After a tragic birth story out of Atlanta, an OBGYN breaks down 'maneuvers of last resort'
"A shoulder dystocia, if you don't know, is an obstetric emergency."
TRIGGER WARNING: This story contains graphic details of childbirth trauma and infant loss.
A couple in Atlanta, Georgia, experienced a devastating loss that by all stretches of the imagination seems impossible. Unfortunately, the unimaginable is one of the rarest of rare birth complications that resulted in the loss of their newborn son.
Jessica Ross and her partner, Treveon Taylor, were excitedly awaiting the delivery of their first child when during the pushing stage of labor, baby Treveon Taylor Jr.'s shoulder got stuck. According to the Cleveland Clinic, shoulder dystocia is when one or both of the baby's shoulders get stuck behind a bone in the pelvis, which doesn't allow the baby to exit the birth canal.
Ross found herself in this very situation, which eventually resulted in an emergency situation in which the doctor had to dislodge the baby from the pelvis and perform a Cesarean section. It is suspected that the force with which the baby was dislodged caused the infant's decapitation.
Doctors and nurses on TikTok have been taking to the app in an attempt to explain how a situation like this occurs. Dr. Fatima Daoud, OB-GYN uploaded two separate videos expanding on information about shoulder dystocia and what she says are "maneuvers of last resort." She explains in the video that maneuvers of last resort are actions taken by the provider that may cause harm to the baby but are necessary to save the baby's and/or mother's life.
"The first thing I'm going to say is that shoulder dystocia, it's rare. But when it does happen it's an unpredictable, unpreventable medical emergency," Daoud explains. "There are risk factors, sure, for shoulder dystocia. But actually, the majority of shoulder dystocias happen in people who have no risk factor at all."
This essentially means that there's no way for a doctor or midwife to know that you may experience shoulder dystocia while delivering your baby. But when it happens, things have to move extremely quickly because once the baby's face hits the air, the clock has started. There are only a few minutes to get the baby out before they've been deprived of oxygen for too long. During this time doctors and nurses try multiple different ways to dislodge the baby's shoulder but if all else fails, they have to move to the maneuvers of last resort.
Daoud explains that decapitation due to shoulder dystocia is "astronomically, astronomically rare" before revealing that it doesn't always mean malpractice has occurred.
#stitch with @wykeishaforthecommunity Major content warning here, but I do feel that as medical professionals we have an obligation to responsibly and respectfully weigh in on prominent medical-related news.
"Is because, when we're trying to resolve a shoulder dystocia when it happens, there are multiple maneuvers that we do. Three of them are what we call maneuvers of last resort. The extreme stuff," Daoud continues. If the extreme stuff doesn't work, what are you going to do? If nothing is working, what are you going to do? And a decapitation is the answer. I'm so sorry to say this, but that doesn't automatically mean malpractice took place."
The OB-GYN apologized multiple times in the video understanding that it's not pleasant information, but it's necessary information to have in order to understand how the couple's doctor may have gotten to that point. It has been reported that this couple's baby died before the Cesarean took place due to how long he was stuck in the birth canal.
In a follow-up video, Daoud goes into more detail about the three last-resort maneuvers before something as horrific as a decapitation occurs. One involves breaking the baby's clavicle to force the shoulders past the pubic bone, and the very last one is the "Zavanelli maneuver," in which they attempt to push the baby back into the uterus via the birth canal.
"Performing a Cesarean in the middle of shoulder dystocia is very much different than performing a Cesarean section that's scheduled or in labor," Daoud says. "It's not even comparing apples to oranges. It's like comparing an apple to a truck."
She goes on to explain that if the Zavanelli Maneuver is unsuccessful and you've attempted all of the other maneuvers of last resort prior to the Zavanelli, the focus becomes saving the mom. Daoud is clear that she is not speculating on the case from Atlanta but explaining how an infant death like this can occur.
It's a tragic thing to consider and an even more tragic thing to experience. Everyone is wishing the parents currently experiencing this unimaginable loss comfort during this difficult time.
Replying to @RaideretteRaiderLicious It’s not as simple as making a cut and scooping the baby out like a typical c-section, though I obviously cannot say what did and did not take place during this tragedy. #zavanellimaneuver #shoulderdystocia
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