Shoulder dystocia is an emergency in which the baby’s head is born but a shoulder becomes difficult to deliver. It is often unpredictable. Maternity teams use a sequence of manoeuvres to create space and release the shoulder as quickly and safely as possible.

Shoulder dystocia can occur without warning and cannot always be prevented by estimating fetal size.

The emergency response involves calling for help, changing maternal position and using recognised manoeuvres.

A clear post-birth explanation and review are important for both physical and emotional recovery.

Risk and prediction

Diabetes, previous shoulder dystocia, larger estimated fetal size and operative vaginal birth can increase risk, but most people with these factors do not experience it and many cases occur without identifiable risk factors.

What happens during the emergency

The team calls for help, records time and uses manoeuvres designed to widen the pelvis or change the baby’s shoulder position. Fundal pressure is avoided because it may worsen impaction. The sequence is adapted to the clinical situation.

Checks after birth

The baby is examined for breathing, nerve or bone injury. The mother is assessed for bleeding and perineal trauma. Most babies recover well, but appropriate paediatric review and follow-up should be arranged when needed.

Planning another pregnancy

Recurrence risk is higher than baseline but does not automatically require caesarean birth. Previous details, fetal size, diabetes, maternal preferences and the consequences of the previous event guide shared decision-making.

Questions worth discussing at your consultation

What factors contributed in my birth?
Were there any injuries requiring follow-up?
How does this change the recommendation for a future birth?
Can I have a formal birth debrief?

When to seek urgent careAfter discharge, urgent assessment is needed for heavy bleeding, fever, severe worsening pain or concern about the baby’s arm movement, breathing, colour or feeding.

Medical note: This page is educational and is structured to support a specialist consultation. Diagnosis, investigations and treatment must be individualised. It has not been presented as a substitute for an examination or emergency assessment.