The 4 Main Types of Obstetrics Claims (Part 2)
Shoulder Dystocia
Shoulder dystocia is a condition where the fetus’ shoulder gets stuck in the mother’s pelvis during the delivery process. It can cause two different types of injuries: a brachial plexus injury (injury to nerves in the baby’s shoulder) and a hypoxic-ischemic injury (HIE).
A brachial plexus injury can occur when there is significant and sustained pressure on the baby’s shoulder during the delivery process. A child with a brachial plexus injury would have reduced or complete loss of use of the arm and hand on the affected side.
The reason why HIE is more likely in shoulder dystocia is because the umbilical cord is more likely to get pinched in the birth canal when the baby is stuck against the mother’s pelvis. If the umbilical cord gets pinched, then the blood flow carrying the oxygenated blood is reduced, and therefore there is less oxygen going to the baby.
Shoulder dystocia is more likely to occur in large babies. Mothers with gestational diabetes are at greater risk as they are more likely to have large babies.
Liability can arise in these cases in two main ways:
- Failure to identify a large baby and proceed to caesarean section prior to shoulder dystocia occurring; and
- Failure to perform the appropriate interventions once shoulder dystocia is encountered in labour and delivery, thereby delaying relief of the shoulder dystocia and delaying delivery unnecessarily.
The Skeels v Iwashkiw case, which was successfully prosecuted by Weir Bowen, is an example of a shoulder dystocia. In that case, the defendants failed to identify that the mother had a high risk pregnancy and failed to properly intervene when shoulder dystocia was encountered.