Shoulder dystocia is the term given when the baby’s shoulder gets stuck behind the mother’s pubic bone during delivery. It’s deemed an emergency situation, as without intervention it stops the baby’s body from being delivered after the head. Stuck in the birth canal, it is dangerous for the baby, as the umbilical cord can be trapped, the baby’s chest cannot expand sufficiently, which can have devastating consequences.
The McRoberts’ manoeuvre is a procedure performed by the midwives and doctors to release the baby’s shoulder. With force and speed, the mother’s legs are pushed up to either side of the chest and held back in a flexed position, to help ‘open up’ the pelvis. At the same time, suprapubic pressure is applied to the mother’s lower abdomen, in the hope of tilting the pubic bone to ‘open up’ the pelvic ring further.
This procedure assists in the safe delivery of the baby, however as it is an emergency situation and the welfare of the baby is paramount, it can be quite rushed and forceful lasting up to a few minutes. The mothers are often left feeling a little battered and bruised!
Complications for the mother following shoulder dystocia:
- Pelvic pain front and back (can be so severe initially walking and moving around is extremely difficult)
- Abdominal pain
- Leg pain
- Weakness and instability of the core, spine and pelvis
Physiotherapy following McRoberts’ manoeuvre:
- Assessment of the pelvis joints, spine and legs
- Advice on positioning for lifting, carrying, walking, feeding and general daily tasks
- Advice on pain management and other therapeutic options
- Manual therapy (including joint mobilisations, soft tissue massage) as indicated
- Teaching pilates based strength and stability exercises
- Advice and graded program for return to exercise and fitness