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Birth Injuries and Shoulder Dystocia

Shoulder dystocia is a dangerous condition that can occur during delivery.  For more information on shoulder dystocia, please see the following information from the American Family Physician Website:

"Shoulder dystocia can be one of the most frightening emergencies in the delivery room. Although many factors have been associated with shoulder dystocia, most cases occur with no warning. Calm and effective management of this emergency is possible with recognition of the impaction and institution of specified maneuvers, such as the McRoberts maneuver, suprapubic pressure, internal rotation, or removal of the posterior arm, to relieve the impacted shoulder and allow for spontaneous delivery of the infant. The "HELPERR" mnemonic from the Advanced Life Support in Obstetrics course can be a useful tool for addressing this emergency. Although no ideal manipulation or treatment exists, all maneuvers in the HELPERR mnemonic aid physicians in completing one of three actions: enlarging the maternal pelvis through cephalad rotation of the symphysis and flattening of the sacrum; collapsing the fetal shoulder width; or altering the orientation of the longitudinal axis of the fetus to the plane of the obstruction. In rare cases in which these interventions are unsuccessful, additional management options, such as intentional clavicle fracture, symphysiotomy, and the Zavanelli maneuver, are described. (Am Fam Physician 2004;69:1707-14. Copyright© 2004 American Academy of Family Physicians.)

Shoulder dystocia is one of the most anxiety-provoking emergencies encountered by physicians practicing maternity care. Typically defined as a delivery in which additional maneuvers are required to deliver the fetus after normal gentle downward traction has failed, shoulder dystocia occurs when the fetal anterior shoulder impacts against the maternal symphysis following delivery of the vertex. Less commonly, shoulder dystocia results from impaction of the posterior shoulder on the sacral promontory.

The overall incidence of shoulder dystocia varies based on fetal weight, occurring in 0.6 to 1.4 percent of all infants with a birth weight of 2,500 g (5 lb, 8 oz) to 4,000 g (8 lb, 13 oz), increasing to a rate of 5 to 9 percent among fetuses weighing 4,000 to 4,500 g (9 lb, 14 oz) born to mothers without diabetes. Shoulder dystocia occurs with equal frequency in primigravid and multigravid women, although it is more common in infants born to women with diabetes. Several additional prenatal and intrapartum factors have been associated with an increased incidence of shoulder dystocia. The single most common risk factor for shoulder dystocia is the use of a vacuum extractor or forceps during delivery. However, most cases occur in fetuses of normal birth weight and are unanticipated, limiting the clinical usefulness of risk-factor identification."

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Unfortunately, shoulder dystocia is often the result of medical malpractice.  The law firm of Gray and White Law repesents victims of medical malpractice, including birth-related injuries.  If your family has been the victim of a birth-related injury, such as Kernicterus, please contact, or email, the experienced attorneys of Gray and White Law for your free consultation.

Gray and White Law

The Speed Mansion

505 West Ormsby Avenue

Louisville, Kentucky 40203

Tel: (502) 637-6000

Toll-Free: (800) 637-6033

Fax: (502) 637-1413

email: mwhite@grayandwhitelaw.com

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