Shoulder Dystocia
Who is this information for? 🤔
This information is for you if you wish to know about shoulder dystocia. You may also find it helpful if the birth of your baby was complicated by shoulder dystocia. It may be helpful if you are a partner, relative, or friend of someone who has been in this situation. source is RCOG
What is shoulder dystocia? 🏥
Shoulder dystocia is when the baby’s head has been born but one of the shoulders becomes stuck behind the mother’s pubic bone, delaying the birth of the baby’s body (see figure below). If this happens, extra help is usually needed to release the baby’s shoulder. In the majority of cases, the baby will be born promptly and safely. 👶
How common is shoulder dystocia? 📊
Shoulder dystocia occurs in about one in 150 (0.7%) vaginal births.
Can shoulder dystocia be predicted? 🔎
Shoulder dystocia usually occurs unexpectedly during childbirth, and most of the time, it is not possible to predict when it will happen. However, it is more likely to occur if:
You have had shoulder dystocia before 🤱
You have diabetes 🍬
Your body mass index (BMI) is 30 or more ⚖️
Your labour is induced 🏥
You have a long labour ⏳
You have an assisted vaginal birth (forceps or ventouse) 🛠️
Can shoulder dystocia be prevented? ❓
In most instances, shoulder dystocia cannot be prevented because it cannot be predicted. If you have diabetes or have developed diabetes in pregnancy, you will usually be offered early induction of labour or planned caesarean section. This will reduce the risk of shoulder dystocia.
What happens if shoulder dystocia occurs? 🚨
Your midwife and obstetrician will be aware that in every birth, there is a possibility of shoulder dystocia. Shoulder dystocia is an emergency, and therefore, when it does occur, speed is of the essence. The baby’s shoulder needs to be released quickly so that the baby’s body can be born and he or she can start breathing air into the lungs. 🏥
What could shoulder dystocia mean for me and my baby? 🤱👶
For Me 💪
Vaginal tears are more common after shoulder dystocia and may extend to the back passage (see RCOG patient information: A Third- or Fourth-degree Tear During Childbirth). Heavier bleeding than normal after birth (postpartum haemorrhage) is also more common, and you may require additional treatment and/or a blood transfusion. 💉
For My Baby 🍼
About one in ten (10%) babies who have shoulder dystocia will have some stretching of the nerves in the neck (see figure on page 1), called brachial plexus injury (BPI), which may cause loss of movement to the arm. The most common type of BPI is called Erb’s palsy. It is usually temporary, and movement will return within hours or days. Permanent damage is rare. 🤲
What about future deliveries? 🤰
If your baby’s birth was complicated by shoulder dystocia, there is an increased risk of shoulder dystocia in future pregnancies; around one in ten women will have shoulder dystocia again in a future pregnancy. In view of this, your obstetrician or midwife will discuss your options for next time, taking into account your individual circumstances and preferences. 🏥
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