What is NOT recommended
Mother's position
Supra pubic pressure
The 'McRobert's manoeuvre'
Manipulation
The 'Zavanelli Manoeuvre'
Episiotomy
Last resorts
There are many 'methods' the caregiver can use to deal with shoulder dystocia. None are considered to be superior to others because shoulder dystocia is so rare (and generally unanticipated) that it is difficult to conduct any research to evaluate them. In addition to this, caregiver's experience of shoulder dystocia is so infrequent, that there is little chance to develop expertise in one technique, or to be able to try various techniques.
Generally, if a caregiver finds a technique that 'works' they will tend to use this on subsequent occasions, but they should be aware of alternatives, if their preferred technique fails. Even with severe shoulder dystocia, there can be varying degrees of severity, meaning not all techniques are guaranteed to work in all cases.
A common reaction for the caregiver when presented with shoulder dystocia can be a hasty response (and even panic) due to the anxiety that is provoked in trying to deliver the baby quickly. It is now recognised that the caregiver usually has about 7 to 10 minutes to deliver the baby, making time a less important factor, as long as the baby's heart rate is normal.
This time allows the caregiver adequate leeway to manipulate the baby (or reposition the woman) unhurriedly, and deliver the baby without overly aggressive pulling on the baby's head, or applying excessive traction to the baby's neck (and possibly causing injury to the baby).
What is NOT recommended
In past years, there were certain techniques that were advocated as being the 'recommended way' to deliver a baby with shoulder dystocia. It is now recognised that most of these methods are: