Handling Shoulder Dystocia
Changing positions, rotating the pelvis, hands and knees, squatting, dancing or bouncing up and down stairs etc - if the baby needs help from their mother to be birthed, the mother will find herself adopting techniques that she intuitively feels will get her baby out.
Instinctive birth is the reason most choose freebirthing - to be free to follow the birthing instincts naturally without interference or hindrance. In doing this, problems such as shoulder dystocia are usually avoided in the first place.
The Gaskin Maneuver brought from Guatemala by Ina May Gaskin
The mother turns over to a hands and knees position. It is believed that the turning process is what dislodges the shoulder. This technique should also work in reverse. If the birthing mother is on her hands and knees, flip over to a semi-sit position. If the baby doesn't rotate and birth, try a supported, upright squat - the position which gives full diameter available for birth.
Other Resources
Shoulder Dystocia Resources at Gentlebirth Archives
The Farm article on Shoulder Dystocia and use of the all-fours position
"From 1971 to the present, the midwives have attended 1750 births. Thirty-five of these were complicated by shoulder dystocia, and all of them were managed by midwives .. Three early births were managed with traditional maneuvers, resulting in some birth injuries. The remaining 32 were managed by having the mother assume the all-fours position, with no mortality, no birth injuries, and with excellent Apgar scores. All the babies for whom follow-up was possible (29 of 35) were developmentally normal (ages 9 months to 15 years). These statistics compare favorably with the reported mortality rates of 21% to 29% and morbidity rates of 16% to 48%. In addition, despite frequent recommendations that any maneuvers to deliver the shoulders be preceded by a generous episiotomy or proctoepisiotomy, 23 of the babies were delivered over an intact perineum, and there were no 3rd or 4th-degree lacerations. Finally, though some authors recommend the time-consuming step of administering general anesthesia to the mother before attempting alternative maneuvers, 23 these babies were all delivered without anesthesia."
All-fours maneuver for reducing shoulder dystocia during labor. Bruner JP, Drummond SB, Meenan AL, Gaskin IM Medline Abstract
