Imagine you’re in the delivery room, in prime position. In a short while, you’ll meet your precious little one who’s been in the oven for the past 9 months! Then suddenly, your doctor tells you to stop pushing!
This can happen if you’re experiencing shoulder dystocia. You might be asking yourself “is labour not stressful, enough?”
However, this is an unpredictable medical emergency that’s uncommon, and can happen to anyone! Here’s a breakdown of what it is and what you can do if it happens to you.
What is shoulder dystocia?
Image source: Pregnancy Birth & Baby
So to explain what is shoulder dystocia and when does it occur, it’s important to understand the labour process (if you aren’t already familiar).
In a nutshell, there are four stages of labour:
- Cervix opening (increased contraction rate)
- Getting ready to push to deliver the baby
- One last push to get the placenta out
- Postpartum changes
The medical emergency can happen during the second stage—preparing yourself to push and deliver the baby. There’s normally a pause after the baby’s head is born and just before the body comes out.
If shoulder dystocia happens, this delay is longer because the baby’s shoulder is stuck behind the mother’s pelvic bone.
When this happens, the baby can’t breathe and the umbilical cord can become squeezed.
This happens in approximately 1 in every 200 births. It’s more common during natural, vaginal births. However, it’s worth noting that shoulder dystocia can also take place during a C-section.
Risk factors for shoulder dystocia
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Mums-to-be, some people will be at higher risk than others of experiencing this medical emergency. Knowing these risks beforehand helps minimise the chance that shoulder dystocia will happen to you and your baby.
If you have gestational diabetes, this increases the risk by 2 to 4 times! You can prevent getting maternal diabetes by sleeping more!
If your fetus is heavier than 4.5kg or the mother’s BMI is higher than 30, these also increase the risk of your baby’s shoulder getting stuck during labour.
What you should do if shoulder dystocia happens?
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If this happens to you, don’t panic. The delivery team will give you support and advise you on how to cope.
It’s normal to worry that the baby isn’t coming through and to push harder. However, your doctor and midwife will tell you to stop pushing! It’s important not to force the issue or you could cause more harm to the baby.
Your doctor will likely advise you to try the McRoberts Manoeuvre. The technique simply involves raising your knees closer to your chest. The midwife or doctor will then gently press on your stomach to help free the baby’s shoulder from the pelvis bone.
This improves the angle of delivery and increases the delivery success rate by 90 per cent!
Alternatively, your doctor may ask you to adopt an all-fours position. They will reach inside your vagina to physically dislodge your baby’s body. However, you’ll have to undergo an episiotomy before this step.
And in really rare cases, your doctor may need to break the baby’s collarbone so he/she can come out. However, rest assured that it heals very quickly.
Generally, babies recover well following shoulder dystocia. But because they were briefly oxygen-deprived, your baby will be placed under further observation in the neonatal intensive care unit.
You also might undergo shock or feelings of guilt for having difficult labour. Your midwife and doctor will assist you in coping with these emotions.
So there you have it! Shoulder dystocia is unpredictable and can happen to anyone, even though it is quite rare. But it is definitely worth knowing what happens in the case if your baby’s shoulder ever gets stuck on your pelvic bone.
Know anyone who’s pregnant? Why not share the knowledge and this article with them?
References: American Family Physician