GITNUXREPORT 2026

Shoulder Dystocia Statistics

Shoulder dystocia is an uncommon but serious childbirth complication with varying risk factors.

Alexander Schmidt

Alexander Schmidt

Research Analyst specializing in technology and digital transformation trends.

First published: Feb 13, 2026

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Key Statistics

Statistic 1

Shoulder dystocia occurs in approximately 0.2% to 3% of all vaginal deliveries

Statistic 2

The incidence of shoulder dystocia is 1.16% in a large U.S. cohort of over 2 million deliveries

Statistic 3

In non-diabetic mothers, shoulder dystocia rate is 0.7% compared to 5.3% in gestational diabetics

Statistic 4

Shoulder dystocia incidence rises to 5-9% when fetal weight exceeds 4000g

Statistic 5

In a Swedish study of 665,000 deliveries, shoulder dystocia occurred in 1.5 per 1000 births

Statistic 6

Prolonged second stage of labor (>60 min) associated with 16.5% shoulder dystocia rate

Statistic 7

Posterior shoulder dystocia accounts for 20-25% of cases

Statistic 8

Incidence in instrumental deliveries is 5-9%

Statistic 9

Shoulder dystocia in macrosomia (>4500g) is 16-35%

Statistic 10

Overall U.K. incidence is 2.4 per 1000 deliveries

Statistic 11

In obese mothers (BMI>30), incidence is 2.4%

Statistic 12

Shoulder dystocia recurrence in subsequent pregnancy is 1.4-16.3%

Statistic 13

Fetal macrosomia (>4000g) is present in 40-50% of shoulder dystocia cases

Statistic 14

Maternal diabetes increases risk 2-4 fold, incidence 3-5%

Statistic 15

In multiparous women, incidence is 0.9%

Statistic 16

Shoulder dystocia occurs in 10% of fetuses >5000g

Statistic 17

National rate in Canada is 1.3 per 1000

Statistic 18

In vacuum deliveries, rate is 7.5%

Statistic 19

Shoulder dystocia in short stature mothers (<155cm) is 4.2%

Statistic 20

Incidence doubled from 1990-2003 (0.63% to 1.34%)

Statistic 21

Shoulder dystocia occurs in approximately 0.6% to 1.4% of cephalic vaginal deliveries

Statistic 22

Incidence increases to 5% with forceps or vacuum assistance

Statistic 23

In fetuses >4500g, rate is 14%

Statistic 24

Recurrence rate after one episode is 9.7%

Statistic 25

In gestational diabetes without macrosomia, incidence 2.5%

Statistic 26

National Health Service (UK) reports 2 per 1000 births

Statistic 27

Incidence in prolonged labor >3h is 8.5%

Statistic 28

McRoberts maneuver succeeds in 90% of cases

Statistic 29

Suprapubic pressure effective in 30-50% additional cases

Statistic 30

Woods screw maneuver used in 10-15% unresolved cases

Statistic 31

Posterior arm delivery resolves 50% severe cases

Statistic 32

Zavanelli (cephalic replacement) in <1%, high morbidity

Statistic 33

Prophylactic cesarean for estimated fetal weight >5000g recommended

Statistic 34

Induction at 39 weeks for diabetics reduces risk by 60%

Statistic 35

Shoulder dystocia drills improve resolution time by 50%

Statistic 36

Elective cesarean for prior severe dystocia

Statistic 37

Glycemic control reduces macrosomia risk 50%

Statistic 38

Avoid mid-pelvic instrumental delivery

Statistic 39

Ultrasound for fetal weight estimation accuracy 70-80%

Statistic 40

Rubin II maneuver in 20% cases

Statistic 41

Delivery of posterior shoulder first in bilateral dystocia

Statistic 42

Team training reduces brachial plexus injury by 40%

Statistic 43

Gaskin maneuver (all-fours) resolves 80% anterior shoulder

Statistic 44

Intentional breech delivery for macrosomia debated

Statistic 45

Ultrasound angle of progression predicts dystocia (AUC 0.85)

Statistic 46

Strict glycemic control OR reduction 0.4

Statistic 47

Avoid pushing >2h in suspected macrosomia

Statistic 48

Simulation training reduces injury 25%

Statistic 49

MRI pelvimetry not routine

Statistic 50

Rotational forceps increase risk 4x, avoid

Statistic 51

Fundal pressure contraindicated

Statistic 52

Counseling for elective CS if EFW>4800g in diabetics

Statistic 53

Postpartum hemorrhage occurs in 11-50% of shoulder dystocia cases

Statistic 54

Maternal third/fourth degree perineal laceration in 3.5-10.5%

Statistic 55

Uterine rupture risk increases 3-fold

Statistic 56

Maternal mortality <0.1% but psychological trauma in 50%

Statistic 57

Rectovaginal fistula in 0.5-2%

Statistic 58

Cesarean section in next pregnancy recommended for prior severe cases (50% recurrence risk)

Statistic 59

Vaginal hematoma in 5-10%

Statistic 60

PTSD symptoms in 17% of mothers post-dystocia

Statistic 61

Blood transfusion needed in 1-3%

Statistic 62

Anal sphincter injury 3.8% vs 1.3% controls

Statistic 63

Long-term pelvic floor dysfunction in 20-30%

Statistic 64

Hysterectomy rare, 0.2%

Statistic 65

Increased cesarean rate in subsequent deliveries (10-20%)

Statistic 66

Maternal stress incontinence doubles post-event

Statistic 67

Maternal nerve injury (femoral) 1%

Statistic 68

Urinary incontinence 25% at 6 months

Statistic 69

Fecal incontinence 5%

Statistic 70

Depression/anxiety 20-30% post-event

Statistic 71

Symphysiotomy performed in 0.1-0.5% severe cases

Statistic 72

Long-term dyspareunia 15%

Statistic 73

Increased risk of placenta previa in next pregnancy 2x

Statistic 74

Severe PPH (>1500ml) in 4%

Statistic 75

Maternal ICU admission <1%

Statistic 76

Perineal pain at 6 weeks 40%

Statistic 77

Permanent brachial plexus injury (Erb's palsy) in 0.5-3% neonates

Statistic 78

Clavicle fracture in 5-10% of cases

Statistic 79

Hypoxic-ischemic encephalopathy (HIE) in 1-4%

Statistic 80

Humeral fracture 0.6-3%

Statistic 81

Perinatal mortality 0.6 per 1000 vs 0.2 baseline

Statistic 82

Transient brachial plexus injury resolves in 80-90%

Statistic 83

Facial nerve palsy 1-3%

Statistic 84

Meconium aspiration syndrome risk x3

Statistic 85

Cerebral palsy association 0.2-1%

Statistic 86

Horner syndrome rare, 0.1%

Statistic 87

NICU admission 10-20%

Statistic 88

Spinal cord injury <0.1%

Statistic 89

Phrenic nerve palsy 0.5%

Statistic 90

Seizures post-event 1%

Statistic 91

Neonatal asphyxia (Apgar<3 at 5min) 3.8%

Statistic 92

Persistent Erb's palsy 1 in 1000 births with dystocia

Statistic 93

Sternocleidomastoid injury 1%

Statistic 94

Fractured scapula rare <0.1%

Statistic 95

Acidosis (pH<7) in 10%

Statistic 96

Long-term neurodevelopmental delay 1-2%

Statistic 97

Diaphragmatic paralysis 0.2%

Statistic 98

Retinal hemorrhage 5%

Statistic 99

Hypotonia at discharge 2%

Statistic 100

Stillbirth risk x4 in unresolved cases

Statistic 101

Maternal diabetes (pregestational) has OR 3.14 for shoulder dystocia

Statistic 102

Fetal macrosomia (>4000g) has OR 9.23

Statistic 103

Maternal obesity (BMI>30) OR 1.7-2.6

Statistic 104

Instrumental vaginal delivery OR 3.8

Statistic 105

Prolonged second stage (>2 hours) OR 4.7

Statistic 106

Post-term pregnancy (>41 weeks) OR 1.5

Statistic 107

Maternal age >35 OR 1.4

Statistic 108

Previous shoulder dystocia OR 10.3

Statistic 109

Gestational diabetes OR 1.8-2.5

Statistic 110

Operative vaginal delivery (forceps) OR 5.4

Statistic 111

Male fetal gender OR 1.2

Statistic 112

Maternal short stature OR 2.1

Statistic 113

Polyhydramnios OR 2.7

Statistic 114

Asian ethnicity OR 1.6 (protective for macrosomia-related)

Statistic 115

BMI >40 OR 3.1

Statistic 116

Shoulder dystocia with brachial plexus injury in 4-16% of cases

Statistic 117

Vacuum extraction OR 2.8

Statistic 118

Nulliparity OR 1.3

Statistic 119

Black race OR 1.7 for shoulder dystocia

Statistic 120

Hispanic ethnicity OR 1.3

Statistic 121

Twin gestation OR 1.5

Statistic 122

Chorioamnionitis OR 2.0

Statistic 123

Maternal weight gain >40lbs OR 1.8

Statistic 124

Fetal malposition (persistent OP) OR 3.2

Statistic 125

Previous macrosomia OR 2.5

Statistic 126

Advanced maternal age >40 OR 1.6

Statistic 127

Pelvic asymmetry OR 2.2

Statistic 128

Anemia in pregnancy OR 1.4

Sources
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While many think of childbirth as universally straightforward, the reality of shoulder dystocia—a sudden obstruction where the baby's shoulders get stuck—is a high-stakes emergency that ranges from a 0.7% chance for the average mother to a staggering 35% for those delivering a baby over ten pounds.

Key Takeaways

  • Shoulder dystocia occurs in approximately 0.2% to 3% of all vaginal deliveries
  • The incidence of shoulder dystocia is 1.16% in a large U.S. cohort of over 2 million deliveries
  • In non-diabetic mothers, shoulder dystocia rate is 0.7% compared to 5.3% in gestational diabetics
  • Maternal diabetes (pregestational) has OR 3.14 for shoulder dystocia
  • Fetal macrosomia (>4000g) has OR 9.23
  • Maternal obesity (BMI>30) OR 1.7-2.6
  • Postpartum hemorrhage occurs in 11-50% of shoulder dystocia cases
  • Maternal third/fourth degree perineal laceration in 3.5-10.5%
  • Uterine rupture risk increases 3-fold
  • Permanent brachial plexus injury (Erb's palsy) in 0.5-3% neonates
  • Clavicle fracture in 5-10% of cases
  • Hypoxic-ischemic encephalopathy (HIE) in 1-4%
  • McRoberts maneuver succeeds in 90% of cases
  • Suprapubic pressure effective in 30-50% additional cases
  • Woods screw maneuver used in 10-15% unresolved cases

Shoulder dystocia is an uncommon but serious childbirth complication with varying risk factors.

Incidence/Prevalence

  • Shoulder dystocia occurs in approximately 0.2% to 3% of all vaginal deliveries
  • The incidence of shoulder dystocia is 1.16% in a large U.S. cohort of over 2 million deliveries
  • In non-diabetic mothers, shoulder dystocia rate is 0.7% compared to 5.3% in gestational diabetics
  • Shoulder dystocia incidence rises to 5-9% when fetal weight exceeds 4000g
  • In a Swedish study of 665,000 deliveries, shoulder dystocia occurred in 1.5 per 1000 births
  • Prolonged second stage of labor (>60 min) associated with 16.5% shoulder dystocia rate
  • Posterior shoulder dystocia accounts for 20-25% of cases
  • Incidence in instrumental deliveries is 5-9%
  • Shoulder dystocia in macrosomia (>4500g) is 16-35%
  • Overall U.K. incidence is 2.4 per 1000 deliveries
  • In obese mothers (BMI>30), incidence is 2.4%
  • Shoulder dystocia recurrence in subsequent pregnancy is 1.4-16.3%
  • Fetal macrosomia (>4000g) is present in 40-50% of shoulder dystocia cases
  • Maternal diabetes increases risk 2-4 fold, incidence 3-5%
  • In multiparous women, incidence is 0.9%
  • Shoulder dystocia occurs in 10% of fetuses >5000g
  • National rate in Canada is 1.3 per 1000
  • In vacuum deliveries, rate is 7.5%
  • Shoulder dystocia in short stature mothers (<155cm) is 4.2%
  • Incidence doubled from 1990-2003 (0.63% to 1.34%)
  • Shoulder dystocia occurs in approximately 0.6% to 1.4% of cephalic vaginal deliveries
  • Incidence increases to 5% with forceps or vacuum assistance
  • In fetuses >4500g, rate is 14%
  • Recurrence rate after one episode is 9.7%
  • In gestational diabetes without macrosomia, incidence 2.5%
  • National Health Service (UK) reports 2 per 1000 births
  • Incidence in prolonged labor >3h is 8.5%

Incidence/Prevalence Interpretation

Shoulder dystocia may be rare overall, but these statistics show it's a predictable specter at deliveries, quietly multiplying its odds with factors like a large baby, diabetes, or forceps, reminding us that childbirth's ordinary miracle has a precise and formidable arithmetic.

Management/Prevention

  • McRoberts maneuver succeeds in 90% of cases
  • Suprapubic pressure effective in 30-50% additional cases
  • Woods screw maneuver used in 10-15% unresolved cases
  • Posterior arm delivery resolves 50% severe cases
  • Zavanelli (cephalic replacement) in <1%, high morbidity
  • Prophylactic cesarean for estimated fetal weight >5000g recommended
  • Induction at 39 weeks for diabetics reduces risk by 60%
  • Shoulder dystocia drills improve resolution time by 50%
  • Elective cesarean for prior severe dystocia
  • Glycemic control reduces macrosomia risk 50%
  • Avoid mid-pelvic instrumental delivery
  • Ultrasound for fetal weight estimation accuracy 70-80%
  • Rubin II maneuver in 20% cases
  • Delivery of posterior shoulder first in bilateral dystocia
  • Team training reduces brachial plexus injury by 40%
  • Gaskin maneuver (all-fours) resolves 80% anterior shoulder
  • Intentional breech delivery for macrosomia debated
  • Ultrasound angle of progression predicts dystocia (AUC 0.85)
  • Strict glycemic control OR reduction 0.4
  • Avoid pushing >2h in suspected macrosomia
  • Simulation training reduces injury 25%
  • MRI pelvimetry not routine
  • Rotational forceps increase risk 4x, avoid
  • Fundal pressure contraindicated
  • Counseling for elective CS if EFW>4800g in diabetics

Management/Prevention Interpretation

While a well-drilled team armed with maneuvers like McRoberts and Gaskin can resolve most shoulder dystocia, the best strategy is a layered defense of glycemic control, timed delivery, and avoiding risky interventions to prevent the emergency altogether.

Maternal Outcomes

  • Postpartum hemorrhage occurs in 11-50% of shoulder dystocia cases
  • Maternal third/fourth degree perineal laceration in 3.5-10.5%
  • Uterine rupture risk increases 3-fold
  • Maternal mortality <0.1% but psychological trauma in 50%
  • Rectovaginal fistula in 0.5-2%
  • Cesarean section in next pregnancy recommended for prior severe cases (50% recurrence risk)
  • Vaginal hematoma in 5-10%
  • PTSD symptoms in 17% of mothers post-dystocia
  • Blood transfusion needed in 1-3%
  • Anal sphincter injury 3.8% vs 1.3% controls
  • Long-term pelvic floor dysfunction in 20-30%
  • Hysterectomy rare, 0.2%
  • Increased cesarean rate in subsequent deliveries (10-20%)
  • Maternal stress incontinence doubles post-event
  • Maternal nerve injury (femoral) 1%
  • Urinary incontinence 25% at 6 months
  • Fecal incontinence 5%
  • Depression/anxiety 20-30% post-event
  • Symphysiotomy performed in 0.1-0.5% severe cases
  • Long-term dyspareunia 15%
  • Increased risk of placenta previa in next pregnancy 2x
  • Severe PPH (>1500ml) in 4%
  • Maternal ICU admission <1%
  • Perineal pain at 6 weeks 40%

Maternal Outcomes Interpretation

While catastrophic outcomes are mercifully rare, shoulder dystocia leaves a devastatingly common legacy of moderate but life-altering complications, essentially ensuring the bill for maternal aftercare comes due for decades.

Neonatal Outcomes

  • Permanent brachial plexus injury (Erb's palsy) in 0.5-3% neonates
  • Clavicle fracture in 5-10% of cases
  • Hypoxic-ischemic encephalopathy (HIE) in 1-4%
  • Humeral fracture 0.6-3%
  • Perinatal mortality 0.6 per 1000 vs 0.2 baseline
  • Transient brachial plexus injury resolves in 80-90%
  • Facial nerve palsy 1-3%
  • Meconium aspiration syndrome risk x3
  • Cerebral palsy association 0.2-1%
  • Horner syndrome rare, 0.1%
  • NICU admission 10-20%
  • Spinal cord injury <0.1%
  • Phrenic nerve palsy 0.5%
  • Seizures post-event 1%
  • Neonatal asphyxia (Apgar<3 at 5min) 3.8%
  • Persistent Erb's palsy 1 in 1000 births with dystocia
  • Sternocleidomastoid injury 1%
  • Fractured scapula rare <0.1%
  • Acidosis (pH<7) in 10%
  • Long-term neurodevelopmental delay 1-2%
  • Diaphragmatic paralysis 0.2%
  • Retinal hemorrhage 5%
  • Hypotonia at discharge 2%
  • Stillbirth risk x4 in unresolved cases

Neonatal Outcomes Interpretation

While the odds of a tragic outcome in shoulder dystocia are individually low, collectively they present a terrifying spectrum of potential complications, turning a routine delivery into a high-stakes lottery where no one wants to draw the winning tickets of permanent nerve damage, hypoxic brain injury, or the stark fourfold increase in stillbirth risk.

Risk Factors

  • Maternal diabetes (pregestational) has OR 3.14 for shoulder dystocia
  • Fetal macrosomia (>4000g) has OR 9.23
  • Maternal obesity (BMI>30) OR 1.7-2.6
  • Instrumental vaginal delivery OR 3.8
  • Prolonged second stage (>2 hours) OR 4.7
  • Post-term pregnancy (>41 weeks) OR 1.5
  • Maternal age >35 OR 1.4
  • Previous shoulder dystocia OR 10.3
  • Gestational diabetes OR 1.8-2.5
  • Operative vaginal delivery (forceps) OR 5.4
  • Male fetal gender OR 1.2
  • Maternal short stature OR 2.1
  • Polyhydramnios OR 2.7
  • Asian ethnicity OR 1.6 (protective for macrosomia-related)
  • BMI >40 OR 3.1
  • Shoulder dystocia with brachial plexus injury in 4-16% of cases
  • Vacuum extraction OR 2.8
  • Nulliparity OR 1.3
  • Black race OR 1.7 for shoulder dystocia
  • Hispanic ethnicity OR 1.3
  • Twin gestation OR 1.5
  • Chorioamnionitis OR 2.0
  • Maternal weight gain >40lbs OR 1.8
  • Fetal malposition (persistent OP) OR 3.2
  • Previous macrosomia OR 2.5
  • Advanced maternal age >40 OR 1.6
  • Pelvic asymmetry OR 2.2
  • Anemia in pregnancy OR 1.4

Risk Factors Interpretation

While having a big baby is the star quarterback of shoulder dystocia risk, with a formidable OR of 9.23, its offensive line includes diabetes, forceps, and a previous history of the condition, all conspiring to make delivery a high-stakes game of inches.