be able to recover a verdict or settlement if your claim is successful. This can go a long way towards helping with any past, current, or future medical costs.

Contacting a Shoulder Dystocia Attorney

Shoulder dystocia birth injury cases can be complex and involve important deadlines, medical experts, and complicated paperwork. If you, or someone you know, had a baby with shoulder dystocia, it's important to have a qualified legal team on your side.

We are available to talk to you 24/7 – there's no reason to handle this on your own. What's more, our legal consultation is totally free and there's never a fee unless we get money for you. 1-866-943-3427.

Sources:

  • "Global burden of obstructed labour in the year 2000." Carmen Dolea and Carla AbouZahr. World Health Organization. July 2003.
  • "Infant Shoulder Dystocia." Birth Injury Guide.
  • "Prolonged Labor: Failure to Progress." American Pregnancy Association. March 24, 2017.
  • "Shoulder Dystocia." Medscape. August 22, 2016.