25 Facts About Shoulder Dystocia

25 Facts About Shoulder Dystocia

At Sommers Roth & Elmaleh in Toronto, we have been helping families affected by medical errors, including the failure to diagnose serious medical conditions, for more than 40 years. We are extremely technically proficient and very knowledgeable about Canada’s medical system and how it interacts with the law. We have an excellent record of obtaining substantial financial compensation for our clients and are well-regarded and respected as leaders in the field.

In addition to being passionate advocates for our clients’ rights, we are equally passionate about educating our clients and regularly provide them with the resources they need to better understand what may have happened to their child, and what they can do to move forward.

This week, we look at 25 facts about shoulder dystocia, including factors that may help predict it, how to properly address it during delivery, and what legal recourse parents can have if it is not.

  • Shoulder dystocia is a complication that occurs during delivery when one or both of the baby’s shoulders become lodged in the birth canal, often because the baby is proportionately too large to fit through.
  • It can also occur when a baby is positioned in such a way that it makes it difficult for them to exit the birth canal, such as face-first or feet-first.
  • Indicators of shoulder dystocia during delivery are that the baby’s face may be red and puffy face once the head is visible, and what is known as the ‘turtle sign’, which is when the head appears and then retracts back into the birth canal.
  • Due to time sensitivity, doctors may panic in a delivery involving shoulder dystocia and pull or maneuver the baby too strenuously, resulting in injury to the baby.
  • When attempting to free the baby from the birth canal, physicians may cause injuries such as brachial plexus palsy, broken bones, and facial injuries.
  • Neonatal brachial plexus palsy occurs when the network of nerves that sends signals from your spinal cord to your shoulder, arm and hand (the brachial plexus) becomes injured through excessive stretch, resulting in numbness or weakness or even permanent loss of movement in the arm on that side.
  • Horner’s syndrome is an injury characterized by facial asymmetry most often in the eyes. The affected eye can have a smaller pupil, a droopy eyelid or elevated lower lid, and the iris may be a lighter colour than the non-affected eye.
  • Shoulder dystocia also presents possible health implications for the mother, such as hemorrhaging, uterine rupture and lacerations.
  • Shoulder dystocia occurs in approximately 1 in every 200 births
  • Shoulder dystocia is more likely to occur in births where one or more of the following factors are present:
    • Maternal diabetes
    • Prolonged labour and delivery
    • Induced labour
    • Maternal obesity
    • Epidural use
    • Fetal macrosomia (a newborn with a birth weight of 8 lbs., 13 oz. or higher)
    • Past deliveries with shoulder dystocia
  • In cases where one or more of the previously listed factors are present, it is advisable that the medical team take steps that will better enable them to handle shoulder dystocia should it occur.
  • These steps can include ensuring additional staff members are on hand at the time of delivery, preparing additional anesthetic, and selecting an OB-GYN with experience in treating shoulder dystocia.
  • It is critical that doctors and staff react quickly if shoulder dystocia occurs because once delivery has begun, the baby cannot breathe properly until their entire body has been fully delivered.
  • There are recommended procedures in place if shoulder dystocia occurs during delivery, and if executed properly, they can help prevent injury to both the baby and the mother.
  • The McRoberts maneuver involves hyper flexing the mother’s legs tightly against her abdomen, which allows for rotation of the pelvis and can assist in releasing the baby’s shoulder from where it is stuck.
  • If that maneuver is unsuccessful on its own, pressure can be applied to the lower abdomen (also known as suprapubic pressure) to facilitate freeing the shoulder.
  • It is critical not to pull on the baby’s head or limbs, but rather to use gentle pressure to reposition the baby so that it can be delivered safely. Aggressively pulling or shifting the baby is the primary cause of injuries in these types of cases.
  • In some instances, an episiotomy may provide more room to maneuver the baby through the birth canal.
  • When injury results, treatment may be possible where the brachial plexus nerves are ruptured rather than torn completely. In cases of rupture, a nerve graft may help to repair the damage caused. If the nerve has been torn completely, this treatment will not be an option.
  • Other methods may help to restore some function, such as aggressive physiotherapy and occupational therapy, or surgical intervention.
  • In cases of injury due to shoulder dystocia, victims may be entitled to compensation where doctors failed to recognize common risks or failed to take the necessary steps to address the issue once it became apparent.
  • In addition to compensation for the injuries themselves, there may also be an entitlement to special damages to address past and future income loss, necessary home modifications, attendant care services or even the purchase of a new home closer to necessary medical services.
  • If you think you or your child suffered injuries related to shoulder dystocia, you may have grounds for a lawsuit that could allow you to receive compensation to provide financial security for yourself and your family.
  • Many children with obstetrical brachial plexus palsy caused by shoulder dystocia are treated in Toronto’s Hospital for Sick Children (Sick Kids) Brachial Plexus Clinic (a subdivision of plastic surgery)
  • Sick Kids Brachial Plexus clinic is headed Dr. Howard Clarke (a plastic surgeon), Dr. Kristen Davidge and Dr. Sevan Hopyan. It has been around for over 30 years. The Brachial Plexus Programme at the Hospital for Sick Children is the largest in Canada and developed both the Active Movement Scale and the ‘Cookie Test’.

      At Sommers, Roth & Elmaleh, our goal is to protect the rights of children and parents whose lives have been impacted by shoulder dystocia resulting from the medical team failing to properly prepare in situations where it is more likely, or failing to follow the steps that can help to facilitate the birth without injury. Over the years, our lawyers have won some of the largest medical malpractice awards in Canadian history for our clients. We offer contingency fee agreements. Call us at 1-844-777-7372 or contact us online for a free consultation.

      Disclaimer and Liability Exclusion

      The information on this page is provided for general information purposes only. It should not be construed as legal advice. It does not constitute legal or other professional advice or an opinion of any kind. Readers should seek specific legal advice regarding any specific legal issues. We do not in any way guarantee or warrant the accuracy, completeness or quality of the information on this page. The posts on this page are current as of their original date of publication, but they should not be relied upon as timely, accurate or fit for any particular purpose.

      Accessing or using this web site or the content herein does not create a lawyer-client relationship.

      This page may contain links to third party web sites. We are unable to, and do not, monitor and guarantee the quality of the information disseminated and accessible through those links, which are provided for convenience only. We do not endorse the information contained in linked web sites nor guarantee its accuracy, timeliness or fitness for a particular purpose.

        If you have been affected by medical malpractice anywhere in Canada contact us for a free consultation.
        You pay us nothing unless we win.



        A lawyer from Sommers Roth & Elmaleh will be in touch with you as soon as possible. Please note that no lawyer-client, advisory, or fiduciary relationship is created by your inquiry. All information provided is confidential.

        The above information is not legal advice. Past results of cases and recoveries by our medical malpractice lawyers against hospitals, doctors, midwives, nurses and other healthcare professionals are not necessarily indicative of future results. The amounts recovered and other litigation outcomes will vary according to the facts in individual cases.


        See Our Lawyer's Reviews

        Hilt this Tamrate
        Hilt this Tamrate
        23 May 2023
        Trustindex verifies that the original source of the review is Google.
        Dear Mr Hilik Y. And Jeremy Syrtash. I would like to express my deepest gratitude to you and Sommers Roth and Elmaleh Professional Corporation staff for all you have done with respect to my wife case. My wife was a victim of Medical Malpractice after giving birth to our daughter. She become legally disabled both physically and mentally. The entire family devastated emotionally as my wife struggle to cope with the new reality. The case of Medical Malpractice is quite often a complex case to prove. However, due to your strong commitment, knowledge and dedication combined with strong professionalism the case was successfully won after a long arduous fight. The victory would not have been possible without your dedication and thorough research in the implementation of the standards of the Sommers Roth and Elmaleh Professional Corporation. Justice prevailed at last which in turn allowed my vulnerable wife to feel more optimistic about her future and that of our family. The positive outcome of this case has changed our lives forever. It would not have been possible without the excellent representation of Sommers Roth and Elmaleh Professional Corporation and its legal counsel. My wife and I will be deeply grateful for the successful outcome of this case for many years to come. Solomon Regassa
        Hector Cardenas
        Hector Cardenas
        4 January 2023
        Trustindex verifies that the original source of the review is Google.
        I would like to take this opportunity to express my most sincere gratitude towards Sommers Roth & Elmaleh, from the day I met with Hilik and his team, they been not only highly knowledgeable but also extremely sensitive towards me and my family, providing us with the best legal service possible. It goes without saying, that I strongly recommend them to anyone looking for a charismatic, quality and result oriented legal team.
        JERRY ZHOU
        JERRY ZHOU
        10 October 2022
        Trustindex verifies that the original source of the review is Google.
        We deeply appreciate Sommers Roth & Elmaleh for their professional skills and hard-working through the whole process of my son’s case. I still remember the first conversation we took with Mr. Hilik Y Elmaleh in his lawyer office sixteen years ago. From then on, your dedication, patience, understanding and continuous communications kept our encouragements and expectations for my son and our family. With the case settled down, my son can receive the full financial support, continuous therapies and finishing his university course. It is no doubt to say that Sommers Roth & Elmaleh not only changed our family’s life but also did contributions to the society, because my son can grow in a happy and health way in his teenage and receive university education from this autumn. Again we hereby strongly recommend the services provided by the lawyer office Sommers Roth & Elmaleh to those who needs the similar legal consultation and support. Even the door of your family was closed by some unfortunate events, there are more windows can be opened. The lawyers in Sommers Roth & Elmaleh are exactly the people who can open the windows and convert the sun-shine again to your family: Mr. Hilik Y Elmaleh,Mr.Jeremy Syrtash, Miss Fanny Peter ...etc. Finally, we express the deepest gratitude and appreciation again to Mr. Hilik Y Elmaleh and lawyer office Sommers Roth & Elmaleh. Wish a brighter future of Sommers Roth & Elmaleh !
        Meggie Zhangkrk6hdjybfjt
        Meggie Zhangkrk6hdjybfjt
        6 October 2022
        Trustindex verifies that the original source of the review is Google.
        I am so glad that my son's CP medical case was completely successful. I appreciate lawyer Hilik Elmaleh, Jeremy Syrtash, Fanny Peter and their team's hard work. They are so knowledgeable, responsible and reliable. Thanks is not enough to express my gratitude. Mr. Hilik Elmaleh deserves "The Best Lawyer in Canada" award.
        Tony Zhou
        Tony Zhou
        29 September 2022
        Trustindex verifies that the original source of the review is Google.
        I would like to extend my gratitude towards Mr. Hilik Elmaleh, Jermey Syntash, and Fanny Peter for their dedication, time, effort, and knowledge invested into my case. This is honestly the best team of lawyers in Canada. I would highly recommend them for any of your cases.
        Dianne Keckes
        Dianne Keckes
        18 July 2022
        Trustindex verifies that the original source of the review is Google.
        I would like to take this opportunity to thank our daughter's "Dream Team", Hilik Elmaleh, Jeremy Syrtash and Fanny Peter. The compassion, dedication, knowledge, experience and their recognition in the legal community have ensured us that we were on the right track working with the firm Sommers, Roth and Elmaleh. Words cannot express enough my gratitude! I will be forever grateful!
        Ivica J Sokic
        Ivica J Sokic
        6 June 2022
        Trustindex verifies that the original source of the review is Google.
        Thank you does not begin to express the depth of gratitude I have for Sommers Roth & Elmaleh Professional Corporation. From the first day I sat in Hilik's office, not once did I feel apprehensive. My concerns and worries were put at ease due to the kindness and compassion of Hilik, Jeremy and Fanny and their relentless persistence to secure my daughter's future. This has been a long but successful endeavor during some difficult times and through it all, the Team has been resilient, informative and were always available. I highly recommend this dedicated and professional law firm and I will be forever in their debt.
        Arden Melnechuk
        Arden Melnechuk
        1 December 2021
        Trustindex verifies that the original source of the review is Google.
        I was in a serious horse accident where the horse was injured and should never have been ridden. The owner of the horse was aware that the horse had chronic arthritis issues and the veterinarians at Guelph had told him the horse could decompensate at any time and could cause serious injury whether being led or ridden and could never be jumped again. The horse had been shown at the grand prix level and the owner had payed quite a bit of money for him. After consulting with several lawyers and having one that did represent me at the discoveries who later quit, Jeremy Syrtash took on the case and followed through with guelph university. That is how we found out that the vets had recommended the above. Without Jeremy's efforts and follow through the case would never have continued on. Because of these efforts the case was successful. Thank you so much Jeremy. You are a dedicated, thorough, excellent lawyer and it's been a pleasure to have you as my lawyer!!
        Megha Sharma
        Megha Sharma
        16 April 2021
        Trustindex verifies that the original source of the review is Google.
        Mr. Elmaleh and his team are very professional and experts in their field. Recommend to everyone who has suffered medical negligence.
        Nick & Whitney Maraschiello-Basnett
        Nick & Whitney Maraschiello-Basnett
        18 July 2020
        Trustindex verifies that the original source of the review is Google.
        We want to start by saying how much we highly recommend Sommers, Roth and Elmaleh for anyone who is dealing with a situation involving medical malpractice. Hilik and the entire firm have allowed us the opportunity to give our little girl the life she deserves. There is no taking back what happened, but they truly turned such a tragedy into a victory. They fought long and hard, and put forth so much time and effort into making the individuals accountable and responsible for the mistakes that were made. They always showed true compassion for our family, guided us with ease, and supported us through every step. This was such a life changing experience with the firm, and honestly we will always be forever grateful and thankful.