Labor & Delivery Complications: Shoulder Dystocia

Expecting a baby can be a time of joy and excitement for expectant parents. For mothers-to-be, there is a great focus placed upon the care of fetal development through proper nutrition, diet, exercise and prenatal visits with an obstetrician or midwife. Unfortunately, not much focus is given on the delivery, itself, and the potential risks and complications that may arise.

As part of your prenatal care, your obstetrician should discuss your plans for labor and delivery. Unfortunately, most women assume the obstetrician will simply choose the method of delivery and pain management without any consideration to your own concerns. As part of your pregnancy, therefore, it is important to discuss all aspects of labor and delivery, including any risks for delivery complications.

One such delivery complication involves a complication known as shoulder dystocia. Described as a complication of vaginal delivery, shoulder dystocia occurs when your infant's shoulder become impacted in the vaginal canal, preventing the full vaginal delivery process. While the use of forceps or vacuum assisted devices, during labor, are the key issues affecting the development of shoulder dystocia, there are other labor and delivery complications that may attribute.

In women who are short statured, develop gestational diabetes and women with a pre-existing pelvic complication, there is an increased risk of shoulder dystocia during labor and delivery. When presented with the complication, shoulder dystocia can result in a fourth degree vaginal tear and post-partum hemorrhaging. In addition, your infant may suffer from complications of the shoulder and brachial plexus, although these usually remedy within the first year of life. As the birth mother, your complications will persistent for the long term.

While you may believe that c-section is the best option to avoiding shoulder dystocia during labor and delivery, it actually is not. In fact, most obstetricians prefer to proceed with vaginal delivery, in light of the risk, and perform a variety of nurse-assisted manipulations during labor, to assist with the delivery. One such manipulation involves a technique known as the McRoberts maneuver in which your thighs will be abducted and bent towards your abdomen, so as to allow for a greater manipulation of delivering your infant.

As with any issues of concern during pregnancy, you will want to discuss with your obstetrician, or midwife, the various risks you may face during labor and delivery. When discussing these risks, conversations with regard to c-section, manipulations during vaginal delivery and even the use of pain medications should be of concern. When faced with a risk for shoulder dystocia, be certain to address which labor and delivery techniques will be used so that you can be best prepared when the labor and delivery process begins.