Shoulder dystocia

Shoulder dystocia occurs when a baby's head is delivered through the vagina, but his shoulders get stuck inside the mother's body. This creates risks for both mother and baby. Dystocia means slow or difficult labor or birth.

Although there are risk factors for shoulder dystocia, health care providers cannot usually predict or prevent it. They often discover it only after labor has begun. If your baby is very large (called macrosomia) before birth, your provider may recommend that you have a cesarean section (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

Are some women more likely than others to have shoulder dystocia?

A pregnant woman may be at risk for shoulder dystocia if:

  • Her baby is very large. (But in most cases of shoulder dystocia, the baby's weight is normal. And for most very large babies, shoulder dystocia doesn't occur.)
  • She has diabetes.
  • She is pregnant with more than one baby.
  • She is obese.
  • She gives birth after the baby's due date.
  • She had a very large baby or a shoulder dystocia in the past.
  • Her labor is induced.
  • She gets an epidural to help with pain during labor. An epidural is pain medicine you get through a tube in your lower back that helps number your lower body during labor. 
  • She has an operative vaginal birth. This means that her provider uses tools, like forceps or a vacuum, to help the baby through the birth canal. 

Shoulder dystocia may occur when the woman has no risk factors.

How can you have a safe birth?

In most cases, a baby is born safely. Here are some things that may be done:

  • Pressing the mother's thighs against her belly.
  • Applying pressure to the mother's lower belly.
  • Turning the baby's shoulder while it is still inside the mother.
  • Cutting a wider opening in the woman's vagina (an episiotomy).

What complications can shoulder dystocia cause?

Usually, the mother and the baby do well and have no permanent damage. But there may be some complications. For the baby, risks include:

  • Injury to the nerves of the shoulder, arms and hand. This may cause shaking or paralysis. In most cases, the problems go away in 6 to 12 months.
  • Lack of oxygen to the brain. In the most severe cases, which are rare, this can cause brain damage and even death.

Complications for the mother include:

  • Heavy bleeding after birth
  • Tearing of the uterus, vagina, cervix or rectum

In most cases, complications can be treated and managed.

Last reviewed: December, 2013