Question re causes of BPI

[DW Mom]

Since I got such a great response on my first question here goes question number two. I'll apologize in advance because I have so many.

I'm trying to figure out how my son was injured. I understand the shoulder dystocia concept. Here's the part that confuses me. I have three sons. The first was born at 9 lbs 6.8 ounces without injury. I did push for 2 hours but my old OB apparently knew what he was doing because my son was born without any problems at all, in fact my old OB told me I was "made for making babies".

My youngest son, Dawson is now 2 weeks 3 days old. He weighed 9 lbs 3.4 ounces at birth. I pushed him out in a total of 10 minutes without any problems according to the OB but he suffered a BPI that left his left arm with no movement but for his hand and fingers. I hear everyone talking about shoulder dystocia and it sounds like something the doctor would definitely notice... wouldn't he? I just don't understand. Am I missing something here?

[richinma2005]

Hi DW MOM,

The dystocia is what happens if the shoulder gets stuck on the pelvis. It is considered to be a medical emergency and there are maneuvers used to dislodge it. Usually hyperflexion of the hips (mcRoberts), is performed first because it is easiest. Then there are some manual techniques also. It sounds as though you don't believe that was the case, and no dystocia occurred. Did the doc pull at all on the head while delivering? Did you or anyone else in the room notice anything unusual? If not, there are reported cases of BPI that occur just as part of the birthing process and ALL of these instances the injury is transient-meaning they get full recovery. I pray that is the case for you.

just because a doctor doesn't note a dystocia doesn't mean that it didn't happen-plenty of people on these boards can attest to that. A dystocia happpens at the very end of the labor, the head is usually out or coming out when the shoulders get stuck. Too much traction or pulling to keep the baby coming is what causes the injury as the neck gets stretched due to the stuck shoulder. Usually the forces applied would leave bruising (did you see any bruising on your baby?)

If he is already moving his arm, you may be a short lived member of this community! Good Luck!

-richinma

[DW Mom]

I'm very hopeful that this is one of those cases that will heal very quickly of course. Thank you for the info. Dawson had very dark bruising from his nose up as well as bruising on the affected shoulder and at the elbow joint. My husband didn't see the doctor do anything "rough". I'll ask him more about it when he gets home. I know they didn't do any maneuvers to dislodge the shoulder if it was stuck that I was informed or aware of.

[F-Litz]

Here's an animation of shoulder dystocia.

http://www.youtube.com/watch?v=_QiKngd0pXc

I remember reading that it takes 40-150 pounds of pressure to injure a nerve. The pressure comes from the shoulder being stuck and the doctor pulling while the shoulder is stuck.

[mlynn]

i would love to post my opinion and what happened to me but of course i cannot u can email me in private! i truley believe my thoughts and cannot post them! i will share u my personal opinion but, that is all i have? god bless u