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good shoulder dystocia: suprapubic pressure


Has 20 years experience.

I never feel confident that I'm applying suprapubic pressure effectively/correctly. I'm afraid I'm either doing too hard or not enough or that I'm at the wrong landmark and it's not helping at all. I've done it and the baby has always come out (knock on wood), but I would like to feel more confident with my technique.

Suggestions? Tips?

One of the doctors was telling me that it's helpful to visualize which way the baby is presenting so that you can push down on the anterior shoulder in a way that makes it rotate towards the baby's chest. Otherwise, just make sure you're up high on a footstool and pushing straight down just above the symphysis pubis.


Specializes in L&D. Has 4 years experience.

i used to work with an old school doc who would call for "suprapubic pressure!" on almost every vag delivery. can we say BLADDER DAMAGE! but advice wise- Graceisland's right!


Specializes in Ortho/Med-Surg, L&D, Observation/ER.

I know what you mean. I feel the same way. However, ever time that I have done suprapubic pressure, the baby has always come out fairly soon after that. That is always one of my fears, that I will do it incorrectly and the baby won't come out.