GynaePulse
Join the launch
EmergenciesFree in the app

Shoulder dystocia

Head born, shoulders stuck. Note the time of head delivery.

Source: RCOG GTG 42 (3rd ed. 2026)
No fundal pressure. No excessive or lateral traction. Stop maternal pushing.

HELPERR

  1. H — Help: midwife, obstetrician, neonatologist, anaesthetist.
  2. E — Evaluate for episiotomy (only for access).
  3. L — Legs: McRoberts.
  4. P — Pressure: suprapubic (Rubin I).
  5. E — Enter: Rubin II, Woods screw, reverse Woods.
  6. R — Remove posterior arm.
  7. R — Roll onto all fours.
Cycle through manoeuvres quickly rather than holding each one. Details: Manoeuvres → Shoulder dystocia.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.