Stern Law is led by Principal Solicitor, Terry Stern, one of the most experienced medical negligence lawyers in NSW with over 35 years’ experience in the field and an Accredited Specialist in Personal injury Law.
Our Commitment: Stern Law is dedicated to a team approach, drawing on a variety of skills and backgrounds in medical negligence law to achieve the best results for our clients.
At Stern Law, we hold a strong interest in birth injury claims, believing that women deserve the right to compensation, following childbirth trauma.
Birth complicated by shoulder dystocia is a life threating condition for unborn babies and their mothers. Concerningly, professional negligence by clinicians in the birth space can contribute to or worsen the likelihood of poor health outcomes including birth injury.
In Marchlewski v Hunter Area Health Service Matter (1998),1 the plaintiff suffered nervous shock occurring from the death of their baby, Maria, during birth. Maria suffered brain damage caused by asphyxia as a result of a prolonged shoulder dystocia which was poorly managed due to outdated hospital guidelines and inadequate skills training of staff. The staff of the birth unit were not familiar with the McRoberts manoeuvre which would have facilitated birth in a timely manner. There were multiple risk factors (including measuring large for gestation and increased amniotic fluid on Ultrasound) which should have been considered so that a more experienced senior obstetrician would have attended the birth. The plaintiff received $200,000 in general damages.
(Image Source: Nucleus Image)
Should I pursue a claim in medical negligence for shoulder dystocia?
To pursue a claim in medical negligence our team can prove the practitioner failed to meet the standard of care by:
Failing to recognise and diagnose the signs of shoulder dystocia.
Failing to respond to the acute nature of a shoulder dystocia emergency and escalate to experienced staff appropriately.
Causing injury to the baby through improper, or incorrect manoeuvres.
Caused injury through excessive force with instruments (forceps) or internal rotations.
Failing to warn a woman about her risk factors and/ or offer alternative mode of birth e.g., Caesarean section.
What is Shoulder Dystocia?
This birth complication arises when a baby’s shoulder becomes stuck behind the mother’s pubic bone which inhibits the normal birthing process. The umbilical cord is compressed which can reduce oxygen flow to the baby.
It is essential that healthcare professionals (both obstetricians and midwives) who work in the birthing space can identify and respond to this emergency effectively and efficiently with the appropriate manoeuvres.
(Image: Nuclues Images)
Consequences of a shoulder dystocia for the neonate include:
Brain damage e.g., cerebral palsy
Brachial plexus injury and erbs palsy (arm weakness or paralysis)
Broken bones
In worst case scenarios, death.
Mothers can also suffer severe complications including; increased likelihood of a significant maternal haemorrhage, injury to the cervix or pelvic floor and severe perineal tearing.
Obstetricians and midwives should always identify any risk factors for shoulder dystocia to facilitate the safest delivery possible for both mother and baby. These include but are not limited to:
Prolonged first and/ or second stage of labour
Induction of labour
Instrumental delivery (forceps, ventouse)
Macrosomia (Estimated fetal weight to be greater than 4.5kg)
Gestational diabetes in pregnancy
Maternal BMI > 30.
History of previous shoulder dystocia
Multiple birth
Caesarean section should be discussed and offered as an option to women who present with these risk factors. However, the incidence of shoulder dystocia remains to occur in births where no risks are identified.
Has your clinician correctly diagnosed shoulder dystocia?
Shoulder dystocia should be recognised when the baby's shoulders fail to deliver shortly after the head during birth
It often presents as the body does not emerge after delivery of the fetal head and retracts into the mother’s perineum, known as ‘turtling’.
All clinicians working in the birth environment should be appropriately skilled on the HELPERR mnemonic, an emergency tool which assists clinicians to attempt different positions and maneouvres to free the obstructed shoulder.
For further information about your birth details, contact your birth provider for a clinical debrief.
If you are unsure whether you have grounds for a birth injury claim, our medical negligence specialists are more than happy to talk through your personal circumstances. We understand the sensitive nature of shoulder dystocia complicated births and will guide you every step of the way.
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Please call us on (02) 9387 1399 or email us at reception@sternlaw.com.au
We look forward to sharing this journey with you.
Written by Sarah Lowrey (Paralegal, Registered Midwife)
Disclaimer: The content of this article is intended only to provide a summary and general overview of matters of interest. It does not constitute medical or legal advice and should not be relied on as such.
[1] Marchlewski v Hunter Area Health Service Matter No 20937/95 [1998] NSWSC 771.
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