If this is true

[katep]

I thought I read somewhere that there were more males than females with BPI, just because boys tend to be larger and macrosomia is a risk factor.

Kate

[vandaroseboom]

I have three kids 2 boys - both obpi and one girl no birth injury - it is certainly true in my family.

[SusanLynn]

I have 4 boys. Our 5th was our daughter LOBPP. None of the babies were large, I had moved, just before the fifth delivery. ;( The new doc couldn't wait for me to hit 10.

[cindyh]

Not true in my case. boy 6lbs 7 oz, girl (robpi) 9lbs 11.5 oz.

[Matt's Dad]

In Matthew's case, he was under 9 lbs. But the one thing that stuck out in my mind when I first saw him at birth was his size at the shoulders. He was broad at the shoulders, which is definitely a male trait. I think this was one of the biggest reasons for his injury, outside of the doctor's poor birthing techniques.

[katep]

I agree, I think shoulder girth vs head size is a big factor in shoulder dystocia. Normally, the head should be the biggest part fitting through the birth canal, and the shoulders should just slide easily behind, twisting and turning as necessary. But if the shoulders are as big or bigger than the head, they also have to dilate the canal, which means they are not free to rotate and can end up trying to get past the pubic bone in a sub-optimal orientation. In Joshua's case, his shoulders were exactly 12 and 6 oclock, instead of being on a slight diagonal where there is more room.

That's not to imply that the Ob/midwife shouldn't know how the deal with stuck shoulders. Understanding that the dystocia is due to a failure of shoulder rotation, however, makes the solutions much more obvious... rather than just try to pull the baby past the obstruction, get those shoulders rotated to where they should be so they'll fit!

Kate