Breech presentation

  1. As the fetus begins to emerge, the hips will deliver.
  2. Avoid aggressive traction, which increases the risk for head entrapment or nuchal arm entrapment. Allow mother to push as far as possible.
  3. Assist delivery of the legs.
  4. When the scapulae appear under the symphysis, sweep the anterior shoulder to unlock it from the pubic bone. Deliver the anterior arm.
  5. Rotate the shoulder girdle to facilitate delivery of the posterior arm.
  6. Rest the fetal body on your dominant palm and forearm.
  7. 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.