Shoulder dystocia is a delivery that is slow or difficult because one or both of your babyâ€™s shoulders get stuck behind your pubic bone during delivery. The longer the problem lasts during delivery, the greater the risk of problems for you and the baby.
Possible problems for you are:
Tearing of the uterus or rectum
Heavy bleeding after the delivery
Bruising or tearing of the cervix or vagina
Bruising or irritation of the bladder
Possible problems for your baby are:
Injury to the nerves in the arm and hand, possibly causing the arm to be paralyzed (the paralysis usually goes away)
A broken arm or collarbone
Puncture and collapse of the baby’s lung if the collarbone breaks
Lack of oxygen, which can cause problems with the babyâ€™s nervous system, brain damage, or death
What is the cause?
Often, the cause of shoulder dystocia is not known. Shoulder dystocia may happen when:
A baby is unusually large. If you are overweight or have diabetes, you are more likely to have a large baby.
The opening of your pelvis is small.
If you are at risk for shoulder dystocia, you may have an ultrasound scan and a pelvic exam to measure the size of your pelvis before you go into labor. An ultrasound scan uses sound waves to show pictures of your uterus, the baby, and the tissue and fluid that surround your baby. This information will help your healthcare provider know how big your baby is and whether the baby’s size might be a problem during delivery.
How is it treated?
If itâ€™s clear before you go into labor that your baby is very big or your pelvis is too small to deliver the baby, your baby may need to be delivered by C-section (an operation that delivers your baby through a cut in your belly and uterus).
During labor your healthcare provider may decide that you need a C-section if:
It takes a long time for your cervix to completely open.
The pushing phase of labor takes a long time.
The baby’s head doesn’t move down the birth canal when you push.
If your babyâ€™s shoulders get stuck, your healthcare provider may:
Cut the tissue between the openings of your vagina and rectum to widen the opening of your vagina.
Raise your legs up and push them back against your stomach to widen your pelvic opening.
Put pressure on your belly to try to free the baby’s shoulder.
Reach into your vagina and try to turn the baby’s shoulder, free an arm, or break the babyâ€™s collarbone to get the babyâ€™s shoulders through the opening.
How can I help prevent shoulder dystocia?
If you are at risk for shoulder dystocia (especially if you have diabetes), talk with your healthcare provider about the possible need for a C-section to avoid the problem.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-09-17 Last reviewed: 2014-09-17
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Shoulder Dystocia: References
ACOG Practice Bulletin: Shoulder Dystocia, Number 40, November 2002. Reaffirmed 2010.
Cunningham, F., K. Leveno, S. Bloom, J. Hauth, L. Gilstrap, K. Wenstrom. Williams Obstetrics. 22nd ed. The Mcgraw Hill Companies, Inc. 2008. Accessed February 1, 2009 from http://www.accessmedicine.com.
Gherman RB, Chauhan S, Ouzounian JG, Lerner H, Gonik B, Goodwin TM. Shoulder dystocia: the unpreventable obstetric emergency with empiric management guidelines. Am J Obstet Gynecol. 2006 Sep;195(3):657-72.
Gibbs, R. B. Karlan, A. Haney, I. Nygaard. Danforthâ€™s Obstetrics and Gynecology. 9th ed. Lippincott Williams and Wilkins, 2008. Accessed on February 1, 2009 from http://www.ovidsp.tx.ovid.com.
Lockwood, C. Guidelines for Perinatal Care. 7th ed. AAP and ACOG. 2012.
Rodis, John, et al. Intrapartum management and outcome of shoulder dystocia. Accessed from http://www.UpToDate.com on October 17, 2013.