Shoulder Dystocia

Shoulder dystocia is an obstetric emergency in which, after delivery of the head, the infant’s shoulder becomes lodged behind the mother’s pubic bone and cannot be delivered with normal traction. It must be relieved quickly with recognized manoeuvres, because prolonged impaction risks hypoxic injury, while excessive or misdirected traction risks injury to the brachial plexus.

Litigation arising from shoulder dystocia commonly alleges failure to anticipate risk factors, failure to perform the recognized release manoeuvres in an appropriate sequence, and the application of excessive lateral traction said to have caused a permanent brachial plexus injury. The standard of care is proven through obstetric and nursing expert evidence and is assessed against the rapidly evolving emergency rather than in hindsight. Causation is frequently contested, because brachial plexus injury can occur even with appropriate management and can arise from the forces of labour itself.

Posts tagged Shoulder Dystocia analyze Ontario and other Canadian decisions involving the recognition and management of shoulder dystocia and the resulting injuries.