Injuries to the mother/birthing parent
The most common injury to the mother or birthing parent is post-partum haemorrhage – or excessive bleeding after birth. This is most likely to be caused by a tear to the perineum or vagina caused by the trauma of the manoeuvres to release the baby. This is estimated to be around 11%(3) of the births which include a shoulder dystocia (not 11% of all births).
Shoulder Dystocia can lead to damage to the birthing woman or person’s perineum and vagina, and of those people whose births included a shoulder dystocia, around 3.8%(3) of them had third or fourth degree tears(5). This is very slightly higher than the rate of third or fourth degree tears which happen in hospital births, which according to RCOG is around 3%(5).
There is also likely to be a higher rate of parents experiencing psychological injuries, such as PTSD, although I have been unable to locate any research specifically on the effects of shoulder dystocia on rates of psychological birth trauma injury. This is because the mental health of birthing women and people is often given far less consideration than physical injuries to the birth parent or baby, even though it is essential to a women’s overall health and wellbeing. It is also worth remembering that not only may parents experience trauma when these types of birth complications happen, but so do the midwives, doctors and other birth attendants. This data is also rarely tracked. Neither is enough focus given to the impact that this trauma has on how midwives and doctors approach birth in the future, and whether their vicarious trauma means that they’re more likely to attempt to encourage pregnant women and people into interventions that aren’t right for them.
Injuries to the baby
The most common injury to the baby is damage to their shoulder, called a brachial plexus injury. RCOG estimates that 2.35% – 16% of babies who have a shoulder dystocia experience a brachial plexus injury, however most babies recover quickly. RCOG states that 1 in 10 of those babies who are actually injured suffer permanent damage. According to RCOG this is around 2 in every 10,000 births. Having said this, brachial plexus injury can happen in a caesarean birth, too – perhaps as high as 3 in every 10,000 caesareans!(6)
The Big Baby Trial’s figures on permanent injury are much higher than RCOG’s. The trial’s website states that 1 in 100 babies who experience a shoulder dystocia will have a permanent shoulder injury(4). There is no explanation given as to why the figures in The Big Baby Trial are so dramatically different to RCOG’s figures.
The biggest fear about shoulder dystocia is the possibility of brain damage or the death of the baby. This is very rare indeed, while of course a devastating tragedy that everyone would like to stop from happening. The website ‘Evidence Based Birth’ discussed the various trials and data on these outcomes in detail(7).