When a child is being born via natural delivery, there are many ways that something could go wrong. One of the most difficult and frightening problems that a mother and baby can experience during labor is something called shoulder dystocia. While there is almost no way to predict it, it does happen with regularity in delivery rooms, and it can either wind up a minor inconvenience, or it can cause severe difficulties.
Shoulder dystocia occurs when a child’s shoulders become lodged or stuck at the entry to the birth canal during delivery. However, sometimes it is hard to pin down when shoulder dystocia is actually occurring. Is it only in cases of time delay? Or is it whenever a physician finds that the child cannot normally be delivered (that is, with only minimal downward pressure)? This is important because without a definition of the malady, it is hard to define a standard of care. If one court says that shoulder dystocia requires a time delay in delivery, this may alter a plaintiff’s chances for recovering compensation in a medical malpractice case.
The major maternal risk factors for shoulder dystocia are gestational diabetes, abnormal pelvic anatomy, and being short in stature. There is also some evidence that induced labor has a slightly higher rate of shoulder dystocia. General factors include a long labor and possible fetal macrosomia (in other words, a baby that is much larger than average for its stage of development).
If shoulder dystocia does occur during a standard vaginal delivery, questions arise regarding the obstetrician’s next move. There are several maneuvers that are considered standard procedure in these cases, and an obstetrician will have been trained in at least one or two of them.
The most common way to assist a child from the birth canal is via traction. However, if a mother or doctor is opposed to traction, the most accepted way to potentially dislodge a baby’s impacted shoulder is called the McRoberts maneuver. The maneuver consists of having the mother pull her legs up until they are resting on her abdomen. This will tilt the pelvis and, in many cases, actually help the impacted shoulder pull free. A study published in 1997 by Benjamin Gherman et al. states that the maneuver alone helped free infants approximately 42% of the time.
Even with the best intentions, however, maternal or fetal injury can result. By far the most common injury sustained to the baby is brachial plexus – that is, nerve damage to the spinal area. However, in extreme circumstances, lack of oxygen to the brain can result, likely due to the umbilical cord becoming trapped. This is dangerous ground for medical professionals; given the lack of clarity around shoulder dystocia and what exactly constitutes the standard of care, one wrong move can lead to ruin.
If you and your child have been affected by shoulder dystocia, you may be able to obtain compensation for your pain and trouble. The injury attorneys at Meinhart, Smith & Manning, PLLC are well versed in this kind of law, and we will do our best to help you. Contact our Louisville office for a free consultation.
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