Shoulder Dystocia
Definition
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
-
Paralysis
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
Causes
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.
Risk Factors
Things that may increase a baby's chance of shoulder dystocia include:
- Mother has diabetes
- Mother is significantly overweight
- Mother has small stature which may mean small pelvis
- A very large baby
- Shoulder dystocia in previous birth
Signs and Symptoms
There are no symptoms of shoulder dystocia.
Diagnosis
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.
Treatment
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.
Prevention
Shoulder dystocia cannot always be prevented. If you have a high risk of shoulder dystocia the doctor may offer:
- Early induced labor—the baby will be smaller
- Planned C-section
Resources
American Congress of Obstetricians and Gynecologists
http://www.acog.org
American Pregnancy Association
http://www.americanpregnancy.org
Canadian Resources
Pregnancy Info—The Society of Obstetricians and
Gynaecologists of Canada
http://www.pregnancyinfo.ca
Women's Health Matters
http://www.womenshealthmatters.ca
References
Menticoglou, S. Shoulder dystocia: incidence, mechanisms,
and management strategies. Int J Womens Health, 2018; 10: 723-732.
Shoulder dystocia. EBSCO DynaMed website. Available
at:https://www.dynamed.com/condition/shoulder-dystocia . Accessed March 21,
2022.
World Health Organization. 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%5Feng.pdf. Accessed March
21, 2022.