Dr Idle

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Shoulder dystocia is a birth injury (also called birth trauma) that happens when one or both of a baby’s shoulders get stuck inside the mother’s pelvis during labor and birth In most cases of shoulder dystocia, babies are born safely. But it can cause serious problems for both mom and baby
Are you at risk for shoulder dystocia?
Shoulder dystocia can happen to any woman. We do know that some things may make you more likely than others to have shoulder dystocia. These are called risk factors. A risk factor is something that makes you at risk for a condition. Having a risk factor doesn’t mean for sure that you’ll have shoulder dystocia. And risk factors for shoulder dystocia don’t seem to be helpful in predicting if you’ll have it. It’s hard for providers to prevent.
Risk factors for shoulder dystocia include:
• Macrosomia
• Having Gestational Diabetes is a medical condition in which your body has too much sugar (called glucose or blood sugar) in your blood. This can damage organs in your body, including blood vessels, nerves, eyes and kidneys. Preexisting diabetes is when you have diabetes before you get pregnant. Gestational diabetes is a kind of diabetes some women get during pregnancy. Diabetes is a risk factor for having a large baby.
• Having shoulder dystocia in a previous pregnancy
• Being pregnant twines or triples or multiple
• Being overweight during pregnant
How is shoulder dystocia treated?
If your provider thinks you may be at risk for shoulder dystocia, she can prepare you ahead of time for what to expect during labor and birth. And she can make sure staff and equipment are ready at the hospital.
If your provider thinks your baby is large or if you have diabetes, your provider may recommend scheduling a c-section. If so, ask about waiting until at least last 39 weeks of pregnancy to have your baby. This gives your baby the time she needs to grow and develop before birth. Scheduling a c-section should be for health reasons only. Your provider may want to schedule a c-section if:
• She thinks your baby weighs at least 5,000 grams (about 11 pounds).
• You have diabetes and she thinks your baby weighs at least 4,500 grams (9 pounds, 15 ounces).
If you have shoulder dystocia, your provider can try several methods to move you and your baby into better positions to open your pelvis wider and move your baby’s shoulders. Your provider may:
• Press your thighs up against your belly. This is called the McRoberts maneuver.
• Press on your lower belly just above your p***c bone. This is called suprap***c pressure.
• Help your baby’s arm out of the birth canal
• Reach up into the va**na to try to turn your baby. Or turn you over so you’re on all fours (on your hands and knees).
• Give you an episiotomy. This is not done routinely but only in cases in which a larger opening to the va**na is helpful and the incision won’t affect the baby.
• Do a c-section, other surgical procedures or break your baby’s collarbone to release his shoulders. These are done only in severe cases of shoulder dystocia that aren’t resolved by other methods.

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