Life Seeds Midwifery & Care

06/18/2025

06/11/2025

Shoulder Dystocia -

Shoulder dystocia is an obstetric emergency that occurs when, after the baby’s head is born, one or both shoulders become stuck behind the mother’s pelvic bones, preventing completion of the birth without additional maneuvers.

It is most commonly caused by the anterior shoulder becoming impacted behind the p***c symphysis. A hallmark sign is the “turtle sign”—when the fetal head retracts slightly against the perineum, resembling a turtle pulling back into its shell.

Key Points:

• Prompt recognition and intervention are critical to prevent complications such as brachial plexus injury, fetal hypoxia, or maternal trauma.
• Management involves a sequence of maneuvers (e.g., McRoberts position, suprap***c pressure, or delivery of the posterior arm) to relieve the obstruction.
• Risk factors include fetal macrosomia, gestational diabetes, previous shoulder dystocia, and prolonged second stage of labor, but it can also occur without any risk factors.

Midwives should be skilled in the identification and management of shoulder dystocia and prepared to act quickly with a calm, coordinated response.

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