One of the things we feel proud of here at Ye Gads is a no holds barred approach to pregnancy and birth and sometimes this means sharing experiences that are not so pleasant.  If you’ve been attending antenatal classes, you will have been learning about how to get through labour successfully, even if that means an emergency c-section, and you’ll understand roughly what is happening and why.  But what if things start to go pear-shaped?  Classes tend not to spend much time (justifiably) on what can go wrong but the reality is that sometimes things do go wrong and, while you can never be prepared for it, perhaps the experiences of someone else can help you feel not so alone, should the worst (God forbid) happen.

One obstetric complication faced by a member of the team here was shoulder dystocia.  This is a rare situation, occurring in approx 0.5% of births…and one which medical staff train for, but which they may never encounter in their career.  Shoulder dystocia means “stuck at the shoulders” and is the situation where the head has emerged but the shoulder gets stuck behind the mother’s pubic bone.  When it occurs, it is a race against time to free the stuck shoulder before lack of oxygen causes brain damage or even death of the baby.

There are a number of procedures that the medical team will follow to try and free the baby – all of which are pretty scary to watch however, this is one of those times where you have to put your trust in them and believe that they will do the best they can.  When they do get the baby out, he/she will often be taken away to be checked over by the neonatal doctor as there are a number of injuries that can have occurred.  Injuries can range from a broken collarbone, brachial plexus injuries to brain injury or damage.  Brachial plexus injuries are fairly common and occur when the nerves in the baby’s neck are temporarily or permanently damaged during the attempt to get the baby out.

The most common type of brachical plexus injury is Erb’s palsy.  This affects the muscles in the upper arm and can cause the arm to be held in an abnormal position called “winging”. The wrist can also be affected being positioned backwards and outwards in what can be described as “waiters tip”.  A less common injury is Klumpke’s palsy, affecting the elbow and forearm.  Most brachial plexus injuries will resolve spontaneously over time as the nerves heal and repair. This is usually aided by extensive physical therapy to help strengthen the muscles and keep movement in the joints.

As well as injury to the baby, the mother can also suffer excessive blood loss through tears and lacerations caused during the delivery and damage to the pelvis as they try to remove the baby.

As we mentioned above, situations like these are rare and there’s no need to panic or worry that it’s going to happen.  Worth noting perhaps are some of the risk factors associated with shoulder dystocia such as:

·         If your partner has diabetes or is overweight before pregnancy

·         If they are short or an older mother

·         If there is excessive weight gain during pregnancy

·         If they develop gestational diabetes

·         If shoulder dystocia occurred in a previous birth

·         If during the birth there is a prolonged second stage

·         If there is protracted decent or head fails to descend

·         If the baby is large (over 4kg)

·         Delivery via ventouse or forceps

It’s not possible to predict whether shoulder dystocia will occur during a birth but, like everything else, do not be afraid or embarrassed to ask questions of the medical staff if you do have a concern about this or anything else.  As the guy (and the one with the straight head, unaffected by any kind of pain relief) it’s your job to speak up for your partner and baby.