[ozmidwifery] shoulder dystocia??

[Ross W Timbs]

Dear Denise, In response to your questions on the 19th March - I have been pondering, and hoping someone else would start the discussion - I find the whole area of classifying degrees of shoulder dystocia very hazy.   It is very subjective, and the skill and experience of the midwife makes a big difference.   I think there is a reluctance to classify mild shoulder dystocia as dystocia at all - because of the potential negative impact that this might have on future births - ie elective CS.   I think the moderate - severe shoulder dystocias are easier to label - because there is invariably some compromise or injury to the baby, which kind of "justifies" the label, and any management of future births.    I guess I also use the condition of the baby as a guide - if I am caring for a woman whose previous birth notes say she had a moderate shoulder dystocia, but the baby had good Apgars, etc, I'd be inclined to believe that it was only mild.   I don't know of any specific definitions or boundaries to classify degrees of dystocia.   Jacky