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RCOG responds to latest HSIB report

News 4 February 2021

HSIB has released its latest maternity national report highlighting that larger than average babies are at increased risk of nerve damage, brain injury or death when their shoulders get stuck during birth. 

HSIB examined the factors that increase the likelihood that shoulder dystocia will occur with larger babies, from pregnancy to labour and birth. From the analysis of their reports, HSIB have pinpointed that many of the challenges lie in how larger than average gestational age babies (LGA) are identified and the subsequent management of care of the mother during pregnancy. 

As a result of the findings of the reviews, HSIB has recommended the RCOG take into consideration the findings of this review when updating the RCOG Green Top shoulder dystocia guideline (No.42).

In response to the report, Dr Tim Draycott, Consultant Obstetrician and Vice President at the Royal College of Obstetricians and Gynaecologists, said:

"We welcome the latest report from HSIB reporting a series of infants with hypoxic brain injuries after shoulder dystocia that reflects similar findings to previous national investigations. 

"71% of the babies in this small series weighed more than 4Kg when they were born and were therefore larger than average. As with all pregnancies, it is very important a discussion takes place between a pregnant woman and her obstetrician or midwife around the risks and benefits of different birth options when the baby is anticipated to be large. 

"We look forward to the results of the ongoing Big Baby trial that will improve our understanding of the pros and cons of induction of labour for women whose baby is anticipated to weigh more than 4Kg and we will update our clinical guideline on shoulder dystocia."


To contact the RCOG press office call +44 (0)7986 183167 or email