Shoulder Dystocia

Causes

Shoulder dystocia is caused by:

• Baby’s shoulders are too wide—larger babies are common in women with diabetes or late-term pregnancies
• The pelvic opening is too small for child

One or both could happen during labor.

Narrow Pelvic Opening

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Risk Factors

Things that may raise a baby's chance of shoulder dystocia include:

• Mother has diabetes or obesity
• Mother has small stature—this may mean a small pelvis
• A very large baby
• Shoulder dystocia in a past birth

Signs and Symptoms

There are no symptoms of shoulder dystocia.

Diagnosis

The doctor or midwife will know when the birth process stops after the head is born.

Prenatal tests will estimate the size of the fetus and the pelvis. These tests may show a risk for shoulder dystocia.

An ultrasound may be done before labor. The doctor will be able to see if the baby is too large to fit safely through the birth canal. A vaginal delivery may not be a safe method if the baby is too large.

Treatment

The goal of treatment is to get the baby unstuck as fast as possible. This will allow the vaginal birth to continue. The doctor or midwife may:

• Reposition the mother
• Reposition the baby to try to move the shoulder away from the bone

A C-section may be needed if the baby remains stuck in the birth canal.

Prevention

Shoulder dystocia cannot always be prevented. The doctor may offer people with a high risk of shoulder dystocia:

• Early induced labor—the baby will be smaller
• Planned C-section