Would you mind sharing your shoulder dystocia stories with me?

[Crossfire]

Dear all, if anyone can face sharing their experience of shoulder dystocia I would be really greatful. I'm a first year student midwife and at the moment I'm learning and 'helping' deliver babies. Just a few days ago I I was with a woman who was ready to give birth to her second child, everything was going really well, she was on the entenox and it was all lovely. When you are a junior student you are absolutely guided by your mentor and his/her hands cover yours while delivering the baby. So I was guiding out the baby's head and all was well. We waited for the moment that the baby turns its body and my mentor had said very quietly in my ear 'big baby'. Baby turned and we were waiting for the next contracting for mum to push baby out...at this point there was no movement, I immediately stepped back as I got a funny feeling and it wasn't my place to continue. My mentor slammed the emergency button, shouted shoulder dystocia and seriously about 5 seconds later the room was full of people who immediately went into action ( the only job I could do now was start keepin times and write down who was doing what) I watched while thinking jeeezz and a midwife was pushing down on the pubic bone and my mentor had her hands around the babies shoulders and turned him slightly so the shoulder was released, ( two other midwives practically had mums knees on her nose as well). From after the babies head was delivered to the time baby was out was less than 90 seconds....I was stunned. Baby was all well and had a slight bruise under one arm.

The purpose of the post is not to tell a horror story but to find out if anyone can remember what happened and if they felt they received good care ( as Im wondering if anything could have been done differently). Mum herself said she didn't really know what was going on as she was still on her entenox but felt like she wa going to fall off the back of the bed at one point.

My mentor explained that it's very rare for a shoulder dystocia ( her first in 8 years). I have been thinking about mum and if this is going to traumatise her and also poor dad who was up at her head watching.

After baby and mum were all sorted out they were both drinking tea and eating mountains of toast and chatting away while cooing over their baby....I wanted to slide down the wall in a heap! ( the baby wasn't even that big and I was thinking about how the hell did I get out my own nearly 11 pounder without getting stuck)...... And I was amazed how the midwives all got on with everything in a calm sunny way afterwards...

this sounds very like my story - 3rd baby and no signs of any problems. I was just on gas and air and leaning over a birthing ball so didn't realise what was going on but my husband said he was beside himself when the red button was pushed and the room suddenly filled with people. Again my baby was out within a minute or so and fine. What really helped me and more importantly my DH was the senior midwife who later came and explained what had happened and answered any questions we had. I think at that stage most women would agree the baby's welfare overtakes the mothers so the midwives just do what they need to do, and explain later. It did support my decision not to haver a home birth which my DH was very against for just this sort of reason - not saying it would have been a different outcome at home but obviously there would not have been that level of help available. I have pictures of the whole thing as it was my last baby and I wanted everything recorded! I also noticed the MW were very careful to document everything in great detail, in case of later problems I guess.

Thanks Lucy for sharing your story, my mentor is very fluffy and she went over everything with mum and dad and they were happy with the care they got. I was wondering though if it might come back and hit the parents a few days later when they are going over what had happened. They both seemed fine....next time I saw a big head I thought eek but this 10.6 baby just slid out so who knows why these things happen?!

Interesting to hear a nurse's experience. I was completely oblivious when this happened to me as no-one on the labour ward mentioned it during or after my dc1's birth. Maybe they just didn't want to upset me, given that there was a good outcome, although I still have a few niggles about the experience and would liked to have been told exactly what happened to me and DC1.
The main inconvenience was when Midwife came for homebirth checking in visit for dc2, took one look at notes mentioning shoulder dystocia and McRoberts manoeuvre ( terms I'd never heard of) and completely u-turned on birth plan. I was just annoyed I hadn't been told about implications for any subsequent birth, given it's a serious complication.
HOWEVER these are tiny tiny whinges compared to parents I've come across on these boards whose children suffered long term damage as a result of SD.

No one mentioned it to me either!

Obviously aware that ds1 was not appearing, I also had a student midwife who helpfully mentioned she could not find a heartbeat....I may have been slightly rude in suggesting either she had better find one or get someone in who could and to be pretty damned quick about it and suddenly there were people everywhere, forms being signed, sections being mentioned

I was rattled to theatre, given a spinal block and ds1 was dragged out with forceps as a last ditch before surgery. He had a small scrape on his cheek and until I rocked up at the hospital pg with dd, three years later, not a bugger even thought to tell me a thing about it.

so thanks for that!

So a sightly different SD experience here from those above.

A consultant/senior dr (not 100% sure) was called in as my DS heart beat wasnt coming back up after contractions so they suggested forceps as baby needed to get out (& fast) to which I consented. Head came out and then I heard the words shoulder dystocia. By that point the 'red button' had already been pushed - consultant clearly said 'baby will need resus' (words that will haunt me forever) before his head was even out. So head came out with forceps then SD mentioned, by this time there was already 2 or 3 midwives (plus a student nurse, who was Brilliant by the way). They were able to do the McRoberts thing very quick, even though my legs were in stirrups and baby came out within a minute or so. I'd an episiotomy (which tore also) and ended up with 4th degree tear. So a fairly rare case to have had such a severe tear and SD, statistically. Plus my epidural ran out so I felt EVERYTHING. I think a midwife explained it to me afterwards but with everything else and the pain/stitches, establishing BF etc its a blur. I found most my answers on mumsnet after reading my notes a couple of weeks later.

I am left very traumatised by the whole birth and am currently having counselling for PTSD and PND. However, not as a result of the SD as this is just one of those things that cannot be predicted so I've accepted this. I think SD on its own can be accepted as it is (as far as I know) only 1 in 200 chance of happening, slightly more if you have had this before.

By the way my DS was 8lb 2oz, and arrived at 38 + 4 (the plus 4 being 4 days of labour).

Forgot to say, DS is now 8 months old.

Also, just want to reiterate my student midwife was brilliant. She sat with me the whole time, chatting about anything & everything while writing up notes and even came into theatre when I had to be stiched up (she nearly passed out) to hold my hand, which I was very grateful for. Just to have a familiar face who had been through it all with me made such a difference while my DH was in shock-with-a-newborn-in-his-arms-that-he-had-no-idea-what-to-do-with while I was in theatre meant a lot.

I had an obstetrician-led birth. Was induced with the drip and had an epidural. All seemed fine until the end - ventouse needed about an hour into pushing as DS was becoming distressed. Then all of a sudden alarm thing went off, loads of staff in the room and legs up to ears. DS delivered in about a minute - distressed, but came round very quickly.

No one told me what had happened, they didn't seem to think it was a very big deal to be honest. Small second degree tear (episiotomy). I only saw shoulder dystocia and mcroberts when I looked at my notes. Asked obs about it and he said 'yes, don't worry, it wasn't a bad case of it' in a manner that suggested he'd seen it quite often.

DS wasn't 'big' 8lbs2 but my partner and I are both very small and slight, so maybe he was big for us! I have wondered whether it was my fault for putting on slightly too much weight in pregnancy. I've been assured this isn't the case, but I still wonder.

Calipo I 'blamed' the drip and being made to lie on back for my SD, which the hospital of course refuted. No-one seems to know why it happens, which is quite frustrating but is just one of those things.

FWIW 2nd birth was great, and no problems, despite loads of extra staff in room, just in case it happened again.

As I understand it, the size of the baby has nothing to do with the likelihood of SD. It has more to to with the position of the mother during labour and with augmentation of labour.

The OP would have probably found it more useful to debrief her experience with an experienced midwife rather than on MN. Have you asked or been offered a debrief by your mentor? Had you learned much about SD before this experience? etc etc. I really can't see what can be gained from asking mums about previous SD experiences on here. Sorry I know I am sounding like an a*se so will stop now.

I experienced an s/d at my homebirth with an 11lb baby.

2 independent midwives present. I knew s/d was a risk because I knew I was carrying a large baby, and had read a lot about it. I just wasn't prepared for it to happen in hospital under the care of a dozy midwife I didn't know and trust (hadn't been happy with midwife care in first birth and had lost all faith in hospital) hence organising HB with an IM whose skills I had a lot of trust in. I'd previously to give birth to a nine and a half pounder so was confident an S/D if it happened could be resolved and that the situation wouldn't become a catastrophe.

So - 7 hour labour, pushing for about 40 minutes. Kneeling in bed, ds's head born slowly slowly, and then everything grinds to a halt. Contraction disappears. I'm pushing and nowt is happening. Midwife calmly says, Shag, do you want to get on your back so I can have a look? Calmly says xxxx ( to friend who was supporting), '"can you phone for an ambulance?". I manage to turn myself onto my back, astonishingly, given I have a giant fucking head between my legs, and she feels around baby's neck. She gets me to pull my own legs right back into macroberts and slide her fingers around ds's shoulder. Can't release baby.

Quietly asks second midwife to have a try. Second midwife slides her fingers in, does something, baby moves, rotates, and she hooks her fingers under his armpits and PULLS. Slowly slowly ds is born until hips are released, then he comes out like a cork out of a bottle. Midwife falls backwards off bed and lands on her arse. There has been about 6 minutes in between birth of head and birth of his body. DS lying motionless and dead white between my legs. First midwife rubs him and then bags and masks him. On the bed next to me.. Congratulates me. He cries, pinks up. She bundles him into my arms.

Door opens and in walk 2 paramedics. One, I'm not to out of it to notice, extremely handsome!

They are sent away. I am staggering like a winded horse but midwife gets me into a big herbal bath with candles around the edge and I come out feeling like a new woman.

No episiotomy. Small second degree tear, which I choose not to have sutured. High as a very high kite for days years after the birth.

I'm eternally greatful to my midwives for keeping their emotions under control during AND after the whole event. There was no shouting, no panicky faces during, and no 'phew that was a close one' comments afterward. I feel that women are vulnerable to psychological trauma during a difficult birth and that they pick up on the feelings of fear and panic their caregiver may be experiencing. So apart from learning your HD drill maybe to practice communicating in urgent situations without displaying fear and panic....

Ishel - size of baby can impact on likelyhood of SD. I think 50% of s/d that occur the baby is over 4.5 kg or something.

The thing about SD is that it's one of those truly unpredictable birth implications. You might be more on guard with a known big baby but it's just as likely to happen to your average 7lber.

Implications? Complications.

Benedict - it does often happen with average size babies. But it is MORE likely with a very large baby.

during my pregnancy I knew something was wrong. I asked at the parentcraft classes what happens if the baby gets stuck. They told me that that does not and can not happen! I asked the consultant, who asked me what size my feet were and when I told her 6, she said I'd be fine. I could feel him 'grating', and I just knew. But everyone dismissed me.

They began to induce me on the Wednesday. By the Saturday I was only 1cm dilated! at 9am they took me down to break my waters etc.

In the evening, I started pushing. All of a sudden, the doctor started to scream. She then yelled HELP ME I NEED HELP HELP ME.

A midwife rushed over and pushed a button and a siren sounded. The double doors flew open and a huge number of people rushed in to the room. Someone grabbed one leg and pushed it right up - towards my head. someone else did the same with the other one. Nobody said anything to me or my husband. A midwife kept pushing down on my stomach from the side, lifting herself off the ground! Still, nothing said to either of us. I remember screaming "WHAT'S HAPPENING?"

My son was then born. Grey and not breathing. We thought he was dead. Still nobody said a word to us. They rushed him over to the resusitaire (I know I've spelled that wrong!) and began to work on him. Then he let out a cry and my husband fainted. I then hemorrhaged. Blood gushing everywhere

Our son had painkillers before he had his first food! (He was on painkillers for several days.)

The next day, he was taken to xray to check his collar bone wasn't broken. By this time he was one solid bruise from his head halfway down his back. And his left arm wasn't moving from his side and his hand was at an odd angle.

A midwife told us that he had got stuck and promised to come and explain to us exactly what had happened. I was in for a week with him and I never saw her again. Nor did I ever see the doctor who had delivered him. All we got was that he had a 'poorly arm' and it would get better.

Well. It turned out that what had happened when the doctor screamed is that instead of performing the mcroberts manouvre she had PULLED HIS HEAD so hard that she had caused permanent nerve damage and left him with Erbs Palsy. The midwife had apparently then pushed her out of the way and it was the midwife who got him out.

he was 10lb 4oz (my next baby was 10lb 5oz, care was superb and he came out just fine)

They never apologised. They all avoided us because they knew what they'd done. They LIED in my notes, which were written retrospectively. We sued and they settled. for nearly £300,000. (now in trust for my son)

My son has had 2 operations and today, aged 13, has very reasonable function in a 'box area' at the front but nothing outside of that and practically no tricep muscle. His elbow is weird, he is at constant risk of shoulder dislocation, he can't raise his arm straight above his head, tuck it up his back, he struggles with buttons, only managed to start doing his own laces this year, his shoulder 'wings' and his arm is slightly smaller than the other one.

I suffered severe pnd - psychosis actually. I thought he had died and been replaced by a demon, and I used to sit there working out how they would have cut him up in order to get him out. I used to shake and sweat when I changed his nappy etc.

What I can't forgive is how they went straight into Cover Our Arses mode.

Oh, and it was several years before I could talk about it without breaking down completely. And I still cry, shake and feel sick if I watch anything to do with birth on the tv.

Oh God, Hecate. I am more traumatised now by my SD than I was at the time, I think because I find it do frustrating not knowing why it happened, and so scary knowing how close we came to disaster, but your story is heart wrenching. I'm so sorry.

My story is long-I hope it's ok to link to my blog where I've already written it. SD Birth story

Hecate and

Your story is shocking. You were very brave to try for another vaginal birth after such a difficult experience.

this discussion of Shoulder Dystocia very interesting

I didn't want another child! But I had a pill failure and once he was in there, I had little choice. I had also been told by a midwife (you know the ones you see during pregnancy) that if I had a cs, because I was so fat, I'd probably die on the table (I'm paraphrasing, but that was basically it. She was a vile, sneering, spiteful woman.) So I was terrified and said only cs if the alternative is my baby will die.

Reading this thread makes me feel hugely grateful for the skill, tact and kindness of my midwives.

DS got his shoulders stuck - so after 28 hours of labour and 2 hrs of pushing got taken down to theatre for forceps trial and possible section. Consultant only got one forcep on before giving up - apparently could feel that I'd been pushing right and he was just firmly wedged.

I had SD with DD, my second baby. I was kneeling on the floor at the foot of the bed, pushing, still with my tens machine on and the entonox tube in my hand. It seemed to be going well, then the midwife said she was just going to call in another midwife for assistance. The second midwife pressed on my lower abdomen, I'm not sure what the original midwife did but she asked me to spread my legs a bit wider, and she was wearing one of those full face perspex masks like the police wear during riots!
In the meantime, the emergency button had been pressed and about 7 people rushed into the room and just sort of stood there. I remember being aware of a lot of people (I could only see their feet) but thought I wouldn't ask why, I'd just concentrate on pushing! DD was out very soon after they all arrived anyway.
They didn't do McRoberts, which seems to be the most common practice for SD, they did the something corkscrew manouvre and another one (will look up proper names once DD has woken up, she's on my lap and I'm trapped). No long term effects, luckily, just a small amount of bruising on DD and a second degree tear on me. DD was 10lb 5oz, I'm normally dress size 8.
In the postnatal ward, every new HCP who came to talk to me had a concerned look on their face and greeted me with the words 'I hear you had a very traumatic birth'. I found this quite confusing as compared to DS's 36hr failed vonteuse, episiotomy, forceps birth, DD's was a doddle!

I can't believe it's that rare either - I know at least 3 or 4 people who have had SD.

"they did the something corkscrew manouvre and another one"

Woods' screw? (ooer!)

"every new HCP who came to talk to me had a concerned look on their face and greeted me with the words 'I hear you had a very traumatic birth"

good grief,when will HCP learn that disgorging themselves all over their patients in this way isn't helpful following a difficult experience?

Obviously someone has to answer questions and check on how mum is feeling,but I honestly think telling her that she's just missed losing her baby by the skin of her teeth is UNHELPFUL.