“Generally speaking, Brachial plexus palsy (Erb’s Palsy) cases fall into three groups: pre-natal, labor and/or delivery.”


  • Pre-existing diabetes
  • Maternal weight (>180 lbs)
  • Prior gestational diabetes
  • Prior macrosomia (large baby)
  • Multiparity (a woman who has previously had a child)
  • Short maternal stature
  • Advanced maternal age
  • Prior shoulder dystocia

Antepartum (pregnancy):

  • Onset of gestational diabetes
  • Postdatism (pregnancy continuing past 42 weeks)
  • Excessive maternal weight gain (>35 lbs.)
  • Macrosomia (large baby >4000grams i.e. 8.8 lbs)

Intrapartum (birth):

  • Use of epidural
  • Protracted descent
  • Prolonged second stage (>2 hours)
  • Failure of descent of head
  • Need for mid-pelvic or assisted delivery
  • Abnormal first stage
  • Induction of labor
  • Improper delivery technique when shoulder dystoca is incurred (No use of the McRobert’s maneuver, Woods maneuver, suprapubic pressure etc.)
  • Use of forceps or vacuum