Shoulder Dystocia

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Shoulder dystocia is an obstetrical complication that occurs in thousands of births throughout the United States each year. This complication has the possibility of causing lifelong injuries to the baby such as a brachial plexus injury, brain injury, or even death.

In a normal delivery, after the head of the baby has emerged from the birth canal, the shoulders slip out easily, and the rest of the baby follows. With shoulder dystocia, this does not happen. Instead, the baby's anterior shoulder becomes stuck behind the mother's pelvic bone causing, a host of potential problems including clavicle fractures, brachial plexus palsy, and fetal hypoxia, which may or may not cause permanent neurological damage.

When the baby is stuck during labor, it cannot breathe because the chest is compressed by the birth canal. As a result, oxygen levels in the baby's blood decrease, causing possible neurological damage. The longer the baby is deprived of oxygen, the more of a chance there is of fetal demise occurring.

The term brachial plexus refers to an injury of the complex set of nerves that control the muscles of the fingers, hands, arms, and shoulders. These nerves originate at the spinal cord and travel down the upper shoulders. One type of brachial plexus is called Erbs Palsy, when it is the upper body that is damaged.

Traumas to the brachial plexus can result in paralysis of one or both arms. This paralysis may be temporary, but if the nerves do not heal correctly, the condition can become permanent. Due to the way the muscles have changed, a person with a brachial plexus injury may have a distorted physical appearance in the areas that are affected.

Most brachial plexus traumas are obtained during a difficult delivery, when a shoulder dystocia has occurred. As a result of the way the baby is stuck in the birth canal, doctors need to apply force to turn the baby the correct way so that it may exit the womb. If excessive force is applied, it can stretch and tear the baby's brachial nerves, causing one of the above conditions.

When a relatively smooth labor goes wrong and shoulder dystocia occurs, doctors are trained to try to push and maneuver the baby gently out of the womb. They are taught to evaluate the possibility of doing an episiotomy if their first efforts of gently turning the baby do not work. An episiotomy does not, however, release the shoulder; it merely gives the doctor more room to try to reposition the baby. If none of the maneuvers the doctor tries frees the baby from the birth canal, there are other extreme measures that may be taken.

An emergency cesarean section can be preformed. The physician can push the baby's head further back into the birth canal and then, after quickly preparing the mother, the baby is cut out of the womb. General anesthesia may also be used to relax the mother's muscles in order to make turning the baby easier; however anesthesia, when used for too long, can have adverse effects on the unborn baby.

While there is no evidence that a shoulder dystocia can be predicted before labor, there are ways for the physician to alleviate the problem without harming the child. Brachial plexus problems usually only occur when a labor or if excessive force is used to remove the baby from the womb.

Due to the nature of these injuries, the medical bills can be considerably large. If your child was injured at birth due to a physician's excessive force or hesitation, you may be eligible to receive compensation for medical malpractice. If your child has any of these types of injuries, it is important that you contact a lawyer. An experienced birth injury lawyer can be paramount in building a strong case to receive compensation for your child's medical expenses. Even if an incident is unintentional, it is a doctor's responsibility to provide immediate care and quick responses to complications. Inexperience and overwork may have contributed to obstetrical errors, but they do not excuse a doctor's poor judgment. Medical expenses accrued from the birth are detrimental to an individual's finances. It is imperative to file claims so that you can cover these bills and provide a normal life for your child.


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