shared decision making: during labor & delivery

Shoulder dystocia

What is Shoulder Dystocia?

Shoulder dystocia is a rare complication that happens in about 1.5% of vaginal deliveries. It means that after the baby’s head comes out, one of the baby’s shoulders becomes stuck behind the mother’s pelvis. It is considered an emergency.

How is It Treated?

To quickly free the shoulder and deliver the baby, the care team must guide the mother through a rapid series of physical maneuvers, which may involve the mother moving her legs into a certain position or getting up on her hands and knees. The care team may also apply pressure to the pubic bone. Sometimes, an episiotomy is also done but an episiotomy alone will not resolve a shoulder dystocia.

These maneuvers are usually successful but in some cases, an emergency C-section may be necessary. Time is of the essence because the baby may receive less oxygen or become injured while in this situation.

Can It Be Prevented?

Few shoulder dystocias can be predicted or prevented because most of them happen when there are no risk factors.

However, there are some risk factors your doctor will take into consideration before labor. These include:

●     Prior history of shoulder dystocia.

●     Maternal Obesity.

●     Gestational diabetes.

●     Baby’s growth goes beyond a specific weight (macrosomia).

If your doctor determines before you go into labor that you are at high risk for shoulder dystocia, they may want to discuss the possibility of a planned C-section delivery.