December 2009
Why A Thorough Medical History is Important If You Are Pregnant
Obstetrics and Gynecology

The Pennsylvania Patient Safety Authority received over 316 reports of babies who experienced getting their shoulder stuck (known as shoulder dystocia) in the birth canal during delivery. In 124 (39%) reports, the babies’ injuries from the shoulder dystocia included: broken bones, nerve damage and internal bleeding. There are several risk factors before and during the delivery that contribute to shoulder dystocia. These risk factors include: if the mother has diabetes, the baby’s weight at birth is over 8.8 pounds, if the baby is known to have a serious birth defect, if the baby is delivered with forceps or a vacuum-type device, and a quick or delayed labor during the second stage of labor. The mother can help her healthcare providers by giving as much information about her medical history as possible before delivery. If it is determined from a mother’s medical history and/or through other medical tests that there is a higher risk for shoulder dystocia during delivery, healthcare providers can prepare as much as possible before delivery to minimize potential injury to the mother and fetus.

For women who are pregnant, there are certain conditions or characteristics that may make you more at risk for having a shoulder dystocia complication during labor. One of the reports submitted to the Authority listed lack of communication with the patient and family as one of the contributory risk factors that led to the shoulder dystocia event. Open communication with your healthcare provider about your health issues may identify possible risk factors for shoulder dystocia and is one of the most important contributions patients and families can provide.
These risk factors include:

  • Diabetes
  • Obesity (extremely overweight)
  • Over age 35
  • Problems with your pelvic anatomy
  • Small stature

To reduce your risk of shoulder dystocia complications make sure your healthcare provider also knows:

  • How many pregnancies you have had and the birth weights of your other children;
  • If forceps and/or a vacuum device were used in the other deliveries;
  • If any of your other children experienced a broken bone during delivery (this may have been related to shoulder dystocia but not documented previously).

For more information about shoulder dystocia and the strategies for healthcare providers to prevent complications go to the Pennsylvania Patient Safety Advisory article, “Neonatal Complications: Recognition and Prompt Treatment of Shoulder Dystocia” at the Authority’s web site,

©2018 Pennsylvania Patient Safety Authority