What maneuvers can help manage a childbirth complicated by shoulder distocia?

• McRoberts maneuver - place mother in extreme lithotomy position with hips completely flexed allowing knees to rest on her chest
  
• If the McRoberts maneuver fails, have an assistant apply moderate suprapubic pressure to the maternal abdomen while you apply gentle downward traction to the fetal head
• Most shoulder dystocias resolve with one of these simple maneuvers. If not, consider episiotomy, delivery of the posterior arm, fracture of the fetal clavicle or cephalic replacement (pushing the fetus back in) with subsequent c-section

For a good review of shoulder dystocia management w/ some pics, click here to view a web page created by the World Health Organization.

Source

Managing Complications in Pregnancy and Childbirth. World Health Organization. 2003. http://www.who.int/reproductive-health/impac/Symptoms/Shoulder_dystocia_S83_S85.html

Roberts: Clinical Procedures in Emergency Medicine, 4th ed.