NREMT Skillset/Shoulder Delivery

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When delivering a baby, first apply gentle downwards traction to the head and pressure to the anterior shoulder to free it from the pubic symphysis before providing gentle upwards traction to pass the posterior shoulder through the birth canal. Occasionally there may be complications with this process where the baby's anterior shoulder remains stuck superior to the pubic symphysis. In this case, continued delivery of the child has the possibility of leading to shoulder dystocia and a McRoberts maneuver may be successful in delivering the child if allowed by local protocol. The McRoberts maneuver involves having a provider aid the mother in bringing her knees closer to her chest while also applying gentle suprapubic pressure on the baby's anterior shoulder while the other assists in the delivery as normal in the ultimate goal of avoiding trauma to the child and an otherwise normal delivery. This maneuver may not be allowed due to the possibility of maternal and fetal trauma from excessive suprapubic pressure.