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Does Shoulder Dystocia Always Happen with Brachial Plexus Damage?

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It’s a Common Misconception that Brachial Plexus Injuries only Happen because of Underlying Shoulder Dystocia.

Many birth injuries result from the forceful expulsion of a baby from the womb to the outside world. Sometimes, the birth injury happens due to the disproportionate size of the fetus to the mother’s pelvis, and at other times, the fetus’s position is the culprit. Other causes lie in the mother’s or fetus’s health and the birth assistant’s errors in delivering a baby under stressful conditions. Both common birth injuries, shoulder dystocia and brachial plexus injury often occur together, although one condition does not necessarily cause the other. Either injury, however, can cause an infant to suffer temporary or permanent damage.

Common Circumstances Associated with Shoulder Dystocia and Brachial Plexus Injury

Brachial plexus injury occurs most often during a breech birth when the baby delivers feet first. It can also occur during prolonged labor, which may be due to a baby weighing more than eight pounds and delivery of a baby whose shoulders are wider than the mother’s birth canal. Shoulder dystocia is a related injury occurring due to the fetus’s poor positioning at birth or disproportionate size to the mother’s pelvis. To leave the birth canal safely and smoothly, a fetus must rotate its shoulders in the pelvic region to be optimal for delivery. When one or both shoulders get stuck behind the mother’s public bone, the mother may not be able to push the baby out, and emergency help is necessary. In addition, the baby’s oxygen supply can diminish when the umbilical cord squeezes. Fetal asphyxiation can lead to brain damage or death, while a baby stuck in the birth canal can lead to collarbone and upper arm fractures.

Nerve damage from the neck and shoulder stretching can cause paralysis in the shoulders, arms, and hands or speech problems. An obstetrician must maneuver the fetus or make room in the mother’s pelvis to avoid devastating injury or death. Sometimes a physician must break the fetus’s collar bone to allow the descent from the birth canal or move the arm stuck behind the fetus. Shoulder dystocia may result from the mother’s health conditions, such as gestational diabetes or obesity, or labor inducement medication.

Are all Brachial Plexus Injuries Caused by Shoulder Dystocia?

Since shoulder dystocia and brachial plexus injuries arise from similar situations, they often appear together. An infant may be born with both injuries. However, one does not necessarily cause the other. Both occur when poor positioning or fit between baby and mother combined with forceful pushing during a vaginal birth wrenches the baby’s neck or shoulder. Recent studies show that the two conditions may co-occur but are not always causally related.

Maternal health conditions may increase the likelihood of one injury or both; for example, diabetes is a high-risk factor. Mothers with diabetes typically have bigger babies and, thus, longer deliveries. And yet, brachial plexus injury can occur with or without shoulder dystocia injury. The studies concluding no causal connection between the two injuries infer that the physician’s maneuvers to assist delivery in cases of shoulder dystocia do not necessarily result in brachial plexus injuries. They note that brachial plexus injuries may occur before the doctor maneuvers the baby for delivery, and less than half of the cases are related to shoulder dystocia. However, shoulder dystocia does increase the risk of a brachial plexus injury. Other studies point to a higher brachial plexus injury rate corresponding with more maneuvers to get the fetus’s shoulders unstuck, including repositioning the posterior arm.

Still other research focused more on the correlation of maternal high-risk factors, such as age, multiple births, and previous incidences of shoulder dystocia or brachial plexus injury. Addressing maternal factors lowered the incidences of brachial plexus damage with shoulder dystocia. Other investigations yielded results that correlated higher maternal and baby weight to higher incidences of brachial plexus injury but only about half of all cases studied showed a causal relationship between shoulder dystocia and brachial plexus injuries. Thus, the aggregate of recent studies correlates brachial plexus injury with shoulder dystocia in about half of birth injury cases where both occurred. Contributing factors include high-risk maternal factors, more physician maneuvers, and the repositioning of the fetus’s rear-positioned arm.

What are Doctors Responsible for?

During labor, doctors must make quick decisions to protect the mother and the baby when delivery stalls due to a stuck shoulder or shoulders. The results may be dire when they make mistakes, improperly maneuver the fetus before exiting the birth canal, or inexpertly reposition the fetus’s arm or body before attempting vaginal birth. As a result, babies die, mothers hemorrhage or permanent injury to either or both occurs. In addition, a birth injury can mean emotional and financial devastation. From the neonatal ICU to countless doctor and therapy visits, children born with birth injuries may need life-long services. If your obstetrician caused your baby’s brachial plexus or shoulder dystocia injury, find out which legal remedies are available to you and your child by contacting our New Jersey attorneys today for a free consultation.

Know Your Rights and Legal Remedies in New Jersey

You should not have to endure financial hardship and the emotional toll of watching your baby suffer. Instead, contact our team of birth injury lawyers to review your case free. You may have questions about your doctor’s part in the birth outcome and what you can do about the damages they caused your family. Knowing the steps you must take and the options available can give you some relief. Since birth malpractice actions are complex, demanding, and difficult to master without constant and long-term practice in this area of law,  you can count on our experienced attorneys to establish how and when negligence occurred in your child’s birth, further support a claim for compensation through expert reviews, testimony, and reports of your case, negotiate a settlement, or pursue the highest verdict through trial litigation.

Call (866)-708-8617 for a no-obligation, confidential, and cost-free consultation with a New Jersey birth injury lawyer to discuss your child’s brachial plexus and shoulder dystocia injuries. We can explore whether you have a claim and fight for top compensation for you and your family.

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