The New York Times (Channon Hodge, October 12, 2014) published a video on a practice simulation of a difficult birth at North Central Bronx Hospital, where the obstetric unit has been closed for a year and is reopening after renovation.  The obstetric team works together in this video to care for a (simulated) mother who arrives in very active labor, pushes the baby’s head out, and then…  shoulder dystocia or stuck shoulders, an obstetric emergency that is one of the most dreaded situations in midwifery practice. 

HELPERR mnemonic from ALSO course from American Academy of Family Practice
HELPERR mnemonic from ALSO course from American Academy of Family Practice

Since true shoulder dystocia is not common (about 1% of births), there is little opportunity to practice the skills needed to handle it without using simulation.  These skills need to be practiced with a team, since it takes a team to deliver and care for a these babies.  Increasingly, continuing education in midwifery and obstetrics offers these opportunities – one example is the American Academy of Family Practice’s ALSO (Advanced Lifesaving Support in Obstetrics) course, which is offered across the US.  But individual hospitals are increasingly offering these trainings for their maternity-care staff, giving physicians, nurses, and midwives the chance to practice skills with others who are likely to be present with them in an actual emergency.

To see the video, go to http://www.nytimes.com/video/nyregion/100000003167168/practicing-for-a-baby-emergency.html?action=click&pgtype=Homepage&module=video-player-region&region=video-player-region&WT.nav=video-player-region.

For more information on shoulder dystocia, go to http://midwifeinsight.com/articles/what-is-shoulder-dystocia/