Whilst certainly not claiming to be a superfan I do occasionally catch an episode of the extremely popular historical drama “Call the midwife” set in London in the 1960s. On the evening of Sunday 7th January, whilst distracted doing something else, my attention was caught when one of the characters in the show began to describe how her daughter (now an adult, disabled and pregnant with her own child) had been injured herself during birth leading to her disability.
The focus was very much on pregnancy and childbirth in the context of disability – a subject rarely covered in drama, and it was refreshing to see it depicted. The disabled pregnant young women, Doreen was played by the fabulous Rosie Jones. Rosie (who may be better known for stand-up comedy) has cerebral palsy and is a writer as well as an actor. There was a very poignant and powerful scene when Doreen talked about how she did not want anyone to see her as “broken”.
Shoulder dystocia and cerebral palsy
Although not described sufficiently in the scene to be certain, the account given by Doreen’s mother earlier in the episode suggested a traumatic delivery, that shoulder dystocia occurred during the birth, and that Doreen’s cerebral palsy was caused through lack of oxygen.
Shoulder dystocia typically occurs when there is a vaginal birth of a larger than average baby. Usually during vaginal delivery, the baby’s head is delivered first and is then swiftly followed by the rest of the baby’s body. In shoulder dystocia, the shoulders become stuck after the baby’s head has delivered. It is an obstetric emergency as the baby’s chest and the umbilical cord are compressed and the baby’s access to oxygen is restricted.
If it is not well managed, then it can lead to the baby suffering an injury to their brachial plexus (a network of nerves in the neck). It can result in brain damage leading to cerebral palsy and even death. Shoulder dystocia is rare, often unpredictable and is a very frightening experience for patients and healthcare professionals alike. It can lead to permanent brachial plexus injury (Erb’s Palsy) and brain injury (leading to Cerebral Palsy) such as in Rosie’s story.
Improvements in management and training
Knowledge and training as to management techniques are much better in modern times than in the 1960’s. There have been National Guidelines in place for the management of shoulder dystocia for many years. However sadly injuries do still occur today.
The impact of disability on individuals and families
It can be devastating for those individuals who have lifelong disabilities following shoulder dystocia, but it can be devastating also for their parents. This is particularly the case for mothers who have been through the trauma of the birth and often carry immense guilt and an unfounded sense of responsibility for their child’s injury. This was clearly depicted by Doreen’s mother in this episode.
It is extremely sad that we cannot say that injuries resulting from shoulder dystocia are now confined to the past, but it is certainly true to say that there have been huge improvements in maternity training and shoulder dystocia management techniques which will have reduced the incident rates of injury.
It is great to see the BBC shining a light on shoulder dystocia and disability in this popular series, not only from the perspective of the injured individual and her mother but also from the midwife who delivered the child, and who felt guilt and remorse.
How can Tozers help?
At Tozers we have a specialist team of lawyers and have for 30 years been seeking compensation for those who suffer injuries as a result of the mismanagement of shoulder dystocia. We are the leading firm in the Country in this area having successfully conducted hundreds of such claims.