healthcarejournalbr.com | September / October 2008 Issue |
Healthcare Journal of Baton Rouge
21
baby is being born. During labor there had been no indication of trouble, but now we
see the baby's delivering head pulled back against the mother. We are suddenly
dealing with what is known as a shoulder dystocia. The baby's shoulders are too
big to deliver and if the correct actions are not taken, the baby may be harmed,
or worse, die. An infant with its head out, but its shoulders stuck can die with-
in five to seven minutes unless it is freed. Obstetricians are taught several
maneuvers to deliver in this case, but seldom get a chance to practice those
procedures outside of the rare emergency. Each maneuver has been used to
save babies from harm, but each also has a high failure rate.
Perinatal morbidity, or harm to the mother or the baby, is reported to
occur in seven in 1,000 births. Prior to the year 2000, most healthcare personnel felt we were doing a
good job of providing care. In labor and delivery negative outcomes were rare. A report published in the
year 2000 by the Institute of Medicine, titled “To Err is Human,” changed the way healthcare profession-
als looked at what we do. Data in that study suggested that millions of Americans died each year as a
by: William Dore Binder, MD, Woman's Hospital