What is Shoulder Dystocia?

What is Shoulder Dystocia?

Dystocia is an abnormal or difficult childbirth or labor. Shoulder dystocia is a specific case of whereby the anterior(front) shoulder of the child is unable to pass below the pubic symphysis, the joint between the pubic bones at the front of the pelvis. This condition also occurs when the child requires significant manipulation to pass below this area. The single most common risk factor for shoulder dystocia is the use of a vacuum extractor or forceps during delivery.
Shoulder dystocia occurs in approximately one half of one percent of all deliveries. Given that there are 4 million babies born each year in the United States, this delivery complication will be experienced by roughly 20,000 women a year. The larger the baby, the more likely it is to occur. However, even with very large babies shoulder dystocia occurs only occasionally and sporadically.

It is diagnosed initially when the shoulders fail to deliver shortly after the fetal head. At an otherwise normal delivery, just after the baby's head has emerged, the neck suddenly retracts back against the mother's perineum causing the baby's cheeks to puff out. The experienced obstetrician knows at this point that the baby's anterior shoulder is caught on the pubic bone and there is a rapidly closing window of time the doctor has to act. Failing the proper actions at this point can result in lifelong injury to the child, including a severe palsy, brain damage, or death in the immediate term.

Peter Kent is the best-selling author of 50 books and hundreds of newspaper and magazine articles.