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Shoulder Dystocia: Nursing Prevention and Posttrauma Care

Jevitt, Cecilia M. CNM, PhD; Morse, Shannon ADN, RNC, LCCE, CLC; O'Donnell, Yong Sue MSN, ARNP

The Journal of Perinatal & Neonatal Nursing: January-March 2008 - Volume 22 - Issue 1 - p 14–20
doi: 10.1097/01.JPN.0000311870.07958.81
Feature Article
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Shoulder dystocia is a birth emergency that occurs in approximately 1% of all births. Shoulder dystocia can be followed by broken clavicle or humerus, brachial plexus injury, fetal hypoxia, or death. Although risk factors for shoulder dystocia include previous birth complicated by shoulder dystocia, maternal obesity, excessive prenatal weight gain, fetal macrosomia, gestational diabetes, and instrumental delivery, shoulder dystocia is not predictable. Perinatal nurses can reduce the risk for shoulder dystocia by teaching mothers about optimal weight gain in pregnancy and assisting mothers with diabetes to prevent hyperglycemia through diet management and medication use. During childbirth preparation or early labor, nurses can educate mothers about position changes and maneuvers used for shoulder dystocia. Nurses play a vital role in obtaining assistance during a shoulder dystocia, keeping time, assisting with maneuvers such as suprapubic pressure, and documenting the dystocia management. Nurses can assist mothers and families to review the shoulder dystocia and any newborn injuries in the postpartum period, thereby reducing confusion and anxiety. Regular drills and case reviews help build nursing shoulder dystocia management skills.

University of South Florida College of Nursing, Tampa (Dr Jevitt); The Baby Place, Florida Hospital, Zephyrhills (Ms Morse); and Tampa General Hospital, Tampa, Florida (Ms O'Donnell).

Corresponding Author: Cecilia M. Jevitt, CNM, PhD, University of South Florida College of Nursing, MDC Box 22, 12901 Bruce B Downs Blvd, Tampa, FL 33612 (cjevitt@health.usf.edu).

Submitted for publication: July 14, 2007

Accepted for publication: October 10, 2007

© 2008 Lippincott Williams & Wilkins, Inc.