What Are The Risk Factors For Shoulder Dystocia?
Why Do Babies Shoulders Get Stuck During Delivery?
Shoulder dystocia is an uncommon and frightening complication that occurs during childbirth. It happens when the baby’s body fails to come out within a minute after the head is brought out. Shoulder dystocia is considered an emergency and doctors usually try to work very fast to resolve the issue in order to avoid complications. Let’s take a look at what causes shoulder dystocia.
What causes shoulder dystocia?
- Carrying a big baby: This happens when the baby has too much weight and could make vaginal birth even harder. If the woman goes through with vaginal delivery, the baby’s shoulder may get stuck.
- Small pelvis: If the mother’s pelvis is too small for smooth passage, the baby’s shoulder could get stuck.
- Gestational diabetes: Gestational diabetes puts your baby at the risk of gaining too much weight because of the extra glucose in your blood. And with extra baby weight , comes the likelihood of the baby’s shoulder getting stuck during delivery.
- Womb overstay: The more the baby stays in the womb the more it grows larger. Therefore, if your baby stays past your due date, this becomes a possible risk.
- Previous cases of shoulder dystocia: If you’ve experienced shoulder dystocia with a previous birth, chances are it can occur again.
- Induced labour is also a factor in what causes shoulder dystocia.
What happens after shoulder dystocia diagnosis?
Now that we’ve looked at some of the causes of shoulder dystocia, let’s look at what the doctors do to ensure minimal damage to the baby and mother through these methods:
- McRoberts manoeuvre: This manoeuvre involves raising the woman’s legs towards her chest, which changes the shape of her pelvis. This frees up more space in order to get the baby’s shoulders loose.
- Pressure on the abdomen: Applying pressure to the mother’s abdomen helps rotate and eventually release the baby’s shoulder.
- Roll the patient: Rolling the patient from a flat position to one where her hands are on her knees on the side helps free the baby’s shoulder. This is because this position changes the dimension of the pelvis, allowing the baby’s shoulder to come out.
- Rubens manoeuvre: This one involves the doctor getting his or her hands to work. Rubens requires the doctor to rotate the baby physically, freeing it from the mother’s pelvis.
- Caesarean surgery: This is not a regular method to free the baby’s shoulder, but when doctors decide to use this method, they push the baby back into the womb before they proceed.
Complications for mother and child after shoulder dystocia
When shoulder dystocia happens, complications may arise both for the baby and for the mother. Therefore, both of them will need to be monitored for some time. The following complications may occur:
For the baby
- There are nerves in the neck that are responsible for the movement of the arm. Most babies can have problems with their nerves because of the stretch, causing temporary or permanent paralysis of the arm. The permanent type of paralysis of the arm is very rare since most babies regain movement within hours or days.
- Shoulder dystocia can sometimes cause a fracture in the baby’s arm or shoulder, which heals most of the time without additional issues.
- In the process of the prolonged delivery, the baby can experience a lack of oxygen to the baby can cause brain damage or even death in some cases.
For the mother
- During childbirth, vaginal tears can happen, either to a third-degree or the fourth, which reaches the rectum or the wall of the vagina. After delivery of the placenta, these can be fixed.
- About one in ten women experience bleeding after shoulder dystocia. Treatment for this is either through a blood transfusion or medication.
- There’s the emotional side of things. Most women feel guilty and responsible for whatever injuries the baby gets during shoulder dystocia. Mothers should know that some things are beyond their control.
Shoulder dystocia occurs in about one in two hundred births. However, preventing it is not possible in most cases because you can’t see it coming, neither can you predict it. However, if you have experienced shoulder dystocia before, you may be at risk of experiencing it again in your next pregnancy, so speak to your doctor about that possibility.