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.
Learning Objectives:
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.
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