Shoulder dystocia is a complication that may occur at birth where the baby’s head is delivered, but one of the baby’s shoulders becomes stuck behind the mother’s pubic bone. This complication is one of the leading causes of Brachial plexus palsy or Erb’s palsy injuries during birth. When a baby is stuck, that may also lead to the child not getting enough oxygen, which can prove deadly. A study published in 2016 in the Women’s Health journal found between 0.15% and 2% of all births involve shoulder dystocia.
What is Brachial Plexus Palsy?
According to the American Academy of Orthopedic Surgeons, Brachial plexus palsy (Erb’s palsy) occurs when a child suffers injuries to the nerves of the brachial plexus – a network of nerves in the shoulder, arm and neck area. Sometimes, when shoulder dystocia occurs, the physician tries vaginal delivery and pulls too hard on the child’s head. This type of excessive force can cause the nerves of the brachial plexus to be severely stretched and/or torn, which can cause the arm to be rotated toward the body and hang limply at the baby’s side. Brachial plexus palsy (Erb’s palsy) is characterized by partial or total paralysis of the child’s arm. Brachial plexus injuries complicate up to 16% of shoulder dystocia births.
Risk Factors for Shoulder Dystocia
There are a number of conditions and circumstances that may increase the risk of shoulder dystocia 
during delivery. These conditions include:
Gestational diabetes: Gestational diabetes is a condition in which your blood sugar levels become high during pregnancy. It affects up to 10% of women who are pregnant in the U.S. each year. If untreated, gestational diabetes can cause problems for your baby, like premature birth or prolonged labor.
Macrosomia: This is a term that describes a baby who is born much larger than average for their gestational age, which is the number of weeks in the uterus. Babies with macrosomia weigh over 8 pounds, 13 ounces. If the child is larger than average, it may make vaginal delivery more difficult.
Cephalopelvic disproportion (CPD): This is when the baby’s head is too large for the size of the mother’s pelvis. A physical examination that measures pelvic size can often be the most accurate method for diagnosing CPD.
Obesity: Women who are obese or have gained more than 50 pounds throughout the pregnancy can also be at higher risk for shoulder dystocia.
How to Prevent Shoulder Dystocia
If there are a number of risk factors present for shoulder dystocia, it may be a good idea to discuss the possibility of scheduling a Cesarean section (C-section) instead of vaginal birth. If your medical provider recommends a vaginal birth and shoulder dystocia occurs, they may have to attempt a number of maneuvers to get the baby out quickly to prevent injuries such as brachial plexus injury. If they can’t resolve the situation immediately, an emergency C-section may have to be performed. Here are some of the common types of procedures and maneuvers doctors attempt when shoulder dystocia occurs:
• Episiotomy: This is where the doctor makes an incision to create more space for the baby to come out.
• McRobert’s Maneuver: This is where two assistants grasp the mother’s legs and sharply flex the thighs back against the abdomen to help release the child who has become stuck.
• Corkscrew maneuver: In this maneuver, the physician will try to rotate the baby’s shoulder to dislodge it from behind the pubic bone.
• Suprapubic pressure maneuver: The doctor may apply pressure externally on the pubic bone to try and dislodge the stuck shoulder.
• The Zavanelli maneuver: This is done when all other maneuvers fail. The doctor takes the baby’s head and pushes it back into the uterus before performing an emergency C-section.
Contacting an Experienced Lawyer
When shoulder dystocia and Brachial plexus palsy (Erb’s palsy) occur because of the doctor or medical team’s negligence (carelessness), your child may be able to receive compensation that may help pay for medical expenses, lost income, cost of therapy, future treatments, permanent injuries, disabilities, past and future pain and suffering, etc.
The experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you. One of our clients secured a $2,850,000 verdict that was reduced by the appeals court to $1,846,000 because the verdict was so large. This was the highest amount upheld by the appellate courts for many, many years. In addition we recovered $1,400,000 for a newborn who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head. Also, one of our clients obtained a verdict for $43,940,000 and another of our clients got a verdict for $23,500,000, both in medical malpractice cases.
We have seen many cases where New York City Health and Hospital Corporation facilities deliver babies who are born with cerebral palsy or Brachial plexus palsy (Erb’s palsy) stemming from negligence (carelessness), and/or medical malpractice in the labor and delivery etc. of the children.
The following list identifies some of these hospitals (operated by New York City Health and Hospital Corporation):
• Jacobi Hospital aka Bronx Municipal 1400 Pelham Parkway South Bronx, New York 10461 718-918-5000
• Lincoln Hospital 234 East 149th Street Bronx, New York 10451 718-579-5000
• North Central Bronx Hospital 3424 Kossuth Avenue Bronx, New York 10467 718-519-5000
• Coney Island Hospital 2601 Ocean Parkway Brooklyn, New York 11235 718-616-3000
• Kings County Hospital 451 Clarkson Avenue Brooklyn, New York 11203 718-245-3131
• Woodhull Hospital 760 Broadway Brooklyn, New York 11206 718-963-8000
• Bellevue Hospital 462 First Avenue New York, New York 10016 212-562-5555
• Harlem Hospital 506 Lenox Avenue New York, New York 10037 212-939-1000
• Metropolitan Hospital 1901 First Avenue New York, New York 10029 212-423-6262
• Elmhurst Hospital 79-01 Broadway Elmhurst, New York 11373 718-334-4000
• Queens Hospital Center 82-68 164th Street Jamaica, New York 11432 718-883-3000
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