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The Obstetric Nightmare of Shoulder Dystocia: A Tale from Two Perspectives

Beck, Cheryl Tatano DNSc, CNM, FAAN

MCN, American Journal of Maternal Child Nursing: January/February 2013 - Volume 38 - Issue 1 - p 34–40
doi: 10.1097/NMC.0b013e3182623e71
Feature

Purpose: Shoulder dystocia is one of the most terrifying of obstetric emergencies. In this secondary analysis of two qualitative studies, the experiences of shoulder dystocia are compared and contrasted from two perspectives: the mothers and the labor and delivery nurses.

Method: In the first study mothers' experiences of shoulder dystocia and caring for their children with obstetric brachial plexus injuries were explored. The second study explored secondary traumatic stress in labor and delivery nurses due to exposure to traumatic births. Krippendorff's content analysis technique of clustering was used to identify data that could be grouped together into themes.

Results: It was striking how similar the perspectives of mothers and their nurses were regarding a shoulder dystocia birth. Four themes emerged from the content analysis of these two data sets: (1) in the midst of the obstetric nightmare; (2) reeling from the trauma that just transpired; (3) enduring heartbreak: the heavy toll on mothers; and (4) haunted by memories: the heavy toll on nurses.

Clinical Implications: Providing emotional support to the mother during shoulder dystocia births and afterward in the postpartum period has been acknowledged. What now needs to be added to best practices for shoulder dystocia are interventions for the nurses themselves. Support for labor and delivery nurses who are involved in this obstetric nightmare is critical.

In this secondary analysis of two qualitative studies, the experiences of shoulder dystocia births are compared from the perspectives of the mothers and the labor and delivery nurses.

Cheryl Tatano Beck is a Distinguished Professor at University of Connecticut School of Nursing, Storrs, CT.

She can be reached via e-mail at cheryl.beck@uconn.edu

This research was supported by the University of Connecticut School of Nursing.

The author declares no conflict of interest.

© 2013 Lippincott Williams & Wilkins, Inc.