How you can prevent shoulder dystocia during your labor and delivery in Kingston, New York.
Shoulder dystocia is an obstetrical emergency, and the baby can die if he/she is not delivered due to compression of the umbilical cord within the birth canal. The other major concern with shoulder dystocia is damage to the upper brachial plexus nerves. These are the nerves that supply the sensory and motor components of the shoulder, arm and hands. Excessive tension on the brachial plexus nerves during the delivery can cause permanent damage, known as Erb's Palsy.
What can be done to manage shoulder dystocia once it is encountered? First, the obstetrician or nurse midwife must stay informed of the time that has elapsed since delivery of the baby's head. The obstetrician or nurse midwife has roughly seven minutes after the delivery of the baby's head to deliver the rest of the body before the baby will sustain brain damage. It is critical that the obstetrician keep track of the amount of time that it takes to
deliver the baby, as every second counts once shoulder dystocia is encountered.
Second, the mother's legs should be hyperflexed against her abdomen. This widens the pelvic opening thus allowing for easier passage of the baby. This is known as the McRobert's Maneuver and it is successful in delivering the baby in about 40% of all cases.
A third step that is often used for shoulder dystocia is "supra-pubic pressure", which is the application of force against the mother's lower abdomen in an attempt to dislodge the stuck shoulder. A nurse or obstetrician will put his/her fist just above the mother's pubic bone (lower part of the abdomen) and push the baby's shoulder in one direction or the other. Many obstetricians will use the McRobert's Maneuver and suprapubic pressure at the same time.
If these maneuvers do not dislodge the baby's shoulder and time is running out, another option is to push the baby back up the birth canal and perform an emergency Cesarean Section. This is typically a last resort. However, by pushing the baby back up the birth canal, the doctor has bought more time to deliver the baby since the umbilical cord is no longer compressed by the mother's pelvic bones.
If you are at risk of having a "big baby" and you want a normal vaginal delivery, you should discuss with your obstetrician how he/she intends to manage shoulder dystocia if it is encountered. You should make sure that you are familiar with the management of shoulder dystocia and what you can expect as a patient. Knowledge is power!