- As the fetus begins to emerge, the hips will deliver.
- Avoid aggressive traction, which increases the risk for head entrapment or nuchal arm entrapment. Allow mother to push as far as possible.
- Assist delivery of the legs.
- When the scapulae appear under the symphysis, sweep the anterior shoulder to unlock it from the pubic bone. Deliver the anterior arm.
- Rotate the shoulder girdle to facilitate delivery of the posterior arm.
- Rest the fetal body on your dominant palm and forearm.
- Place your dominant-hand index and middle fingers over the infant’s maxilla to maintain head flexion. Place non-dominant hand between the scapulae. Apply downward traction on the shoulders with non-dominant hand, then elevate the body of the fetus to deliver the head.