§ GUIDE · SHOULDER DYSTOCIA

When the shoulders get stuck,
and what the law asks next.

Shoulder dystocia is an obstetric emergency: after the head is born, a shoulder catches behind the mother's pubic bone. Most babies are delivered safely with recognised manoeuvres. When things go wrong, two very different injuries can follow, and the claims work differently.

MHE settlement

£5,557,500

Taylor agreed damages

£1,150,000

Recovered in Taylor

£0

Claim until child turns

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§ TWO INJURIES, TWO CLAIMS

The arm, and the brain.

Brachial plexus injury

Traction on the baby's head can stretch or tear the nerves running from the neck to the arm, causing Erb's palsy: weakness or paralysis of the arm, sometimes permanent. The allegation is normally that excessive or wrongly directed traction was used instead of recognised manoeuvres.

Brain injury from delay

If the baby stays stuck too long, oxygen deprivation can cause hypoxic-ischaemic encephalopathy and cerebral palsy. In MHE v Wye Valley NHS Trust [2024] EWHC 25 (KB) the manoeuvres failed and the trust admitted in 2012 that it had failed to deliver the baby with sufficient or safe speed. The child was left with cerebral palsy and the settlement approved in 2024 was £5,557,500 plus stepped periodical payments for life.

§ THE MANOEUVRES

What should happen when the shoulders will not come.

Obstetric teams follow a recognised drill: the McRoberts manoeuvre, which sharply flexes the mother's hips, suprapubic pressure to dislodge the shoulder, and then internal manoeuvres or delivery of the posterior arm. The point of the drill is that it relieves the obstruction without pulling harder on the baby's head.

A claim will usually allege that the drill was not followed, that it was abandoned too soon, or that traction was applied instead.

§ JUDGED BY THE YEAR OF THE BIRTH

Today's teaching does not decide a birth from decades ago.

Taylor v Chesterfield Royal Hospital [2019] EWHC 1043 (QB) concerned a birth in November 1992. A large baby's shoulder became stuck and the registrar used moderate downward traction to free her, causing a permanent brachial plexus injury. Quantum had been agreed at £1,150,000 subject to liability.

The judge found that traction of that kind was accepted practice in 1992, even though it is avoided now, and dismissed the claim. Nothing was recovered. Because Erb's palsy claims often concern births many years earlier, this issue arises constantly: the question is always what a competent clinician would have done at the time.

§ THE CASE THAT CHANGED CONSENT

Montgomery began with a shoulder dystocia risk.

Montgomery v Lanarkshire Health Board [2015] UKSC 11 is now the leading UK case on informed consent, and it arose from exactly this scenario. A diabetic mother of small stature was not told of the roughly 10 per cent risk of shoulder dystocia in a vaginal birth, or offered a caesarean. Her son was born with cerebral palsy. The Supreme Court held that doctors must disclose material risks and reasonable alternatives.

So a shoulder dystocia claim can be framed two ways: that the emergency was mishandled, or that the mother should have been told the risk and offered a caesarean beforehand.

§ TIME LIMITS

Children have until their twenty-first birthday.

The three-year limitation period does not start until a child turns 18, so a claim can be brought at any time before they are 21. A parent can bring it sooner as litigation friend. Where the child lacks the capacity to manage their own affairs, no limitation period runs at all. That is why birth claims are routinely brought years after the delivery, as MHE shows, where the birth was in 2009 and the settlement was approved in 2024.

§ THE JUDGMENTS BEHIND THIS GUIDE

Three judgments from the delivery room.

An approved cerebral palsy settlement, a failed Erb's palsy claim from a 1992 birth, and the Supreme Court decision on consent that began with shoulder dystocia.

Settlement approved£5.56M

MHE v Wye Valley NHS Trust

[2024] EWHC 25 (KB)·2024·Settlement approved by the court

The baby's shoulders became stuck during delivery and manoeuvres failed, so she was deprived of oxygen and left with cerebral palsy; the Trust admitted in 2012 that it failed to deliver her with sufficient or safe speed. The court approved a settlement of about £5.56m plus lifelong periodical payments.

Shoulder dystocia claims are not only about arm injuries; a prolonged delay in freeing the baby can cause brain injury, and damages then reflect lifelong care needs. Approval judgments like this are one of the few public sources showing what such settlements are worth.

Claim failed

Rebeccah Taylor v Chesterfield Royal Hospital NHS Foundation Trust

[2019] EWHC 1043 (QB)·2019·Liability decided at trial

A 4.93kg baby's shoulder became stuck at delivery and the registrar used moderate downward traction to free her, causing a permanent brachial plexus injury. The judge found that traction of that kind was accepted practice in 1992, even though it is now avoided, so the claim failed.

Negligence is judged by the standards at the time of the birth, not today's guidance, which is decisive in many historic Erb's palsy claims. An agreed damages figure is worth nothing unless breach of duty is proved.

Claimant succeeded

Montgomery v Lanarkshire Health Board

[2015] UKSC 11·2015·Appeal decision

A diabetic mother of small stature was not told of the roughly 10 per cent risk of shoulder dystocia in a vaginal birth or offered a caesarean, and her son was born with cerebral palsy. The Supreme Court held doctors must tell patients about material risks and reasonable alternatives, replacing the old doctor-knows-best approach to consent.

Since Montgomery, a claim can succeed where a patient was not warned of a risk that a reasonable person in their position would consider significant, even if some doctors would not have mentioned it. It underpins most modern consent-based negligence claims.

Browse the whole case library →

Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

§ QUESTIONS

Common questions

What is shoulder dystocia?

An obstetric emergency where, after the baby's head is delivered, a shoulder becomes caught behind the mother's pubic bone. Recognised manoeuvres such as McRoberts and suprapubic pressure are used to free it.

Is Erb's palsy always caused by negligence?

No. Brachial plexus injury can occur even where the delivery is managed properly. A claim has to show that the care fell below the standard of the time and caused the injury.

My child was born years ago. Is it too late?

Probably not. The three years do not begin until the child turns 18, so a claim can usually be brought until their 21st birthday, and there is no time limit at all while a person lacks capacity to manage their own affairs.

Why did the claim in Taylor fail?

Because the birth was in 1992 and the judge found that the traction used was accepted practice at that time, even though it is avoided today. Negligence is judged by the standards of the year of the birth.

Should I have been offered a caesarean?

Since Montgomery v Lanarkshire, doctors must tell you about material risks and reasonable alternatives, which can include a caesarean where there are risk factors for shoulder dystocia. Whether that applied in your case depends on what you were told and your circumstances.

What are these claims worth?

It depends entirely on the injury. A permanent brachial plexus injury and a brain injury requiring lifelong care are valued very differently: MHE's cerebral palsy settlement was £5,557,500 plus payments for life.

§ MORE GUIDES

Plain answers to the other questions people ask.

Periodical payments →

How periodical payment orders work: a lump sum plus index-linked yearly payments for life, stepped payments, and why headline totals differ. Real settlements.

Settlement approval →

Why a settlement for a child or protected party must be approved by a judge, what the judge checks, and what public approval judgments reveal about real sums.

Consent claims →

Informed consent claims since Montgomery: material risks, reasonable alternatives, consent as an ongoing process, and why documented consent defeats claims.

Payout examples →

UK medical negligence payout examples by claim type, typical compensation ranges, and what decides the amount. Then check your own claim free.

Fatal negligence payouts →

What compensation after a death caused by medical negligence can include: the bereavement award, dependency, funeral costs and the estate's claim.

NHS payout data →

Official NHS Resolution figures, band by band, for 2024/25.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.

When the shoulders get stuck,and what the law asks next.