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Understanding Shoulder Dystocia |
What is shoulder dystocia?
Shoulder dystocia occurs when, after delivery of the fetal head, the baby's anterior shoulder gets stuck behind the mother's pubic bone—or, occasionally, the baby’s posterior shoulder impinges on the mother’s sacrum. If this happens, the remainder of the baby does not follow the head easily out of the vagina as it usually does during vaginal deliveries.
Shoulder dystocia occurs when, after delivery of the fetal head, the baby's anterior shoulder gets stuck behind the mother's pubic bone—or, occasionally, the baby’s posterior shoulder impinges on the mother’s sacrum. If this happens, the remainder of the baby does not follow the head easily out of the vagina as it usually does during vaginal deliveries.
This simple definition of shoulder dystocia, however, glosses over many complexities. For example, should a delivery be categorized as involving shoulder dystocia only when there is some time delay -- 60 seconds is often suggested in this context--between the delivery of a baby's head and shoulders? Or is shoulder dystocia present any time that a delivering clinician finds that the shoulders cannot be delivered with the normal amount of downward traction on the fetal head? Some have suggested that the definition of true shoulder dystocia requires that the birth attendant had to perform special maneuvers in order to deliver the shoulders.
Exactly how shoulder dystocia is defined is more than just a semantic issue. It sets the parameters for the collection of statistics related to shoulder dystocia, a necessity for research aimed at decreasing shoulder dystocia related injuries. It also determines when a baby's injuries might be attributed to a physician's/midwives' actions during labor and delivery. 1 |
"Furthermore, an emerging scientific discipline based on the study of the “mirror neuron system” is a reminder that the adrenaline the birth attendant might release is contagious; the main preoccupation of an authentic midwife should therefore be to maintain her own level of adrenaline as low as possible. " - Michel Odent |
Our Panel of Experts
Augustine Colebrook, CPM
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Marie Meakin, CNMMarie graduated from the University of New Mexico in 2013 with a Masters Degree in Nursing and a concentration in Midwifery. Prior to that she received a Bachelors from the University of Maryland in 1989. She spent over twenty years as a nurse working in Maternal Child Health before deciding to go Midwifery school. She has worked as a nurse in pediatric oncology/bone marrow transplant, the pediatric ICU, and in Labor and Delivery. She has loved her roles as a Labor and Delivery unit educator, interim nurse manager, a birth assistant/ doula, and a child birth educator. Her general philosophy is that the vast majority of women can have normal healthy pregnancies and birth with minimal or no intervention. She has loved attending births in homes, birth centers, hospitals and even a couple of back yards. Today, attends births at a free standing birth center in Annapolis, Maryland.
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Sarita Bennet, DO, CPMSarita began studying birth and midwifery with her first pregnancy in 1978. She became a direct-entry midwife through self-study and the use of any available resource but mostly through the blessing of attending women giving birth in their own homes. Her deep trust of birth and women’s power, has grown through her 20 years of Osteopathic medical training and practice. Now, as a Certified Professional Midwife and an Osteopathic Family Physician, she combines both fields to provide gourmet care to women and their babies. Sarita also serves the midwifery community as the vice president of the Midwives Alliance of North America board of directors. She is proud to serve the people of Charlottesville, VA and surrounding areas offering homebirth midwifery and family practice care.
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Charlene Campbell, LM, CPM, BSM, MSMCharlene has been practicing midwifery since 1988 in Canada and in the United States. She has provided maternity care for hundreds of women in homes and in birth centers. By 2005 she had received her Associate’s, Bachelor’s, and Master’s Degrees in midwifery. After receiving her degrees, she became a professor at the Midwives College of Utah and had also served as the Academic Dean for a short period of time there. Charlene has training and experience with providing maternity care in low-resource and post-disaster settings and has collaborated with teams in Jamaica and Central Mexico. She has also been instrumental in improving licensing procedures in Washington State to make midwifery certification more attainable for women of diverse backgrounds. She has also served on the board of directors for the Midwives Association of Washington.
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