Shoulder Dystocia: Prediction, Prevention, and Appropriate Response
Shoulder dystocia is considered one of the most dangerous complications of birth, as corroborated by the high number of malpractice claims resulting from it. Despite this, experts cannot agree on what defines it, what causes it, or whether or not it is possible to predict it. As for treatment, the HELPERR mnemonic is standard of care, but is this truly the best response with fully mobile clients, or does it reflect the limitations of hospital birth with epidural anesthesia?
In this presentation, the physiology of undisturbed birth, including cardinal movements the baby must accomplish to minimize the likelihood of shoulder dystocia developing, will be explained, with an examination of how common hospital practices, such as the use of Pitocin during labor or maternal positioning in second stage, can undermine these. Because this complication carries a high degree of urgency, time-efficient techniques will be presented for both anterior shoulder dystocia and bilateral shoulder dystocia, with indications for follow up for the birthing person and the newborn.
This presentation was originally presented at our 2023 GOLD Midwifery Conference.
Renowned expert Elizabeth Davis has been a midwife, reproductive health care specialist, educator and consultant for over 40 years. She is internationally active in promoting physiologic, undisturbed birth and is widely sought after for her expertise in midwifery education, legislation, and organizational development. She is the author six widely translated books on birth, sexuality, and female psychology, including “Orgasmic Birth: Your Guide to a Safe, Satisfying, and Pleasurable Birth Experience,” “The Rhythms of Women’s Desire: How Female Sexuality Unfolds at Every Stage of Life,” and the textbook “Heart & Hands: A Midwife’s Guide to Pregnancy and Birth,” now in an updated 2019 5th edition (see https://elizabethdavis.com for details). She served as Regional Representative and Education Committee Chair for the Midwives Alliance of North America (MANA), as President of Midwifery Education Accreditation Council (MEAC), and as midwife consultant to the State of California’s Alternative Birthing Methods Study. She is the recipient of the California Association of Midwives’ Brazen Woman Award, and Midwifery Today’s Lifetime Achievement Award. She is Co-founder of the MEAC accredited National Midwifery Institute, and author/instructor of Heart & Hands Coursework.
Objective 1: List three factors that may predict shoulder dystocia.
Objective 2: Describe the 3 cardinal signs of true shoulder dystocia, and the limitations of the HELPERR mnemonic when working with fully mobile birthing persons.
Objective 3: Describe the most effective techniques for responding to both anterior shoulder dystocia and bilateral shoulder dystocia, with indications for follow up care for the birthing person and the newborn.
Shoulder dystocia is considered one of the most dangerous complications of birth, as corroborated by the high number of malpractice claims resulting from it. Despite this, experts cannot agree on what defines it, what causes it, or whether or not it is possible to predict it. As for treatment, the HELPERR mnemonic is standard of care, but is this truly the best response with fully mobile clients, or does it reflect the limitations of hospital birth with epidural anesthesia?
In this presentation, the physiology of undisturbed birth, including cardinal movements the baby must accomplish to minimize the likelihood of shoulder dystocia developing, will be explained, with an examination of how common hospital practices, such as the use of Pitocin during labor or maternal positioning in second stage, can undermine these. Because this complication carries a high degree of urgency, time-efficient techniques will be presented for both anterior shoulder dystocia and bilateral shoulder dystocia, with indications for follow up for the birthing person and the newborn.
Accreditation
Midwifery CEUs - MEAC / NARM Contact Hours
This program is accredited through the Midwifery Education & Accreditation Council (MEAC) for 1 Contact Hour (0.1 MEAC CEU).
It is also recognized by the North American Registry of Midwives(NARM) for 1 CEU/Contact Hour. Please note that 0.1 MEAC CEU is equivalent to 1.0 NARM CEU/Contact Hour.
ACNM CEs
This program is approved for 1.25 Contact Hours (CEs) by the American College of Nurse-Midwives. This credit is applicable to Nurse-Midwives, Certified Midwives, Registered Nurses and may be accepted by other certifying bodies.
ACM CPD Endorsed Hours
This is an Australian College of Midwives CPD Endorsed Activity. This program is approved for 1.25 ACM CPD Endorsed Hours.
CERPs - Continuing Education Recognition Points
Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators.
GOLD Conferences has been designated as a Long Term Provider of CERPs by IBLCE--Approval #CLT114-07. This program is approved for 1.25 R-CERPs.
If you have already participated in this program, you are not eligible to receive additional credits for viewing it again. Please send us an email to [email protected] if you have any questions.
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