(Stuck Shoulder Delivery)
Shoulder dystocia is when the baby's shoulders become stuck during birth. This is an emergency that can cause serious problems.
Most babies will be born safely with some help. Sometimes the baby may be stuck in the birth canal too long. That can cause problems for the baby, such as:
- Lack of oxygen
- Broken arm or collarbone
- Arm nerve damage
It can also cause problems for the mother, such as:
- Tearing or bruising of the cervix, rectum, or vagina
- Bruising to the bladder
- Severe bleeding
The baby's shoulder is lodged behind the mother's pubic bone.
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Shoulder dystocia is caused by:
- Baby’s shoulders are too wide—larger babies are common in women with diabetes or late-term pregnancies
- The pelvic opening is too small for child
One or both could happen during labor.
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Things that may raise a baby's chance of shoulder dystocia include:
- Mother has diabetes or obesity
- Mother has small stature—this may mean a small pelvis
- A very large baby
- Shoulder dystocia in a past birth
Signs and Symptoms
There are no symptoms of shoulder dystocia.
The doctor or midwife will know when the birth process stops after the head is born.
Prenatal tests will estimate the size of the fetus and the pelvis. These tests may show a risk for shoulder dystocia.
An ultrasound may be done before labor. The doctor will be able to see if the baby is too large to fit safely through the birth canal. A vaginal delivery may not be a safe method if the baby is too large.
The goal of treatment is to get the baby unstuck as fast as possible. This will allow the vaginal birth to continue. The doctor or midwife may:
- Reposition the mother
- Reposition the baby to try to move the shoulder away from the bone
A C-section may be needed if the baby remains stuck in the birth canal.
Shoulder dystocia cannot always be prevented. The doctor may offer people with a high risk of shoulder dystocia:
- Early induced labor—the baby will be smaller
- Planned C-section
- Menticoglou, S. Shoulder dystocia: incidence, mechanisms, and management strategies. International Journal of Women's Health, 2018; 10: 723-732.
- Shoulder dystocia. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/shoulder-dystocia.
- Managing complications in pregnancy and childbirth: a guide for midwives and doctors. World Health Organization website. Available at: http://whqlibdoc.who.int/publications/2007/9241545879_eng.pdf.
- Yenigül, A.E., Yenigül, N.N., et al. A retrospective analysis of risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury: a single-center experience. Acta Orthopaedica Traumatologica Turcica, 2020; 54 (6): 609-613.
- Mary-Beth Seymour, RN
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