WHAT YOU NEED TO KNOW: What is shoulder dystocia? Shoulder dystocia develops when your baby's head is delivered, but one or both of his shoulders become stuck. This prevents your baby from moving through your birth canal. Shoulder dystocia is a life-threatening emergency that can cause serious problems for you and your baby. What increases the risk for shoulder dystocia? - Abnormal pelvis shape or small frame of the mother
- Obesity of the mother, or gestational diabetes
- Pregnancy past the due date, or induced labor
- The baby's weight is more than 8 pounds, 13 ounces
- Use of forceps or a vacuum device to help deliver the baby
- Shoulder dystocia in a past pregnancy
What will healthcare providers do to help deliver my baby? - Your position may be changed. Your knees will be brought up toward your chest to create more room for your baby's shoulder to pass. Healthcare providers may turn you onto your hands and knees if your baby's shoulder is still stuck.
- Pressure may be applied to your abdomen. Your healthcare provider may push on your abdomen, above your pubic bone. The pushing may help move your baby's shoulder down far enough to free it.
- Your baby's position may be changed. Your healthcare provider may turn your baby's shoulder to move it into the correct position.
- You may need an episiotomy. Episiotomy is a procedure used to cut your perineum (area between your vagina and anus). This makes the opening larger for your baby to pass through.
How are problems from shoulder dystocia treated or managed? - You may be given medicines to reduce your pain or to prevent or treat a bacterial infection. You may also need treatment to stop severe bleeding. Surgery may be needed to repair damage to your uterus or other body areas.
- Your baby will be examined for shoulder or arm problems. A broken clavicle (collarbone) or arm in a newborn usually heals on its own in 6 to 8 weeks. Your baby's sleeve may be pinned to his clothes, or he may be given a sling to keep his arm from moving.
What are the risks of shoulder dystocia? - Your baby's broken clavicle may need to be repaired with surgery if it has not healed within 3 months. He may have permanent nerve damage in his shoulder, arm, or hand. He may need surgery to repair damaged nerves when he is 3 to 6 months old. He may have paralysis or develop facial palsy. He may have permanent brain damage from hypoxia (lack of oxygen).
- You may have severe bleeding after you give birth. Your uterus, vagina, cervix, or rectum may tear. Your bladder muscle may become weak and you may have incontinence (urine leakage).
How can I prevent shoulder dystocia in a future pregnancy? Manage your weight before you become pregnant. Keep your weight gain within the limits suggested by your healthcare provider. If you develop gestational diabetes, follow your healthcare provider's instructions to manage your condition. Your healthcare provider may suggest a planned cesarean section to reduce the risk for shoulder dystocia. What can I do to manage problems from shoulder dystocia? - Apply ice to your perineum as directed. Apply ice for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
- Use a sitz bath as directed. A sitz bath is a pan that fits on the toilet bowl. You fill it with warm water and sit in it to help decrease pain, swelling, and bruising. You may also create a sitz bath by filling a bathtub with about 6 inches of warm water. Ask how long and how often to take a sitz bath.
- Handle your baby carefully. Be careful not to move your baby's arm when you pick him up.
- Take your baby to therapy or treatment as directed. Your baby may need to work with a physical therapist to help strengthen his muscles. He may also need treatment for nerve damage.
When should I seek immediate care? - You have a fever, severe abdominal pain, and foul-smelling discharge from your vagina.
- Your baby is irritable, fussy, or cries constantly and you cannot soothe him.
When should I contact my healthcare provider? - You have new or worsening pain, even after you take pain medicine.
- You have bleeding from your vagina that fills 1 sanitary pad within 1 hour.
- You have swelling in your perineum that does not get better within a few days.
- You have questions or concerns about your baby's condition or care.
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