Shoulder Dystocia Explained: Risk Factors and Prevention February 8, 2024.

Shoulder Dystocia Explained: Risk Factors and Prevention

Shoulder dystocia occurs when one or both of a baby’s shoulders get stuck during a vaginal delivery. This makes the birth difficult and there needs to be emergency medical intervention. 

There are no warning signs of shoulder dystocia. But, some factors may increase the risk of complications during labor. The obstetrician should always assess expecting mothers for these risk factors. This way they can jump into action if complications do arise.

Risk factors of shoulder dystocia include:

  • Diabetes
  • Having twins or triplets
  • Baby weighing more than 8 pounds, 13 ounces
  • Mother being 35 years of age or older
  • Having shoulder dystocia in a previous birth
  • Obesity

A common question is “Can shoulder dystocia be prevented?” The simple answer is no because it can happen to anyone. But, there are ways to lower the risk. This includes receiving proper care, managing diabetes, and maintaining a healthy lifestyle during pregnancy.

Long-Term Effects of Shoulder Dystocia

If shoulder dystocia is not diagnosed and treated quickly, then the child will likely suffer the consequences. Some babies have no long-term effects, while others may have permanent disabilities. 

The long-term effects of shoulder dystocia can include:

  • Birth asphyxia
  • Cerebral palsy
  • Erb’s palsy

Birth Asphyxia

As a fetus develops in the womb an umbilical cord forms, which connects the fetus to the placenta. The umbilical cord supplies blood and oxygen to the infant until right after birth. In some shoulder dystocia cases, the umbilical cord becomes pressed causing the baby to not receive enough oxygen. This is called birth asphyxia, or hypoxic ischemic encephalopathy (HIE). In simple terms, this refers to when there is not enough oxygen to the newborn’s brain before or during birth. Brain damage can quickly happen if the baby is not being closely monitored.

Symptoms of birth asphyxia or HIE include:

  • Low heart rate
  • Weak breathing
  • Poor muscle tone
  • Blue-gray skin color

Children who had mild cases of birth asphyxia could very well make a full recovery and go on to live normal lives. But, if the low oxygen levels were not quickly detected by doctors, then the child could suffer from severe brain damage. 

The long-term effects of birth asphyxia mainly depends on how long the baby went without oxygen. It can also depend on if and when the doctors started to administer therapeutic hypothermia.

Therapeutic hypothermia may sound scary, but it is an effective treatment for babies with birth asphyxia. This treatment cools the baby’s body to slow cell activity. The lower body temperature gives the cells a chance to recover from the damage. The goal of therapeutic hypothermia is to stop further brain cell damage. 

In severe cases, where birth asphyxia was not treated quickly, the child is at a higher risk of having permanent disabilities. Around 25% to 60% of newborns who had birth asphyxia will develop neurological conditions.

Common conditions include:

  • Cerebral palsy
  • Mental health disorders
  • Learning disabilities
  • Epilepsy
  • Hearing issues
  • Breathing issues

Some of these conditions will require life-long care. Life-long medical treatments and care can cause a financial strain on the family. This is why it is important to hire a birth injury attorney to get your family the compensation they deserve.

Cerebral Palsy

Cerebral palsy is the most common motor disability in children. In the United States, around 10,000 children are diagnosed with cerebral palsy each year. Cerebral palsy mainly affects movement, coordination, balance, and posture. 

Cerebral palsy can occur from injuries or abnormalities in the brain while in the womb. But, it can also occur if there is a lack of oxygen during birth. This typically happens when the umbilical cord is pressed during labor, causing brain damage.

Symptoms of cerebral palsy after birth include:

  • Milestone delays
    • Delayed sitting, crawling, rolling
  • Unable to lift their head
  • Stiff or floppy muscles
  • Unable to grasp small objects

If you suspect that your child has cerebral palsy, it is important to get your child checked out by a doctor. Cerebral palsy is a condition that requires life-long care. There are treatments, medications, and surgeries that may help a child with cerebral palsy but there is no cure.

The lifespan of someone with cerebral palsy varies. It depends on how severe their cerebral palsy is and their other health problems. 

Some health problems associated with cerebral palsy include:

  • Osteoporosis (weak/ brittle bones)
  • Scoliosis
  • Epilepsy
  • Digestive issues
  • Difficulty swallowing
  • Pressure sores

Erb’s Palsy

Shoulder dystocia also commonly affects the brachial plexus nerves. These nerves are in the shoulder, torso, and spine. Brachial plexus nerves are responsible for controlling arm, shoulder, and hand movements. 

Erb’s palsy is a condition that develops when there is damage to the brachial plexus nerves during labor. This damage can happen if the child’s head or shoulders are pulled on forcefully during birth. This forceful motion can cause the nerves to strain or tear.

The symptoms of Erb’s Palsy include:

  • Little to no movement of the affected arm
  • Poor reflexes
  • Unable to grab small objects

In mild cases, the child’s brachial plexus nerves will fully recover. But, in severe cases, the child’s arm and hand might be very weak or even unusable. 

Also, for some children, their affected arm may be smaller than their unaffected arm. This is due to the torn nerves affecting the growth. As the child gets older the size difference will be more noticeable.

Treatments can be done to improve the symptoms of Erb’s palsy. The most common treatment is physical therapy. This will help the affected shoulder, arm, and hand have a greater range of motion. Surgery may also be needed to cure Erb’s palsy. Yale Medicine explains this surgery as “nerve grafting across the injured segments”.

These treatments to help children with Erb’s palsy are not cheap. Medical care is excessively expensive in the United States. If you file a claim against the hospital or doctors who were negligent during your labor, you may receive compensation. This compensation would help you be able to afford the medical care that your child needs. It would also allow you to hold the negligent doctors accountable so it won't happen again to another child. 

If Erb’s Palsy goes untreated for a long time, it will be harder for the child to treat it later in life. This could mean that their arm would be very weak or even unusable.

Contact our Knowledgeable Birth Injury Attorneys

We recognize that birth injuries are devastating and life-changing for families. We strive to get justice for the families who were affected by birth injuries. Birth injuries can affect families with expensive treatment costs and childcare costs. These costs can be millions of dollars throughout the child’s life. This can cause the family to be financially unstable when trying to pay for their child’s treatment. That’s why you should turn to a trusted medical malpractice attorney to fight for compensation for your child’s injuries. 

If your child had shoulder dystocia which led to birth asphyxia, cerebral palsy, or Erb’s palsy, we encourage you to reach out to our Cleveland birth injury attorneys. To see if you have a birth injury case, contact our experienced birth injury attorneys at (440) 333-3800 or fill out our quick online form