Shoulder Dystocia

Reviewed by James Brann, MD
Shoulder dystocia occurs sometimes during a vaginal delivery. When it happens, your child’s shoulder becomes stuck behind your pelvic bone as the baby moves through the birth canal and into the vagina. This then leads to the baby becoming stuck in the birth canal.

Shoulder dystocia is considered an emergency, and needs immediate treatment.
Normally, doctors and midwives don’t know that shoulder dystocia is going to happen. However, it’s more likely to occur when a child is larger than normal size. Pregnant women who have diabetes, or those who are overweight, are also more prone to having large babies. If you’ve had should dystocia in a prior pregnancy, it’s also at an increased risk of happening again.

Sometimes shoulder dystocia occurs for an unknown reason. Due to this, there’s no way to always prevent it from happening.

Symptoms

There are no symptoms for the mother. As delivery progresses, your doctor or midwife will notice your baby’s shoulders aren’t coming out of your vagina as they should be after your baby’s head comes out.

Treatment

Immediately after your doctor or midwife notices shoulder dystocia, they’ll tell you to stop pushing. Then, they’ll try different methods to help you deliver. This may include:
  • Reaching into your vagina to help make the baby unstuck
  • Pressing on your belly, pushing down on baby’s shoulders
  • Moving your thighs onto your belly to make more room for baby

Problems

Shoulder dystocia can lead to problems for both baby and mom. The most common for a baby include:
  • Nerve damage - If your baby’s neck stretches too much, the nerves surrounding the shoulder may get damaged. This can make your baby’s arm weak and lead to trouble moving the arm. Doctors may refer to this injury as Erb’s palsy.
  • Broken collarbone or arm
The mother is most at risk of bleeding due to tissue tears around her vagina. If you’ve had a baby with shoulder dystocia in the past and become pregnant again, your doctor will want to talk to you about the chances of it occurring again. They may recommend with your next delivery that you have a C-section.


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