New obstetrical research has confirmed a link between the mother’s size, fetal weight, and shoulder dystocia. Based on this research, Dr. Emily Hamilton of Montréal, Canada appears to have developed a means by which the majority of pregnant women destined to experience a shoulder dystocia birth can be detected. The CALM Shoulder ScreenTM (patent pending) is such a tool currently undergoing clinical application.  This Screen hopes to be a preventative measure to foresee this possible injury and avert it.

Currently, the possible ways to prevent shoulder dystocia are:

·         To perform elective C-sections for suspected macrosomia babies;

·         To induce labor in pregnant patients before their due dates to prevent babies from becoming macrosomic;

·         To attempt diet and/or blood sugar control to limit maternal weight gain.

O’Leary, in his book on shoulder dystocia, states:

A well-prepared obstetrician or midwife can anticipate this problem [shoulder dystocia] as a result of routinely identifying those risk factors that predispose to shoulder dystocia.  Thus, prevention requires identification of risk factors, which leads to anticipation of the problem . . .

The presence of macrosomia of 45000g alone is justification for cesarean section in non-obese women.  The presence of macrosomia of 4000-4500g may in itself be sufficient to warrant abdominal delivery when other risk factors, especially a platypoid (flat) pelvis, diabetes and/or obesity, are present.


The first step in treating shoulder dystocia is recognizing when it occurs.

During delivery, there are two main signs that indicate a shoulder dystocia is present:

  1. The baby’s body does not emerge with standard moderate traction and maternal pushing after delivery of the fetal head.
  2. The “turtle sign.”  This is when the fetal head suddenly retracts back against the mother’s perineum after it emerges from the vagina.  The baby’s cheeks bulge out, resembling a turtle pulling its head back into its shell.  This retraction of the fetal head is caused by the baby’s anterior shoulder being caught on the back of the maternal pubic bone, preventing delivery of the remainder of the baby.

If your or a loved one’s baby has experienced a shoulder dystocia injury and you feel it may have been prevented, contact the Shelton Law Group at (888) 761-7204 or (502) 409-6460, or visit  We will work with you to ascertain whether you have a medical negligence claim resulting from a failure to provide appropriate preventative measures and subsequent treatment.