If your baby was injured by shoulder dystocia during birth in the UK, you may be able to claim compensation if the delivery team managed the emergency negligently. Common injuries include Erb’s palsy (brachial plexus damage causing weakness or paralysis of the arm) and, in severe cases, oxygen deprivation. Claims are brought against the NHS trust responsible, and a child’s claim has no time limit until they turn 18.
Shoulder dystocia is an obstetric emergency that occurs when the baby’s head delivers vaginally but one or both shoulders become trapped behind the mother’s pubic bone. It requires immediate, skilled action from the delivery team to free the baby and avoid injury. When that action is delayed, performed with excessive force, or fails to follow established protocols, the consequences for both baby and mother can be devastating. This guide explains how shoulder dystocia claims work under UK law. We are an independent information service, not a law firm.
What is shoulder dystocia?
During a normal vaginal delivery, the baby’s shoulders rotate and pass through the birth canal shortly after the head is born. In shoulder dystocia, the anterior shoulder (the one closest to the mother’s front) lodges behind the pubic symphysis and does not deliver with normal gentle traction. The condition is a genuine emergency because the umbilical cord may be compressed, limiting oxygen supply to the baby. The delivery team must act quickly and follow a recognised sequence of manoeuvres to resolve the impaction.
Risk factors and antenatal planning
The Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guideline 42 identifies several risk factors that clinicians should assess during pregnancy:
- Fetal macrosomia — a large baby, particularly an estimated weight above 4,500g.
- Maternal diabetes — gestational or pre-existing, which can increase fetal size, especially trunk girth.
- Previous shoulder dystocia — recurrence rates are significant, and RCOG advises discussing elective caesarean.
- Maternal obesity and excessive gestational weight gain.
- Prolonged labour or slow progress in the second stage.
A claim may arise at this stage if clinicians failed to identify and document risk factors, failed to discuss the risks with the mother, or failed to offer a planned caesarean section where the risk profile warranted it. The consent standard is set by Montgomery v Lanarkshire Health Board [2015]: the mother must be informed of material risks so she can make an informed choice about the mode of delivery.
Injuries caused by shoulder dystocia
| Injury | Cause | Prognosis |
|---|---|---|
| Erb’s palsy | Damage to upper brachial plexus nerves (C5–C6) from excessive lateral traction on the head | Many improve in the first year; some require nerve graft or transfer surgery; a proportion are permanent |
| Klumpke’s palsy | Damage to lower brachial plexus nerves (C8–T1) | Less common; can affect hand function; prognosis varies |
| Total brachial plexus palsy | Avulsion or rupture of all roots | Often permanent with significant disability |
| Hypoxic-ischaemic encephalopathy | Prolonged cord compression during a delayed delivery | Can cause cerebral palsy or long-term neurological damage |
| Fractured clavicle or humerus | Delivery manoeuvres or excessive force | Usually heals well in neonates |
The mother may also suffer injuries, including severe perineal tears (third- or fourth-degree), postpartum haemorrhage, and psychological trauma or PTSD from the emergency.
Proving negligence
Not every shoulder dystocia injury is caused by negligence. The emergency can occur unpredictably and, even with perfect care, some injuries still happen. A claim succeeds where you can show the delivery team fell below the standard expected of reasonably competent practitioners. Common grounds include:
- Excessive traction. Applying too much downward force on the baby’s head to try to pull the anterior shoulder free, rather than using recognised release manoeuvres.
- Failure to follow the correct manoeuvre sequence. RCOG Guideline 42 recommends a structured approach: call for help, McRoberts’ manoeuvre (hyperflexion of the mother’s thighs), suprapubic pressure, and then internal rotational manoeuvres. Skipping steps or proceeding to fundal pressure (pushing on the top of the uterus, which is contraindicated) can cause or worsen injury.
- Failure to anticipate. If risk factors were present and documented but the team did not prepare — for example, by having senior staff available or by discussing the management plan — this may be negligent.
- Failure to offer caesarean. Where the risk profile strongly favoured a caesarean and this was not discussed with the mother, the consent-based claim under Montgomery may apply.
- Delay in delivery. If the head-to-body delivery interval was prolonged because of slow or ineffective management, and this caused or worsened hypoxia, that delay may constitute negligence.
Compensation
General damages for a brachial plexus injury are assessed under the Judicial College Guidelines (17th edition, 2024), primarily the chapters on arm injuries. The amount depends on the extent and permanence of the nerve damage and the impact on the child’s life. Severe permanent injury with major functional loss attracts substantially higher awards than temporary palsy that resolves fully.
Special damages can include physiotherapy, occupational therapy, surgical costs (nerve grafts, tendon transfers), adapted equipment, additional educational support, future loss of earnings (projected from the child’s likely career), and the cost of care. In the most serious cases involving brain injury from hypoxia, lifetime care costs can result in multi-million-pound settlements.
The mother’s claim for any injuries she sustained is separate and additional.
Time limits
A claim on behalf of the child has no time limit until the child turns 18. After that, the standard three-year limitation period applies (Limitation Act 1980, s.28). A litigation friend — usually a parent — brings the claim on the child’s behalf during childhood. The mother’s own claim is subject to the standard three-year limit from the date of delivery or date of knowledge (ss.11 and 14). Despite the generous child deadline, early investigation is strongly advisable while witnesses and records are still available.
Getting help
We are not a law firm. For a clinical negligence solicitor experienced in birth injury cases, use the Law Society “Find a Solicitor” service or contact Action against Medical Accidents (AvMA). Most birth injury claims are funded on a no-win-no-fee basis.
Frequently asked questions
What is shoulder dystocia?
Shoulder dystocia is an obstetric emergency that occurs during vaginal delivery when the baby's head is born but one or both shoulders become impacted behind the mother's pubic bone. It requires prompt and skilled manoeuvres to release the trapped shoulder and deliver the baby safely. If not managed correctly, it can injure the baby's brachial plexus nerves or cause oxygen deprivation.
What is Erb's palsy?
Erb's palsy is a condition caused by damage to the upper brachial plexus nerves (C5-C6, sometimes C7) during birth. It typically results in weakness or paralysis of the affected arm. Many cases improve with physiotherapy over the first year of life, but some require surgery and a proportion result in permanent disability with limited arm function.
Can I claim compensation for shoulder dystocia?
You can claim if negligent management of the shoulder dystocia caused the injury. This may include using excessive traction on the baby's head, failing to follow recognised manoeuvres in the correct sequence, failing to anticipate shoulder dystocia in a high-risk delivery, or failing to offer a caesarean section when risk factors were present. Not every shoulder dystocia injury is negligent, as the emergency can occur unpredictably.
What are the risk factors for shoulder dystocia?
Known risk factors include fetal macrosomia (a large baby, particularly over 4,500g), maternal diabetes (gestational or pre-existing), a history of shoulder dystocia in a previous delivery, prolonged labour, and maternal obesity. The RCOG Green-top Guideline 42 advises clinicians to assess and document these risk factors and consider them when planning the mode of delivery.
How long do I have to claim on behalf of my child?
A claim on behalf of a child has no fixed time limit until the child turns 18. From their 18th birthday, they have three years to bring a claim in their own right. This means a shoulder dystocia claim can be brought at any time during childhood. A litigation friend (usually a parent) brings the claim on the child's behalf until they reach adulthood.
What compensation could my child receive?
Compensation depends on the severity of the injury. For Erb's palsy that resolves fully, general damages may be relatively modest. For permanent brachial plexus injury with significant loss of arm function, general damages assessed under the Judicial College Guidelines (17th edition, 2024) can be substantial. Special damages may include the cost of physiotherapy, surgery, occupational therapy, adapted equipment and future loss of earnings.
Can the mother also claim?
Yes. Shoulder dystocia can cause serious injuries to the mother as well, including third- or fourth-degree perineal tears, postpartum haemorrhage, and psychological trauma. If these injuries were caused or worsened by negligent management of the delivery, the mother can bring a separate claim in her own right alongside the child's claim.
What evidence is needed?
Key evidence includes the full maternity medical records (antenatal notes, partogram, delivery notes, neonatal records), imaging and nerve conduction studies for the baby, and an independent expert report from a consultant obstetrician on the management of the delivery. A paediatric neurologist may also be needed to assess the child's prognosis and long-term needs.
Get help from official, free sources
- Solicitors Regulation Authority (SRA) — check a solicitor is regulated
- The Law Society — Find a Solicitor — clinical negligence accredited specialists
- Citizens Advice — free, impartial guidance on your rights
- Action against Medical Accidents (AvMA) — charity supporting victims of medical harm
Related guides: birth injury claims, medical negligence claims, claiming for a child, nerve damage claims, brain injury claims, and no win, no fee explained.