Erb’s Palsy and Shoulder Dystocia

Shoulder dystocia is a condition in which the baby’s shoulder becomes “stuck” on the mother’s pelvic bone during birth. Shoulder dystocia is treatable, but sometimes the delivering obstetrician uses an improper technique, damaging the brachial plexus and injuring the nerves that control the shoulder, arm, elbow, forearm, wrist and hand.

Shoulder dystocia is difficult to predict. Although many factors are correlated with an increased likelihood of shoulder dystocia — such as fetal macrosomia (a pre-birth weight of 9 pounds or over), maternal diabetes or obesity, gestation beyond 40 weeks, and a platypelliod or otherwise unusually shaped pelvis in the mother — the majority of women with those conditions deliver without shoulder dystocia. Usually, shoulder dystocia is caused not by a condition in the mother, but by the practical aspects of delivery. If the baby is in an unusual orientation during delivery, then, regardless of their size and regardless of the mother’s condition, their shoulder can become stuck on the pelvic bone.

Doctors, nurses and midwifes often can’t tell if a baby will develop shoulder dystocia before it happens. Once it happens, however,  doctors and midwives are trained to deal with it through a variety of methods, including by:

  • performing an episiotomy, in which a small incision is made to make more room for the baby;
  • the McRobert’s maneuver, in which the mother’s legs are flexed closely to her abdomen;
  • exerting pressure on the pubic bone;
  • intentionally breaking the newborn’s clavicle bone; or,
  • using  forceps or a vacuum to pull the child out.

The are two common types of medical malpractice that happen while treating shoulder dystocia.

Sometimes, the shoulder dystocia isn’t recognized and treated quickly enough, leading to hypoxia, oxygen deprivation, fetal distress, and brain damage.

Other times, the shoulder dystocia is treated with too much force or an improper technique, which can breaking the baby’s neck, injure the baby’s spinal cord, or, more commonly, damaging the brachial plexus and causing the nerve injuries that lead to Erb’s Palsy.

Thus, in a birth injury lawsuit alleging malpractice relating to shoulder dystocia, the case will often be decided by reviewing how quickly the hospital acted and if the delivering doctor used their technique correctly.

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