Obstetrical Malpractice: Shoulder Dystocia Cases in Florida

Shoulder Dystocia occurs during vaginal delivery when the baby’s shoulder gets stuck behind the mother’s pubic bone. It is considered an obstetrical emergency because when it happens, the baby is in a precarious circumstance.  The baby’s head is outside of the birth canal, but the baby is still getting oxygen via the transfer of blood with its mother through the umbilical cord.  During shoulder dystocia, the umbilical cord is stuck in the birth canal and being compressed along with the baby. Compression on the cord causes a decrease in blood and oxygen flowing to the baby.  If delivery doesn’t take place quickly, the baby can suffer major hypoxic injury, and even death.

There are three standard maneuvers that obstetricians use to un-stick the shoulder and get the baby out, including, usually in this order:

McRoberts Maneuver: This involves flexing the mother’s legs tightly to her abdomen to change the angle of the pelvis, which can help to free the baby’s shoulder.

Suprapubic Pressure: Applying pressure just above the mother’s pubic bone can help to dislodge the baby’s shoulder.

Delivery of the Posterior Arm: The obstetrician may try to deliver the baby’s posterior arm first, which can reduce the width of the baby’s shoulders and allow for easier delivery.

In severe cases, when the above maneuvers fail to get the baby out, as a last resort an obstetrician may intentionally break the baby’s clavicle, allowing the shoulders to fold closer together and thus delivering the baby.  This procedure is called a cleidotomy or claviculectomy. It sounds horrible but is considered acceptable when the other maneuvers fail and it is done to prevent the baby from sustaining brain damage or death while stuck in the birth canal. The fractured clavicle usually will heal without any long-term injury to the baby because the bones of the newborn are considered “green,” meaning more flexible and having a greater capacity to heal than the bones of an adult.  The clavicle of a baby can actually bend and break without completely severing, similar to how a young green tree branch can bend without snapping off.

“Fundal pressure” should not be used.  The difference between fundal pressure and suprapubic pressure is that suprapubic pressure is applied just above the mother’s pubic bone.  Fundal pressure is applying pressure to the upper portion of the uterus, and instead of relieving the problem fundal pressure can make the dystocia more difficult to resolve.

When shoulder dystocia occurs and the maneuvers to overcome it are not done properly, shoulder dystocia can lead to severe permanent injuries to the baby’s shoulder and spine, causing partial or complete disfunction of affected the limb.  The delay in delivery can also lead to brain damage and even death of the baby.

Please contact us if you would like a free evaluation of your potential shoulder dystocia malpractice claim.

More Obstetrical Malpractice Birth Injury Information:
Read about Obstetrical malpractice and emergency cesarian sections
Read about $12 million Federal Tort Claims Act recovery in Florida birth injury case.
Read about Florida’s No-fault system for certain types of birth injuries (NICA program).
Read about Florida Supreme Court striking down obstetrician’s “mandatory” patient arbitration agreement.
Read about new Florida law allowing C-sections outside of hospitals.
Read about Appellate court upholding baby weight distinctions in Florida’s NICA program.
Read about University of Miami Hospital being denied immunity under Florida’s NICA program.