Every parent hopes for a happy, healthy baby at birth. Unfortunately, in about 0.2 to 3 percent of all vaginal deliveries in which a fetus is positioned head-down in the birth canal, the baby suffers from shoulder dystocia. This serious injury can cause lifelong disability.
According to epidemiological studies, the incidence of shoulder dystocia increases with the size of the infant. Babies less than about 8.8 pounds have a risk of only about one percent, whereas babies 8.8 to 9.9 pounds have a 5 to 9 percent increased risk. Babies over that risk have a 14 to 23 percent increased risk.
Parents faced with this injury are right to wonder if it could have been prevented. At Shapiro, Washburn & Sharp, our attorneys have helped many families in Virginia and the surrounding areas understand whether a birth injury like shoulder dystocia could be grounds for a legal claim and how medical mistakes might lead to lasting harm.
In the article below, we’ll explain what your rights are and how to proceed if you feel your doctor, medical team, or hospital made a mistake during the birth of your baby. Meanwhile, if you or a loved one is dealing with this issue, please call our Virginia Beach medical malpractice attorneys today at 833-997-1774 for a free consultation.
What is Shoulder Dystocia?
Shoulder dystocia is a condition in which the baby’s shoulder gets stuck behind the mother’s pelvic bone after the head is delivered. It often qualifies as a medical emergency because it can delay the rest of the birth, raising the risk of harm to both the mother and the baby. In other words, the mother is no longer able to deliver the baby through pushing alone and requires medical assistance to complete the birth.
According to one 2010 study, “Shoulder Dystocia (SD) is the nightmare of obstetricians. Despite its low incidence, SD still represents a huge risk of morbidity for both the mother and fetus.”
Though most shoulder dystocia cases happen when the baby is large, according to one study, 43 percent of infants affected weighed less than about 8.8 pounds at birth. This means that this risk is always present, regardless of the circumstances, and doctors must be aware of it and take the necessary precautions to prevent it.
Another study, however, contradicted those findings. According to their findings, a higher birth rate did not affect the risk of brachial plexus injury. The researchers wrote: “We found forceps/vacuum delivery to be an independent risk factor for OBPI [obstetric brachial plexus injury], regardless of birth weight.” In other words, the use of birth-assistance tools was more associated with risk in this study than the infant’s size.
There are other factors, as well, that can contribute to shoulder dystocia. Maternal diabetes, for example, can increase the risk, as it often leads to larger babies with larger-than-usual shoulders and chests. According to one 2020 study, diabetic patients have a 2-3 times increased risk of shoulder dystocia.
A previous history of shoulder dystocia, as well as prolonged labor and the use of assisted delivery tools, can increase the risk of the condition.
How Do Doctors Respond?
When shoulder dystocia occurs, doctors have to act fast to save both the mother and baby. They may reposition the mother, apply specific pressure techniques, and in some cases, perform an episiotomy to create more room for the baby. How fast they respond and how knowledgeable they are can make a significant difference in the outcome.
The baby’s stuck position puts pressure on a group of nerves surrounding the shoulder, known as the brachial plexus. This group of nerves controls movement and sensation in the arm, hand, and fingers. It starts in the spinal cord in the neck and then extends through the shoulder, branching out through the entire upper arm.
When shoulder dystocia occurs, the pressure and strain put on the baby’s neck and shoulder area can damage this delicate group of nerves. Sometimes the damage is minimal, but depending on how the medical team responds and the difficulty of the birth, it can extend to more severe damage.
In less severe cases, the nerves are stretched but not torn, which means the baby will suffer only temporary weakness or paralysis. More moderate to severe damage to these nerves could result in partial or complete tearing, which can result in permanent disability.
Exactly where the damage occurs determines which parts of the arm are affected. Some children have weakness in the shoulder and upper arm, while others may struggle to move their hands and fingers.
Can a Child Recover from a Brachial Plexus Injury?
Many infants with brachial plexus injuries do end up recovering much of their arm and hand function. In a review of several studies, for instance, researchers found a rate of spontaneous recovery ranging from 66 to 75 percent, occurring within six months to a year. Early diagnosis and advanced therapeutic techniques can help improve a child’s recovery rate.
For those who do recover, the healing process usually starts early, within the first few weeks of life. Parents may notice gradual improvements. Early physical therapy and splinting can play crucial roles in maximizing recovery potential.
Unfortunately, some injuries become permanent. In reports by pediatricians and specialists with follow-up times of greater than three years, about 50 to 90 percent of injuries remained permanent. Recovery depends heavily on how severe the injury was in the first place.
The impact on a child’s life can be substantial. Activities that most of us take for granted, such as reaching overhead, grasping objects, or participating in sports, may become challenging or impossible. The affected arm can sometimes appear smaller than the unaffected side because of muscle weakness and underdevelopment. Some children also experience ongoing pain or unusual sensations in the affected limb.
Permanent injuries often require ongoing medical care, therapy, and sometimes, multiple surgeries. The emotional and financial burden on families can be substantial, particularly when the injury might have been prevented through proper medical management.
Does Medical Malpractice Apply?
Shoulder dystocia doesn’t automatically mean that the medical team made a mistake. Even under the best of circumstances, the condition can sometimes occur.
That means that it’s best to consult with a medical malpractice lawyer. If the healthcare providers failed to meet acceptable standards when it comes to preventing, recognizing, or managing the situation, then you may be eligible for a legal claim.
Maybe the mother had risk factors that could have caused shoulder dystocia, and the doctors didn’t take the proper precautions. Or perhaps the healthcare providers failed to recognize maternal diabetes, or to realize that the mother had a previous history of shoulder dystocia during birth. Improper use of delivery instruments or failure to recommend a cesarean section when necessary may also be grounds for a medical malpractice claim.
How a Medical Malpractice Attorney Can Help
At Shapiro, Washburn & Sharp, we are experienced in birth injury cases. We will thoroughly review the labor and delivery records, as well as the prenatal assessments, to determine if the standard of care was met in your case. We also consult with obstetric and pediatric nerve experts to determine whether the doctors performed as they should have.
If you believe that a doctor failed to act appropriately during the birthing process and your baby was diagnosed with shoulder dystocia, contact us right away. We are committed to helping families, as we did for a young mother who delivered a baby suffering from a brachial plexus injury. We helped negotiate a $1 million settlement for her and her baby.
We have several locations to serve you, including offices in Virginia Beach, Norfolk, Portsmouth, Suffolk, Hampton, and Chesapeake.
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An experienced personal injury attorney with dual licensure in Virginia and North Carolina, Eric Washburn received a B.B.A. in Finance from James Madison University—initially worked in the information technology field before obtaining his law degree from Thomas M. Cooley Law School in Lansing, Michigan. Once an Assistant Commonwealth’s Attorney in Danville, Va., Eric has been recognized by Super Lawyers Magazine as a “Rising Star” Super Lawyer in Virginia since 2014.
