Shoulder dystocia

Mimi2RN, ASN, RN · Aug 23, 2011

It's better for the baby to have a deliberately fractured clavicle than to be stuck with the head out. Clavicles heal, a baby that's down at delivery could have permanent damage.

NurseNora, BSN, RN · Aug 23, 2011

If you Google shoulder dystocia most of what you find will be from lawyers looking for business--interesting, some of them. There is at least one very good video on U Tube (You Tube?) showing just what happens when the shoulder gets stuck behind the symphisis and how the various maneuvers work to free the shoulder.

miss81, BSN, RN · Aug 23, 2011

We have some old fashion Docs that will ask you to perform fundal pressure! That's a BIG NO NO! There is a place and time for it, but this is not it! I guess they don't get the mechanics of how the baby is stuck. Otherwise they wouldn't ask you to do it!

**canoehead, BSN, RN** · Aug 27, 2011

Shoulder dystocia is better than a sudden code blue for adrenaline rushes. You will be shakey for days, even with a good outcome. Baby can be born with lovely gray-blue bruising from the neck up, and it can take a few days to clear. If you're alone in the room hit that code button early, hemorrahge and serious lacerations can follow a stuck infant.

halkogirl · Sep 5, 2011

My first son had shoulder dystocia. They pushed my legs back as far as they would go and the nurse got on the bed and pushed with her fist. I couldn't see what the doc was doing but I swear his arms were in up to his elbows trying to do something. I passed out from the pain right after he was out. I ended up with a 4th degree lac- my son had just a bruise on his arm. My doc, who is family practice, called in a OB to sew me up, as I was hemorrhaging. It was the scariest thing ever.

Childbirth can be stressful even when things go right. From a patient perspective, and after giving birth again, I can tell you that any mom that goes through it needs a little extra care. I couldn't even sit up right to breastfeed because of the lac. Coughing or sneezing made me cry. I couldn't even drive a car for two weeks afterward because I couldn't turn my head from side to side well enough to check my blind spot. On top of the pain from the lac, I was worried about my son being hurt and bruised. I wish that someone had addressed my psychological needs more when I was in the hospital. I know that it is not just the nurse's job, but if it effects nurses emotionally, imagine how the mom feels. My nurses were great, but I wish I had a little more emotional support while I was in the hospital. Just my two cents.

On a brighter note, my second son was delivered by two wonderful nurses. I went from being dilated 3 cm to 8 cm in 15 mins, from 8 to 10 in two minutes, and from 10 to baby in three minutes. Doctor showed up about 10 minutes after he was born. My doctor quit delivering babies shortly after- I wonder why? :)

Bridget41040 · Oct 10, 2011

I'm a RN just getting into postpartum hoping to eventually get in L&D, but my experience with shoulder dystocia comes from experiencing myself. I'm 5'2 and delivered an 10 pound 15 ounce baby on my due date... all natural. The entired labor from water breaking to delivery was just over 6 hours.... and the only complication, the only part that was truly painful for me, was the dystocia part... specifically as the doctor dug his hands trying to pull the baby out! They say that size doesn't always matter for dystocia, it can happen to smaller babies too, and position is a key factor as well. They tried almost everything with me, except for he Gaskin manuever. They never had me try going on my hands and knees to open the pelvic cavity. Maybe they were too rushes and freaking out to try that one. I was flat on my back, they pull my knees back but to be honst I don't think that helped. The doctor thought he fractured my baby's clavicle. I felt a pop and he was out... 5 minutes?? I didnt look at the clock but it felt like it was a lot longer than that. My baby was healthy, no broken clavicle... though it took him a few days to really use that arm and my doctor says it was one of the scariest births he attanded.

If I have another baby again, I know I'm totally at risk for delivering huge babies. But I'm a big believer on positioning. With the last one I layed flat on my bad (because that was most comfortable for me), had no pain meds and the labor was totally managable using self-hypnosis (any of you heard of hypnobabies? amazing!)... but I would attempt to labor in position that open my pelvic cavity more so the baby wouldn't get stuck.

Everyone was totally freaking out on me though. Yelling, frantic, screaming for me to push. Please don't do that to your patient. I finally had one nurse, calmly, but firmly MAKE me look her in the eye and push with me. There was something peaceful about her. I was able to keep pushing despit the horrid pain because I felt like she connected with me.

SE_BSN_RN, BSN · Nov 11, 2011

My second son had shoulder dystocia....I knew exactly what was happening when I heard my doc say "We need more nurses in here," and my nurse began pushing on me...and I began to push as hard as I could...but for crying out loud be careful not to "yank the legs back" too fast and hard....a friend of mine had that happen to her and now she has nerve problems because of it.

My poor baby had a bruised face, and I think my OB manually broke the clavicle. Now the little pain is a 5 year old inquisitive kiddo with no problems what so ever....runs me ragged! My OB nurses were awesome with the births of all my kids.

Forgot to say, though, that I had a 3rd degree tear and I was so swollen I couldn't pee. I was begging for a catheter, I hurt so bad. My nurse brought cotton balls soaked with peppermint oil and put them in a hat for me. I have never been so relieved to pee in my life!!