What Are Common Mistakes in Shoulder Dystocia

Last Updated on January 8, 2025 by Michelle Wan

Shoulder dystocia is a rare but critical childbirth complication that occurs when one or both of a baby’s shoulders become stuck behind the mother’s pelvic bone during delivery. When managed correctly, many cases of shoulder dystocia can result in safe outcomes for both mother and baby. However, mistakes made during its recognition and management can lead to severe injuries, including brachial plexus damage, fractures, and oxygen deprivation.

This article delves into common mistakes in shoulder dystocia cases, their potential consequences, and how families can seek justice if medical negligence is suspected.

What Is Shoulder Dystocia?

Shoulder dystocia happens during the second stage of labor, when the baby’s head is delivered, but the shoulders are unable to pass through the birth canal. While shoulder dystocia can be unpredictable, certain risk factors—such as fetal macrosomia (larger-than-average babies) or gestational diabetes—increase the likelihood of this complication.

Proper management is essential to prevent injuries to the baby and the mother. Unfortunately, errors in identifying or addressing shoulder dystocia can lead to devastating outcomes.

Common Mistakes in Shoulder Dystocia Management

Failure to Recognize Risk Factors During Pregnancy

• Mistake: Healthcare providers may overlook conditions such as maternal obesity, gestational diabetes, or fetal macrosomia, all of which heighten the risk of shoulder dystocia.
• Impact: Failing to identify risk factors may prevent proactive measures, such as scheduling a cesarean section to reduce complications.

Delayed Recognition During Delivery

• Mistake: Failing to identify the signs of shoulder dystocia, such as the “turtle sign” (when the baby’s head retracts back toward the perineum), can delay necessary interventions.
• Impact: Delays increase the risk of oxygen deprivation, which can lead to hypoxic-ischemic encephalopathy (HIE) or other serious conditions.

Improper Use of Maneuvers

• Mistake: Applying excessive force or incorrect techniques during delivery can cause injuries. For instance:
  • Using too much traction on the baby’s head can result in brachial plexus injuries like Erb’s palsy.
  • Failing to execute the McRoberts or Woods corkscrew maneuvers correctly may prolong the delivery and worsen complications.
• Impact: These errors can cause fractures, nerve damage, or even permanent disabilities.

Inappropriate Use of Delivery Tools

• Mistake: Misusing tools such as forceps or vacuum extractors to resolve shoulder dystocia can lead to significant trauma.
• Impact: Delivery tools used improperly may cause skull fractures, brain injury, or severe lacerations.

Delaying or Failing to Perform an Emergency Cesarean Section

• Mistake: In cases where vaginal delivery is unsafe, a cesarean section may be necessary. Delays in transitioning to surgery can escalate complications.
• Impact: Prolonged oxygen deprivation can lead to brain damage, including conditions like cerebral palsy.

Lack of Communication Among Medical Staff

• Mistake: Poor communication between the obstetrician, nurses, and other delivery staff can result in delays or errors in care.
• Impact: A lack of coordination increases the likelihood of mistakes and may prevent timely and effective interventions.

Failure to Document the Event Properly

• Mistake: Inadequate or incomplete documentation of the shoulder dystocia event and its management can create challenges in evaluating the care provided.
• Impact: Poor documentation may obscure whether the proper standard of care was followed, making it harder for families to pursue justice in cases of medical negligence.

Consequences of Shoulder Dystocia Mistakes

Mistakes in recognizing or managing shoulder dystocia can have severe consequences for both the baby and the mother:

For the Baby:

• Brachial Plexus Injuries: Damage to the network of nerves controlling the arm and shoulder, potentially resulting in Erb’s palsy.
• Fractures: Broken collarbones or arms caused by improper delivery techniques.
• Hypoxic-Ischemic Encephalopathy (HIE): Brain injury caused by prolonged oxygen deprivation.
• Cerebral Palsy: Motor and developmental impairments due to brain damage.

For the Mother:

• Severe Tears: Vaginal or perineal injuries requiring extensive recovery.
• Postpartum Hemorrhage: Excessive bleeding that can lead to further complications.
• Emotional Trauma: Psychological distress resulting from a difficult delivery or injuries to the baby.

How to Reduce Risks and Avoid Mistakes

While not all cases of shoulder dystocia can be predicted, proper planning and skilled care can reduce risks and improve outcomes.

1. Prenatal Monitoring:
   • Identify and manage risk factors such as gestational diabetes or macrosomia.
   • Consider planned cesarean sections for high-risk pregnancies.
2. Timely Recognition:
   • Train healthcare providers to recognize the signs of shoulder dystocia, including the turtle sign and slow progression during delivery.
3. Skillful Management:
   • Ensure that delivery staff are trained in maneuvers such as McRoberts, Woods corkscrew, and suprapubic pressure.
   • Avoid excessive force or inappropriate use of tools during delivery.
4. Communication and Preparedness:
   • Encourage clear communication among medical staff to ensure prompt and coordinated action.
5. Thorough Documentation:
   • Maintain accurate records of all interventions and outcomes to evaluate the quality of care provided.

Legal Options for Shoulder Dystocia Injuries

In some cases, shoulder dystocia injuries are preventable and result from medical negligence. Families affected by these errors may be eligible to file a medical malpractice claim to seek compensation for:

• Medical expenses for treatments, surgeries, and therapies.
• Long-term care costs, such as physical or occupational therapy.
• Lost wages if a parent must reduce work hours to care for the child.
• Pain and suffering caused by physical and emotional trauma.

To build a successful case, families will need to demonstrate that the healthcare provider failed to meet the standard of care, directly causing the injury.

How Thomas & Wan LLP Can Help

At Thomas & Wan LLP, we understand the devastating impact shoulder dystocia injuries can have on families. Our experienced attorneys are dedicated to helping families navigate the complexities of medical malpractice claims and secure the resources needed for recovery and future care.

Our services include:

• Free Case Evaluations: Determine whether negligence played a role in your case.
• Thorough Investigations: Collaborate with medical experts to review records and identify mistakes.
• Compassionate Advocacy: Support you every step of the way, ensuring your voice is heard.

Mistakes in managing shoulder dystocia can have lifelong consequences for families, but understanding these errors helps empower parents to advocate for proper care. If your family has been affected by shoulder dystocia injuries and you suspect medical negligence, you have legal options to seek justice and secure the support your child needs.

Contact Thomas & Wan LLP today for a free consultation. Let us help you fight for your family’s future with compassion and expertise.