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Help! Knees to chest. Push above pubic bone not belly. Do not pull head.
Step 1: Call for help — extra people immediately
Step 2: McRoberts — flex mother knees to chest
Step 3: Suprapubic pressure not fundal — push diagonally
Step 4: Do not pull head
Step 5: Prepare for neonatal resuscitation
DEVELOPMENT FIXTURE — Do NOT fundal pressure — worsens impaction.
DEVELOPMENT FIXTURE — Do NOT pull head downward excessively — brachial injury.
Shoulder dystocia always needs documentation and neonatal check.