Shoulder Dystocia & Brachial Plexus Injuries
When a baby’s shoulder gets stuck during delivery, how the medical team responds in those seconds can determine whether a nerve injury like Erb’s palsy is permanent.
Medically reviewed · By [MEDICAL REVIEWER], [CREDENTIALS] · Sources: ACOG · Legally reviewed by Larry F. Taylor, Jr.
What it is
Shoulder dystocia occurs when a baby’s shoulder becomes lodged behind the mother’s pelvic bone during delivery. If handled improperly, the resulting stretching or tearing of the brachial plexus nerves can cause Erb’s palsy or other nerve damage in the baby’s arm.
Causes
Risk factors include large babies, maternal diabetes, and prolonged labor — but injury most often results from excessive pulling or improper maneuvers used to free the shoulder.
Signs
- Limp or weak arm on one side (Erb's palsy)
- Lack of movement or grip in the affected hand
- Arm held in a bent, rotated position
Diagnosis
Diagnosed through physical exam and imaging shortly after birth, with severity assessed over the following weeks as nerves either recover or show permanent damage.
Treatment
Physical therapy helps many infants regain function; severe cases may require nerve grafting or reconstructive surgery, sometimes with lifelong limitations.
How negligence causes it
ACOG-recommended maneuvers exist to manage shoulder dystocia safely. Excessive downward traction on the head, rather than following those protocols, is a leading cause of preventable brachial plexus injury.
Your legal rights
If your child’s arm injury followed a difficult delivery, a records review can clarify whether recommended delivery maneuvers were followed.
Compensation
Claims may cover ongoing physical therapy, potential surgery, adaptive needs and long-term impact on earning capacity.
Sources
American College of Obstetricians and Gynecologists (ACOG) practice guidance on shoulder dystocia management. This page is for general information only and is not medical or legal advice.
Frequently asked questions
Does Erb's palsy always resolve?
Many infants recover significant function with therapy, but moderate to severe cases can result in permanent limitation.
How soon should I seek legal advice?
As soon as possible — medical records and delivery notes are most complete and available early.