Dystocia is a term that encompasses a range of difficulties in labor and delivery. This is a common problem in about one in five births, and it can be a challenge for both the mother and the baby.
Fetal dystocia is when the fetus is abnormally large for the pelvic opening or is in a position that makes delivery difficult. Medical professionals diagnose fetal dystocia by examination or ultrasonography and may recommend augmentation of labor, physical maneuvers to reposition the fetus, or cesarean delivery.
Cervical dystocia is when the cervix doesn’t dilate enough during labor to make it easy for the baby to enter the birth canal. Doctors use different labor techniques to help babies get through the cervix when this happens, including the McRoberts maneuver, suprapubic pressure and other techniques.
Your obstetrician can also do a few special moves to try and dislodge your baby’s shoulders from your pubic bone so they can pass through the pelvic opening more easily. These can include the R roll, the Gaskin maneuver, the clavicle fracture and the Zavanelli maneuver.
A lot of women have shoulder dystocia, especially those with a smaller pubic bone or larger than average babies. This can cause the baby to be stuck in your pelvis after their head is delivered. It can also cause them to become trapped in your uterus, which can make it hard for you to deliver the baby vaginally.
In rare cases, your obstetrician might need to break your baby’s collarbone so their shoulders can come out of your pelvis. If this happens, it will take time for the collarbone to heal and for you to be able to give birth vaginally again.
During this time, you might feel very anxious or stressed. Your midwife, doctor or a maternal child health nurse can help you deal with the situation and keep yourself calm.
When it comes to delivering your baby, the best thing you can do is trust your birth team and be open with them about your feelings. This will help them offer you the best care during labor and birth, as well as make sure everything goes smoothly for you and your baby.
You can also talk to your obstetrician about your birth preferences so that you can plan for what you would like in your next pregnancy. Some of these preferences might not be possible, so your birth team will work with you to find the best options for you and your baby.
Your baby can have a very hard time recovering from shoulder dystocia because it can prevent them from getting enough oxygen, so they might need to spend some time in the neonatal intensive care unit. They might also need physiotherapy and support with breastfeeding, depending on what happened.
Shoulder dystocia is more common in women with gestational diabetes or if their babies are very big. Your obstetrician will tell you about these risks and how to lower them.
