Does NO use of Stirrups=Shoulder Dystocia

fergus51 · Aug 5, 2004

No, I don't think stirrups prevent dystocias. It's true that you open up the pelvis by bringing the legs up and out, but you don't need stirrups to do that, just the arms of a support person and a nurse, and millions of women deliver in other positions without problems.

QuilterLPN · Aug 5, 2004

I'm not an OBRN, but I never had to use stirrups with any of my own three deliveries. Just grabbed my knees. No problems!

SmilingBluEyes · Aug 5, 2004

NO! The factors causing dystocia are more complicated than that.

bam_bam · Aug 5, 2004

We NEVER use stirrups! Rarely a shoulder dystocia. I haven't used stirrups in over 6 years.

profjanmc · Aug 5, 2004

The worry of stirrups comes in causing nerve damage to the legs.....

The shoulder dystocia issue isn't a problem with stirrups, you just push (gently) legs to the shoulders from the stirrups. The other issue for me is holding legs for deliveries. I personally don't like being a human set of stirrups and we have had a number of nurses injured with leg-holding.

Shoulder dystocia is becoming more common I think partially because of the increase in obesity.

LizzyL&DRN · Aug 5, 2004

interesting comments. many of the nurses i work with feel it is related since it seems to happen mostly to one doctor who prefers to deliver in the bed. of course it has happened to other doctors with pts in stirrups. how often do shoulders occur in other facilities? i was reading something in a different post someone wrote regarding a conference they attended where the speaker said that during a shoulder dystocia all too commonly the doctor waits too long rather than attempting delivery of the posterior arm first. i was involved in one recently when mcroberts was performed and immediate delivery of the posterior arm was done. the baby came right out without incident. i realize the arm of the baby was probably right up by his face, (i couldn't see from my perspective)and pulling the arm out alleviated the dystocia. but i was impressed. shoulders are so scary!!!! :uhoh3:

tantalus · Aug 6, 2004

I've been a UK midwife since May '92...I can only give approximates but I've personally delivered at least 150 babies....not to mention the numerous women I looked after in labor...I can count on one hand the number of dystocias I've seen...Thankfully.

I'd have to say that stirrups don't contribute...in the UK it's not even recommended when dystocia is suspected....a lateral position is preferred and I have seen this one work in a dystocia situation.

That's my two cents worth anyhow.

palesarah · Aug 6, 2004

also only been working a year in L&D- but I've neither seen stirrups used nor I have seen a shoulder dystocia (thank god!)

L&D_RN_OH · Aug 7, 2004

Rarely use stirrups. Many of our docs don't break the bed down and those that do still don't use the stirrups. We do 100-125 deliverie/month and rarely see a dystocia. I think the last one we had while I was at work was several months ago.

obeyacts2 · Aug 7, 2004

Hello? Women were having safe, simple uncomplicated births for thousands of years before stirrups were ever invented. I think dystocia results from other factors.

Laura

mitchsmom · Aug 7, 2004

Although I hope to be a CNM and I think that natural is better when possible, I disagree with the idea that births were "safe, simple uncomplicated births" historically. I would say that birth is the safest now overall that it has ever been. Infant and maternal mortality used to be astounding.

Now, s. dystocia in particular, I don't know about. I don't know how the rates compare historically with now. That's an interesting question. I would venture to say that it does happen more now, with women evolving to have smaller pelvises and bigger babies.

Of course morally we have to help women nowadays who would have not had a good birth outcome in the past, but over time that also breeds more people who don't give birth as well and makes for more and more complications.

(None of that is to say that I'm sticking up for the use of stirrups.)

If you see holes in my reasoning, feel free to debate with me.

PS.. I was just wondering, to the OP: do you think that the doc who is using the stirrups is also using other practices along with that, that may also contribute? I mean, I have no idea what it would be, but does he do other practices that are different from the other docs with less dystocias? Or are the stirrups the only thing you have noticed?