In the typical birth of an infant, the baby arrives head first, followed by the shoulders and the rest of the body. However, in certain circumstances, the head delivers but the shoulders cannot fit through easily. This is called “shoulder dystocia” and can be an obstetrical emergency. The umbilical cord may be compressed inside the birth canal which can have grave consequences for the baby if this situation is not quickly remedied.
One risk factor for shoulder dystocia is macrosomia or large size of the baby. There are several well-recognized risk factors for this. Maternal obesity may play a role. Moms with diabetes also have a higher incidence of having large babies. In order to help minimize the incidence of these conditions, special attention should be paid to mothers with these risk factors during prenatal care. Diabetes screening and management should be carefully monitored. Sonograms and fetal measurements can help with estimates of the baby’s weight. If shoulder dystocia develops during labor, there are special steps that can be taken at that critical time to try to deliver the baby in the least traumatic fashion.
Sometimes nerve injuries can occur in infants who have suffered shoulder dystocia, one such unfortunate condition is called “Erb’s palsy.” In this condition, the baby has paralysis of the arm and/or hand due to nerve damage to the brachial plexus of nerves. While some infants may improve or recover without additional treatment, many may need special procedures and even surgery to recover some function.
Medical malpractice can arise in situations where the mother has not been properly screened for gestational diabetes, or the diabetes was not properly managed. There are situations where test results may have indicated an excessively large baby but a C-Section was not done or offered. Also, the proper precautions or techniques may not have been used during labor with shoulder dystocia and nerve damage or Erb’s palsy may have resulted.