What is the recommended position and action for managing a shoulder dystocia during delivery?

• A. Lying on back with legs flat
• B. Knees-to-chest position and reattempt delivery
• C. Standing upright
• D. Left lateral decubitus

Answer: (B)

Shoulder dystocia requires quickly widening the birth canal and repositioning the baby to free the impacted shoulder. Placing the mother in a knee-to-chest position (McRoberts) straightens the spine and tilts the pelvis, increasing the pelvic outlet and aligning the fetal shoulders for easier passage. After achieving this position, you reattempt vaginal delivery using additional maneuvers as needed, such as applying suprapubic pressure and delivering the posterior arm, to relieve the obstruction and advance delivery. Other positions don’t provide the same pelvic opening or realignment benefits, so they’re not the first-line approach.