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Brachial Plexus and Shoulder Dystocia

What are shoulder dystocia and brachial plexus injuries?

Shoulder dystocia and brachial plexus injuries are birth injuries that affect the baby’s nervous system.  Shoulder dystocia is a major risk factor in the baby sustaining a brachial plexus injury. When a baby’s shoulder gets stuck on the mother’s pelvis during labor, it can cause too much stretch on the brachial plexus nerves in the neck and shoulder area. When these nerves get damaged, the infant may be unable to move their shoulder, arm, or hand. Shoulder dystocia and brachial plexus injuries occur in as many as 2.5 out of every 1,000 live births, according to Volpe’s Neurology of the Newborn from 2018. 

Risk Factors

Risk factors for shoulder dystocia include a condition called macrosomnia.  This is a condition where the fetus is bigger than average, weighing greater than 8lbs 13 oz. This condition can put the mother at greater risk for shoulder dystocia. Other risk factors for shoulder dystocia and brachial plexus injuries include:

  • Being pregnant with twins, triplets, or other multiple births
  • Receiving medicine to induce labor
  • Receiving an epidural
  • Baby in breech position
  • A prolonged or arrested labor
  • Using tools such as forceps or a vacuum during delivery
  • Diabetes in the expectant mother

Are brachial plexus injuries preventable?

Doctors can often prevent shoulder dystocia and brachial plexus injuries by following proper procedures. There are several approved techniques for delivering babies with shoulder dystocia to minimize injury to the brachial plexus nerves. Doctors who fail to follow the correct techniques can be held responsible for the resulting birth injury. While some brachial plexus injuries are minor and temporary, the injury is sometimes permanent.

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Types of brachial plexus injuries

Erb’s Palsy

Erb’s palsy is a form of a brachial plexus injury. One or two of every 1,000 live births have this condition. In this condition, the upper nerves of the brachial plexus are affected. As a result, the infant may be unable to move the shoulder, but might be able to move their fingers.


Global Palsy

This condition affects both the upper and lower branchial plexus nerves. Infants may be unable to move any muscles in the affected arm below the shoulder and lack total sensation in the arm.




Treatment and Outcomes

Problems cause by shoulder dystocia and brachial plexus injuries may take years to resolve and require daily physical therapy. If there are no improvements after the first 3-6 months, the infant may additional treatments such as:

  • Nerve graft – surgery to correct nerve damage
  • Nerve transfer – a donor nerve is used to reconnect the torn nerve
  • Muscle or tendon transfers – can help restore some motion to affected arm or joint
  • Botox injections – can help paralyze one muscle so that the affected muscle can become stronger. This is often used in conjunction with physical therapy

Compensation for injuries

Most shoulder dystocia and brachial plexus injuries will eventually resolve. However, this type of birth injury often requires months of physical therapy and sometimes even surgery. Some injuries never fully resolve, and the infant can face life-long complications.


Too often, these injuries occur due to medical mistakes. If you believe that physician negligence caused or contributed to your child’s injury, you may be eligible for financial payment to help offset these expenses. Our birth injury law firm can file a claim to help you pay for the medical care that your child needs.  Contact us today for a free consultation. We understand the stress that parents face when their child has a birth injury. Our attorneys will listen to you situation and provide the guidance and support you need at this challenging time.

In 2006, it was estimated that over 157,000 birth injuries could have been avoided to both mother and infant.

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