Fast forward to March 11, 2011. I am was reading a summary of post on the Nebraska Friends of Midwives yahoo group. I see a post about a local midwife losing a lawsuit. Imagine my shock and horror when I read it and see that its Marilyn Lowe! I found the comments made by the attorney of the parents to be ignorant, biased and personally abhorrent. Here is a link to the story: http://www.omaha.com/article/20100311/NEWS97/703119800/-1
After reading the story I immediately got online and looked into Shoulder Dystocia. Here are some facts I found on an information website done by Dr. Henry Lerner. His website is the worlds leading source for information on Shoulder Dystocia.
Shoulder dystocia happens in 1% of all deliveries...so in the US that is 40,000 cases per year (approximately 4million babies were born in 2007, the last year I could find stats for).
20% of babies with shoulder Dystocia will suffer some sort of injury either temporary or permanent.
Brachial Plexus damage will happen in 10% of all shoulder dystocia deliveries. (The brachial plexus is a network of nerves that conducts signals from the spinal cord, which is housed in the spinal canal of the vertebral column (or spine), to the shoulder, arm and hand.)
Brachial Plexus damage can happen without shoulder dystocia. It happens in both vaginal births where there is no dystocia, and in c-section births.
Babies with shoulder dystocia must be delivered fully as quickly as possible to avoid fetal asphixiation. This is because once the head is delivered the umbilical cord is compressed between the babies body and the mothers birth canal. This significantly decreases or completely cuts off blood flow between mother and baby.
Between 200 and 400 babies will have permanent brachial plexus injuries each year in the US.
A study done in 1988 found that the amount of experience a doctor or midwife has delivering babies has no affect on injuries to the fetus resulting from shoulder dystocia.
A number of different studies all found that it is extremely difficult to accurately predict which babies will have shoulder dystocia.
ACOG says this about shoulder dystocia:
Most cases cannot be predicted or prevented because there are no accurate methods to identify which fetuses will develop the condition.
Ultrasonic measurement to estimate macrosomia has limited accuracy. (Macrosomia is a baby weighing over 4000 grams or 8 pounds 13 ounces)
Planned c-sections based on suspected macrosomia is not a reasonable strategy. (One study showed that 1000 unneeded c-sections would take place to prevent 1 case of shoulder dystocia resulting in brachial plexus injury.)
On his website Dr. Lerner says "This automatic assignment of responsibility to an OB or Midwife for brachial plexus injury whenever shoulder dystocia occurs is inappropriate and not supported by literature."
I found this information very interesting and it made me feel even more strongly that Marilyn Lowe should not be held liable in this case. I feel so strongly that I plan to send a letter to the editor. The following is a rough draft, awaiting some major editing by friends before I actually send it...