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Birth Injury - Shoulder Dystocia with Brachial Plexus Injury. This medical exhibit pictures a lesser known cause of shoulder dystocia, or brachial plexus injury, during normal vaginal delivery. In this case, the baby's left shoulder is caught behind the mother's sacrum instead of the typical shoulder dystocia injury caused by the mother's pubic symphysis (pubic bone). The baby is facing the viewer in this illustration.