Help the mother give birth
What to do
You may have to do things which cause pain to the mother but are necessary
to save the baby’s life and prevent brain damage. You must work quickly. As you
are working be sure to reassure the mother to help her stay relaxed.
Here are 4 methods for helping the shoulders come out. Try one method
at a time, in the order listed here.
1. Try the hands-and-knees position.
Put the mother in the hands-and-knees
position.
Cup your hands around the baby’s head
and gently pull straight back while
counting to 30. When you see the shoulder,
pull up and deliver normally.
If this does not work, try the next method.
2. Try pressure above the pubic bone.
Quickly bring the mother to the edge of the bed. If she is on the floor, put
something under her hips to raise them off the ground. You will need some
space for the baby’s head when you pull down.
Help the mother grab her knees and pull them
back as far as she can. Have helpers hold her
legs in this position.
Ask a helper or any other person in the room
to press hard just above the mother’s
pubic bone — not on the mother’s belly.
The helper should push down hard.
Ask the mother to push as hard as she can.
Cup your hands around the baby’s head (do not hold the
baby’s neck) and gently pull straight back while counting to 30. When you
see the shoulder appear, pull up gently on the head and deliver normally.
If this does not work, try the next method.
3. Try pushing the baby’s shoulder from the inside.
With the mother in the hands-and-knees
position, put your gloved hand inside the
vagina along the baby’s back. Put your fingers
on the back of the shoulder that is nearest to
the mother’s back.
Push the shoulder forward until it moves to the side.
Deliver the baby in the usual way, pulling back while counting to 30.
If this does not work, try the next method.
A Book for Midwives (2010)
211