Birth Injuries: Does the HELPERR Mnemonic Really Help?

| Apr 19, 2021 | Medical Malpractice

The HELPERR mnemonic, which is examined below, helps doctors and nurses deal with shoulder dystocia emergencies. If the baby is too big to drift through the mother’s narrow birth canal, the umbilical cord could essentially strangle the baby in about five minutes.

Especially if the mother had prenatal care, shoulder dystocia issues should never affect the events in the delivery room. In a perfect world, doctors should recognize the signs, such as a LGA (Large for Gestational Age) baby or a mother’s history of delivering large babies, and anticipate such problems. But we don’t live in a perfect world.

Hypoxia, or a lack of oxygen to the brain, causes cerebral palsy. In many instances, the brain damage is so bad that children essentially are prisoners inside their own bodies. These families need substantial financial resources to raise these children, and a Kentucky personal injury attorney can make that happen.

Call for Help

The first step in any list is usually the most critical one. In this situation, it’s also the most difficult one, at least for many doctors and nurses.

Many professionals consider asking for help to be a sign of weakness. Additionally, many doctors reason that the clock is ticking, so there’s no time to wait. Instead, they must act. Unfortunately for mothers and babies, this action usually does more harm than good.

In the doctor’s defense, sometimes help is unavailable. Regardless of the facts, shoulder dystocia emergencies almost always go to the next level.

Evaluate for Episiotomy

It’s hard to believe this E is still on the list. An episiotomy is an incision on the mother’s perineum (area between the anus and genitals) which widens the birth canal. Episiotomies are sometimes necessary in a few cases. These cases almost never involve shoulder dystocia emergencies. 

Too many times, episiotomies cause uncontrollable maternal bleeding at a time when mothers need every ounce of strength. These procedures usually have long-term ill effects as well, such as intense pain during sexual intercourse.

Reposition the Mother’s Legs

It’s also hard to believe this L isn’t higher on the list. Repositioning the legs is also known as the McRoberts Maneuver. The doctor hyperflexes the mother’s legs to her abdomen. That repositioning makes gravity the doctor’s ally instead of the doctor’s enemy. Statistically, the McRoberts Maneuver is about 80 percent effective.

However, this technique does not work instantly. It takes a few minutes. And, by this time, doctors know they may not have a few minutes. Therefore, doctors often prematurely move to the next level.

Suprapubic Pressure

As the HELPERR mnemonic progresses, the interventions become increasingly desperate This P is the first desperate measure.

Basically, applying suprapubic pressure is a bit like performing CPR on the mother’s abdomen. The doctor hopes to dislodge the baby and force the infant down the mother’s birth canal. Most infants are so frail that the pressure on the mother’s body could cause a permanent injury.485

Enter Maneuvers

This phrase is a euphemistic way to describe risky device interventions. These devices often include:

  • Forceps: These surgical tools resemble large salad tongs. The doctor grabs the baby’s head and tries to pull the baby out of the mother. This excessive force usually causes a head injury at best. At worst, the doctor might almost literally tear the baby in two.
  • Vacuum Extractor: The doctor puts a cap on the baby’s head. This cap is attached to a surgical vacuum. Ten, the doctor turns on the vacuum and tries to suck the baby out of the mother. You can imagine what could happen next.

Other times, doctors use their hands to try and pull the baby out. This intervention isn’t as extreme as a device delivery, but it could still cause permanent injury.

Remove the Posterior Arm

With the clock ticking down close to zero, the measures become even more desperate. Often as a last resort, the doctor removes the baby’s arm, to eliminate half of the shoulder dystocia problem. The doctor assumes that it’s better to go through life with a healthy brain and one arm than an unhealthy brain and two arms. That assumption is probably correct, but it’s the doctor’s own negligence which brought things to this point.

Roll the Patient

The doctor moves the mother onto her side. Basically, the doctor hopes that the prior interventions have partially worked, and this final intervention may be the last piece of the puzzle. Frequently, however, rolling the mother onto her side is the doctor’s way of saying “We did all we could.”

Birth injuries are perhaps the most tragic and most preventable personal injuries. For a free consultation with an experienced personal injury lawyer in Lexington, contact the Goode Law Office, PLLC. Home and hospital visits are available. #goodelawyers