Why Did My Baby’s Shoulder Pop During Birth? When to Worry About Shoulder Dystocia or Nerve Injury

Hearing or feeling a popping sound or sensation during your baby’s shoulder delivery can be alarming. You may wonder whether it was a normal part of birth or a sign that something went wrong. While some popping during delivery can occur without injury, a pop during a difficult shoulder delivery should be discussed with the medical team because shoulder dystocia, clavicle fracture, or brachial plexus injury may need to be ruled out. Understanding what the pop might mean and what signs to watch for in your newborn can help you know when to ask questions and seek medical evaluation.

What Causes a Popping Sound or Feeling During Shoulder Delivery?

Popping sounds or sensations during childbirth can have several explanations. Some are benign, while others may indicate that the delivery involved unusual mechanical forces.

Normal Joint and Soft Tissue Movement

Newborn joints and soft tissues are flexible and designed to navigate the birth canal. During delivery, the baby’s shoulders rotate and shift to pass through the pelvis. This movement may sometimes be described as a pop, click, or shift. However, parents cannot tell from the sound alone whether it came from normal movement, soft tissue movement, the collarbone, or another structure.

In many cases, these sounds are not associated with injury. The baby’s body is adapting to the forces of birth, and some degree of joint noise can be part of that process. However, the sound alone does not tell you whether everything went smoothly or whether the baby sustained an injury.

Mechanical Forces During Shoulder Delivery

When a baby’s shoulders are delivered, the provider may apply traction or use specific maneuvers to guide the shoulders out. If the shoulders are stuck behind the mother’s pubic bone, a condition known as shoulder dystocia, the provider must act quickly to free them. The extra force or repositioning involved in releasing an impacted shoulder can sometimes produce an audible or palpable pop.

This pop may come from the shoulder joint itself, the collarbone, or the soft tissues around the shoulder and neck. In some cases, it may be associated with stretching or compression of the nerves that control arm movement. If you notice that one arm moves less than the other, appears limp, or does not respond normally during newborn reflexes, ask your baby’s medical team to evaluate it promptly.

Is It Normal for a Baby’s Shoulder to Pop During Birth?

Whether a pop is normal depends on the context of the delivery and the baby’s condition afterward.

When Popping May Be Benign

If your baby’s shoulders delivered without complication, the provider did not report any difficulty, and your baby is moving both arms equally and vigorously after birth, the pop may have been a benign joint sound. Some babies are born with no issues despite a sound during delivery.

You may also hear popping or clicking in other newborn joints, such as the hips, during routine exams. Some newborn clicking or popping sounds may be harmless, especially if your baby moves both arms normally and the newborn exam is reassuring. Still, a pop during a difficult shoulder delivery should be evaluated in the context of the delivery record and the baby’s physical exam. However, any pop that occurs during a difficult shoulder delivery should be evaluated in context with the baby’s physical exam and the details of the birth.

When Popping Warrants Further Evaluation

If the pop occurred during a delivery that involved shoulder dystocia, significant traction, or maneuvers to free the shoulders, it is important to pay close attention to your baby’s arm movement and overall tone. A pop that coincides with difficulty delivering the shoulders may indicate that the shoulder joint, collarbone, or nerves were affected by the forces involved.

Even if your baby seems calm immediately after birth, some signs of nerve injury or soft tissue damage may not be obvious right away. Observing your baby’s movement over the first hours and days can help identify whether the pop was associated with an injury that needs medical attention.

How Shoulder Dystocia Can Cause Popping Sounds

Shoulder dystocia is an obstetric emergency that occurs when one or both shoulders do not deliver with the usual gentle traction after the baby’s head is born and additional maneuvers are needed.

What Happens During Shoulder Dystocia

In shoulder dystocia, one or both of the baby’s shoulders may become impacted after the head has delivered, and the clinician may need to use specific maneuvers to complete the birth. The provider must use specific techniques to rotate the baby’s body, reposition the mother, or apply controlled traction to free the shoulders. These maneuvers are often necessary to complete the delivery safely, but they can place significant stress on the baby’s shoulder, collarbone, and neck.

When the impacted shoulder is finally released, the sudden movement or shift in position can produce a popping sound or sensation. This may be felt by the provider, the mother, or both. The pop may reflect the shoulder joint moving past the pubic bone, soft tissue releasing, or strain on the structures around the shoulder and neck.

Traction and Release Mechanics

The amount of force required to deliver the shoulders can vary. In some cases, gentle maneuvers are enough. In others, additional maneuvers may be needed. If excessive force is applied, or if traction places too much stress on the baby’s neck and shoulder area, there may be concern for injury to the collarbone, shoulder area, or the brachial plexus, a network of nerves that helps control arm movement and sensation.

A pop that occurs during or immediately after the application of traction may indicate that these structures were affected. While not every pop during shoulder dystocia results in permanent injury, it is a sign that the delivery involved unusual mechanical forces and that the baby should be carefully examined.

Popping Sounds and Brachial Plexus Nerve Injuries

The brachial plexus is a group of nerves that runs from the neck through the shoulder and down the arm. These nerves control movement and sensation in the shoulder, arm, and hand.

Why A Pop And Arm Weakness Should Be Evaluated Together

During a difficult shoulder delivery, the baby’s neck and shoulder area may be exposed to traction or pressure as the provider works to free the shoulders. If the brachial plexus nerves are stretched or injured, the baby may show weakness, reduced movement, or abnormal positioning of the affected arm after birth.

The sound itself does not confirm nerve injury. What matters most after birth is whether your baby moves both arms equally, has normal newborn reflexes on both sides, and shows no signs of pain, swelling, or tenderness around the shoulder or collarbone.

Types of Brachial Plexus Injury

Brachial plexus injuries range in severity. A mild nerve injury may improve over time, while more serious injuries may need specialist follow-up, therapy, or surgery. More severe injuries involve partial or complete nerve tears, which may require surgery and can result in lasting weakness or paralysis.

The presence of a pop during delivery does not tell you which type of injury, if any, occurred. What matters more is how your baby’s arm moves and functions after birth. Observable signs in the newborn exam and over the following days and weeks provide the most important clues.

Signs the Pop May Indicate an Injury (What to Look For)

If you heard or felt a pop during your baby’s shoulder delivery, watch for specific physical signs that may suggest an injury occurred.

Immediate Newborn Signs

Right after birth, observe whether your baby moves both arms equally. A baby with a brachial plexus injury may hold one arm limp or close to the body, with little or no movement. The affected arm may appear floppy or hang in an unusual position.

Check whether your baby has a strong grasp reflex in both hands. When you place your finger in the baby’s palm, a healthy newborn will typically grip it. Weakness or absence of the grasp reflex on one side can be a sign to report promptly, especially if it appears with reduced movement, limpness, or unusual arm positioning.

The Moro reflex, also called the startle reflex, is another important sign. When startled, a baby should extend both arms outward and then bring them back in. If one arm does not move symmetrically or remains limp during this reflex, it may point to nerve damage.

Swelling, bruising, or tenderness around the shoulder or collarbone can also suggest injury. A fractured clavicle may cause the baby to cry when the arm is moved or when pressure is applied to the area.

Signs That Emerge Over Days or Weeks

Some nerve injuries are not immediately obvious. In the days and weeks after birth, you may notice that your baby consistently favors one arm, does not bring one hand to the mouth, or shows limited movement when reaching or grasping.

Persistent weakness, reduced muscle tone in one arm, or delayed arm movement skills should be discussed with your pediatrician, especially after a difficult delivery or documented shoulder dystocia. Early identification and intervention can improve outcomes, so it is important to share your observations with your pediatrician.

What to Do If You Heard or Felt Your Baby’s Shoulder Pop

If you experienced or were told about a popping sound or sensation during your baby’s shoulder delivery, take steps to ensure your baby is thoroughly evaluated.

Observe Arm Movement and Reflexes

In the hours after birth, watch how your baby moves. Compare the movement and strength of both arms. Note whether your baby can lift both arms, grasp with both hands, and respond to touch on both sides.

If you notice any asymmetry, weakness, or unusual positioning, bring it to the attention of the nursing staff or pediatrician right away. Even subtle differences in movement can be important clues.

Request a Thorough Newborn Exam

Ask the pediatrician to perform a detailed examination of your baby’s arms, shoulders, and reflexes. Make sure the provider is aware that you heard or felt a pop during delivery and that you have concerns about arm movement.

The newborn exam should include assessment of the Moro reflex, grasp reflex, muscle tone, and range of motion in both arms. If the provider identifies any abnormalities, they may recommend imaging, such as an X-ray to check for a fractured clavicle, or a referral to a specialist for further evaluation of possible nerve injury.

Questions to Ask Your Medical Team About the Delivery

Understanding what happened during your baby’s delivery can help you interpret the significance of the popping sound and determine whether follow-up is needed.

Understanding What Happened During Delivery

Ask your obstetrician or midwife whether shoulder dystocia occurred during the delivery. Find out what maneuvers were used to deliver the shoulders and whether significant traction was applied.

You can also ask whether the provider felt or heard anything unusual during the shoulder delivery and whether they documented any concerns in the delivery record. Providers are trained to note complications such as shoulder dystocia, difficult extractions, and any immediate signs of injury in the baby.

Reviewing Delivery and Newborn Records

Request copies of your delivery records and your baby’s newborn exam notes. These documents can provide important details about what happened during the birth and what the medical team observed immediately afterward.

The delivery record may include notes about shoulder dystocia, the use of specific maneuvers, the amount of time it took to deliver the shoulders, and any injuries identified at birth. The newborn exam should document arm movement, reflexes, and any physical findings that raised concern.

Reviewing these records can help you understand whether the pop was associated with a difficult delivery and whether your baby showed any signs of injury that warrant ongoing monitoring or treatment.

When A Difficult Shoulder Delivery May Raise Legal Questions

Not every difficult delivery, shoulder dystocia, popping sound, or birth injury is the result of negligence. However, there are situations in which the care provided during delivery may fall below the accepted standard.

Excessive Traction or Improper Maneuvers

Providers are trained to use specific techniques to manage shoulder dystocia and minimize the risk of injury. If excessive force is applied, if proper maneuvers are not attempted, or if the provider fails to call for assistance during a shoulder dystocia emergency, the risk of injury to the baby increases.

A popping sound alone does not prove that the delivery was managed improperly. However, if the record shows shoulder dystocia, excessive traction, delayed response, lack of appropriate maneuvers, or missed newborn injury signs, and the baby later shows evidence of nerve injury, fracture, or other harm, families may want the records reviewed by a qualified professional.

Failure to Recognize or Document Injury

Even when a difficult delivery occurs, providers have a responsibility to recognize signs of injury in the newborn and document their findings. If a baby shows obvious weakness, asymmetry, or other concerning signs after a delivery involving shoulder dystocia, the provider should note these findings and arrange for appropriate follow-up.

A missed or delayed evaluation can affect follow-up planning, therapy timing, and the family’s understanding of what happened during delivery. If you believe your baby’s injury was not recognized or addressed in a timely manner, it may be worth consulting with a professional who can review the medical records and assess whether the care provided was appropriate.

Frequently Asked Questions

Watching Your Baby’s Development After a Difficult Delivery

If you heard or felt a pop during your baby’s shoulder delivery, ask whether shoulder dystocia was documented, request a careful newborn exam, and watch for arm weakness, pain, swelling, asymmetry, or limited movement in the days after birth. Keep copies of the delivery and newborn records, and ask your pediatrician what follow-up is needed if your baby’s arm movement does not look the same on both sides.

This article is for educational and informational purposes only. It is not medical advice and cannot replace evaluation from your baby’s pediatrician or another qualified medical professional. If you notice arm weakness, pain, swelling, color change, poor feeding, breathing problems, or any concerning symptoms in your newborn, contact your pediatrician or seek medical care. This article is also not legal advice. If you have questions about whether a birth injury may have been preventable, consider consulting an attorney who handles birth injury cases.