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Does the HELPERR Mnemonic Really Help?


Shoulder dystocia is one of the most common causes of birth injuries in Hillsborough County. If the baby’s shoulders are too large to allow smooth movement down the mother’s birth canal, the umbilical cord may wrap itself around the baby’s neck. If that happens, permanent brain injury is only about five minutes away.

To avoid such injuries, many hospitals instruct doctors and nurses to follow the HELPERR mnemonic device. But at many stages, this procedure may cause more harm than good.

Damages in a medical malpractice birth injury claim usually include compensation for economic losses, such as medical bills, and noneconomic losses, such as pain and suffering. Due to the high doctor-patient duty of care, additional punitive damages are usually available in these cases as well.

Call for Help

One would think that this reaction naturally comes first. But many doctors skip this step, usually because of overconfidence and previous misdiagnosis.

For many doctors, especially birth specialists, asking for help is a sign of weakness. Furthermore, many doctors detected a risk of shoulder dystocia during the mother’s prenatal visits. However, they often dismiss the symptoms as “borderline.” So, they approach an emergency situation with an “I’ve got this” mentality. Normally, that attitude is a good thing. But in this context, it’s a bad thing.

Evaluate for Episiotomy

Once upon a time, doctors routinely cut into the mother’s perineum (area between the vagina and anus) to widen the birth canal, whether the mother was in distress or not. So, at one point, an episiotomy made sense.

But now, doctors know these incisions often cause uncontrollable maternal bleeding. They also cause intense pain and lack of mobility after the birth. Therefore, making such incisions is arguably medical malpractice in and of itself. And, these cuts do little to help the baby move faster.

Leg Repositioning (the McRoberts Maneuver)

This technique is probably too far down the list. The McRoberts Maneuver, which is simply lifting the mother’s legs, is effective in about 80 percent of cases. But it takes some time to work. And by the time the doctor arrives at step three, several precious minutes have already ticked off the clock.

Suprapubic Pressure

Doctors essentially perform CPR on the mother’s pelvis in an attempt to dislodge the baby. But the baby is so tiny that any additional force, including suprapubic pressure on the mother, could cause a permanent injury.

Enter Maneuvers

The doctor tries to push the baby into a more favorable position. Such invasive maneuvers do not just risk serious injury to the child, as mentioned above. They may also make the situation worse. According to one medical journal, “These maneuvers can be difficult to perform when the anterior shoulder is wedged beneath the symphysis.” Furthermore, “At times, it is necessary to push the fetus up into the pelvis slightly to accomplish the maneuvers.”

Remove the Posterior Arm

By this time, the five-minute clock is approaching zero, and doctors are desperate. Not to put too fine a point on it, but they believe delivering a live, one-armed baby is better than delivering a stillborn baby with two arms.

Roll the Patient

If the doctor rolls the mother onto all fours, gravity sometimes does most of the work by gently pulling the baby down. Like the McRoberts Maneuver, this technique should be higher on the list. It is often effective, but it takes time to work. By this point, unfortunately, everyone is probably out of time.

Contact Compassionate Attorneys

Birth injuries have devastating consequences for Florida families. For a free consultation with an experienced Brandon personal injury lawyer, contact Reed & Reed, Attorneys at Law. We have four area offices (St. Petersburg, Lakeland, Tampa, and Clearwater).

Brandon Personal Injury
Reed & Reed, Attorneys at Law, is located in Brandon, FL and serves clients in
and around Brandon, Tampa, Apollo Beach, Sydney, Gibsonton, Balm, Valrico, Wimauma, Sun City Center, Lithia, Ruskin, Durant, and Hillsborough County.

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