Maternity Staff Need Shoulder Problem Training – Guidelines

– Training on the management of shoulder dystocia should extend to all maternity staff, say new guidelines published yesterday. The condition occurs when one of the baby’s shoulders becomes stuck behind the mother’s pelvic bone during childbirth, preventing the birth from proceeding. The baby may have extensive arm damage or even die. Problems for the mother can include haemorrhage (11 per cent of mothers) and severe tearing (four per cent).


A revised Green-top Guideline from the Royal College of Obstetricians and Gynaecologists states that “all maternity staff should participate in multi-professional shoulder dystocia training with accurate mannequins”.


Training can reduce preventable injury, states the guidance, It recommends annual, multi-professional training with manoeuvres demonstrated and practiced on a highly realistic model.


It reports on a study that found just 43 per cent of midwives and doctors could successfully manage a severe shoulder dystocia simulation within five minutes. But after a 40 minute simulation training session, 83 per cent could successfully complete the delivery.


When the head-to-body delivery time is less than five minutes there is a very low rate of hypoxic ischaemic injury, that is, dangerously reduced blood flow to the brain.


“Routine traction in an axial direction can be used to diagnose shoulder dystocia,” the guidelines state, adding that downward traction on the baby’s head should be avoided.