The brachial plexus is the leash of nerves which stems from the base of the neck and extends across the shoulder and into the arm. This can be damaged (sometimes significantly) during childbirth. This typically occurs when, during delivery, the baby’s shoulder becomes stuck behind the mother’s Symphysis Pubis. When this occurs it is a recognised obstetric emergency. The baby’s head will have already been delivered but his chest will be compressed so that he cannot breathe. Obstetricians and Midwives are aware that, generally, the baby must be fully delivered within 10 minutes otherwise there is a serious risk that the baby could sustain brain damage or even die, and that timescale could be less if the baby has already been distressed during the delivery. In such an emergency the baby’s head may be pulled very hard (so called obstetric traction) and if it is pulled too hard the nerves of the brachial plexus could become bruised, stressed or completely torn. Depending on the nature of the injury, the baby may have significant problems with the use of that arm in the future and may also require surgery and/or physiotherapy.

This kind of emergency (known as a shoulder dystocia) can be handled properly so that the baby does not develop any injury. A repertoire of well known manoeuvres should be performed but if they are not and injury occurs then it is likely there will have been negligence. Those manoeuvres include:-

1. As soon as a shoulder dystocia occurs a Senior Obstetrician/Doctor should be summoned.
2. The mother’s position should be changed into the McRoberts position (this usually allows for the mother to be placed flat on her back and for the flexion of her hips back onto her abdomen).
3. Suprapubic pressure should be applied. This involves pressing down on the mother to try and free up the stuck shoulder.
4. There should be rotation of the shoulders internally - this would involve the Obstetrician manually attempting to rotate the shoulder off the Symphysis pubis.
5. A large episiotomy should be made - this will be with a view to facilitating an easier delivery.

If you think your child has suffered an injury following shoulder dystocia please contact us. We can appraise the case for you over the telephone and this will not cost anything. Furthermore, most children will qualify for free legal aid/public funding.