When shoulder dystocia occurs it immediately threatens the safety of both mother and baby. It is treated as an obstetrical emergency. If shoulder dystocia is not properly identified and overcome, a baby can potentially die or suffer serious brain damage from oxygen deprivation. As a result, OB/GYNs have a very limited window of time to act in response to shoulder dystocia. Unfortunately, the response to shoulder dystocia by doctors can often be just as risky for the baby.

When shoulder dystocia is first encountered during delivery, the doctor’s initial step is to accurately determine the actual orientation of the baby’s anterior shoulder relative to the birth canal. Accurate assessment of shoulder position and orientation is critical because the specific orientation will dictate what obstetrical techniques and/or maneuvers will be most effective in dislodging the shoulder. Certain techniques are designed for use with specific orientations.

After the orientation of the shoulder has been fully assessed the doctor must decide on a strategy for responding to the situation, including which of the various techniques to employ. This is where things can get very tricky. It is very important to overcome the dystocia and deliver the baby as quickly as possible.

At the same time, however, excessive haste, overly aggressive manipulation, hyperflexion of the baby’s neck, or the use of excessive force will easily cause injury to the baby. A very high level of skill is required to overcome the baby’s shoulder dystocia without injuring the mother or child.

The problem is that shoulder dystocia simply does not occur often enough for most doctors to develop expertise or test out various methods. As a result, many OB/GYNs lack confidence in their skills which often causes them to panic and make rushed decisions.