Erb's Palsy

Erb’s palsy is a birth injury that affects the shoulder, arm and hand. With proper treatment, sometimes including surgery, many children can recover from Erb’s palsy, but some are permanently disabled. One of the most frustrating facts about Erb’s palsy is that it is entirely preventable. C-section will always prevent Erb’s palsy. In rare cases where C-section is not possible, there are other well-established delivery techniques that will prevent the injury. Erb’s palsy is the result of medical malpractice.

Understanding Erb’s Palsy

Erb’s palsy is a brachial plexus injury. The brachial plexus is a nerve bundle located between the neck and shoulder. It controls the arm and hand. Damage to the brachial plexus can rob your child of the use of the affected arm and hand forever. When caught early and treated properly, it can be fully corrected in some children. Symptoms and consequences of Erb’s palsy can include:

• Paralysis of the shoulder, arm, and hand
• Loss of feeling in the shoulder, arm and hand
• Atrophy of the muscles in the shoulder and arm (deltoid, biceps, and brachialis)
• Hand that does not function properly
• Fixed elbow
• Arm that is shorter than normal
• Rotated arm
• Winged shoulder blade
• Sloped shoulder

How the Injury Causing Erb’s Palsy Occurs

Injury to the brachial plexus is caused by applying too much force to the baby during a difficult delivery, stretching or tearing the brachial plexus nerves. It happens to babies who get a shoulder stuck behind the mother’s pubic bone. That is called shoulder dystocia. The position and size of the baby, as well as the size, shape, and health of the mother can indicate whether shoulder dystocia is likely to occur during delivery. Risk factors include:

• Large baby
• Overdue baby
• Prolonged labor
• Above normal weight gain during pregnancy
• Short or small mother
• Flat, contracted, or small pelvis in mother
• Obese mother
• Mother with diabetes
• Mother of advanced age
• Breech position

Why Erb’s Palsy is Medical Malpractice

The risk factors for Erb’s palsy are not difficult for medical professionals to spot, if they are monitoring you properly during your pregnancy. C-section can prevent Erb’s palsy. In fact, it is the best way to prevent the injury. However, C-section is not always an option. Shoulder dystocia may be discovered too late to perform C-section, and in rare cases C-section is too dangerous.

When C-section is not an option there are still several techniques that can be used to deliver your baby without injury including:

• The McRoberts maneuver
• Reaching inside and rotating the baby (Wood’s corkscrew)
• Repositioning the baby by applying pressure outside the body (suprapubic pressure)
• Rolling the mother onto all fours
• Removing the posterior arm from the birth canal

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