For a mother-to-be, giving birth is a time of great hope and a little bit of fear. Everyone hopes that everything will go well and they will be able to hold a healthy baby in their arms. Most of the time, everything goes according to plan, but sometimes small emergencies can arise. But don't worry, the doctors and nurses who will be taking care of you and your baby are trained and prepared for all of this. Today, we are going to talk about a special procedure that is used in such a situation.
What exactly is the McRoberts Maneuver?
Simply put, the McRoberts Maneuver is a special technique used during childbirth to free a baby's shoulder or both shoulders when they get stuck in the mother's pelvis. Imagine that even though the baby's head comes out of the vagina, the rest of the body is delayed. That's because the baby's shoulder is stuck.
At this time, the doctor or midwife will bend your legs at the knees and press them firmly against your stomach. This movement will slightly shift the position of your pelvic bone, making it easier for the baby to come out from the position where it is stuck. Although this is a simple action from the outside, it will help the baby come out from the inside.
What does 'shoulder stiffness' mean? Does that mean Shoulder Dystocia?
Yes, that's right. In medical terms, we call this Shoulder Dystocia . In a normal delivery, after the baby's head comes out, the shoulders come out easily. But sometimes one or both shoulders can get stuck behind the pubic symphysis , where the two front bones of the mother's pelvis meet.
This can be a serious situation. Because the baby's body is delayed in coming out, the baby may be deprived of oxygen. But the important thing is that in most cases, the baby can be saved without any harm due to the quick action of the doctors. The McRoberts maneuver is the first and most successful method used in such a situation.
A doctor will diagnose Shoulder Dystocia when:
- If the baby's head has come out of the vagina, but the rest of the body has not come out after about a minute.
- If the baby's head appears to come out and then go back in a little (this is called the 'turtle sign').
Who is more at risk for this?
Although it is difficult to pinpoint the exact cause of Shoulder Dystocia, some people are at a slightly higher risk of developing it. However, keep in mind that this condition can occur even in people without these risk factors. And not everyone who has these risk factors will develop it.
| Risk Factor | Simple explanation |
|---|---|
| Small pelvis | If the mother's pelvic floor is relatively small, there may not be enough room for the baby to emerge. |
| Fetal Macrosomia (Large Baby Weight) | Generally, if you are expecting a baby weighing more than 4 kilos, there is a greater chance of it getting stuck due to the large shoulders. |
| Having a high birth weight baby in a previous delivery | If there has been a history of having a baby that was overweight, there is a chance that it will happen again. |
| Excessive weight gain during pregnancy | Uncontrolled weight gain in the mother can also affect the baby's weight gain. |
| Diabetes | Mothers with gestational diabetes are more likely to have overweight babies. |
How successful is the McRoberts Maneuver?
This method is very successful. When the McRoberts maneuver is performed alone, it has a success rate of about 42% .
But there is another method used in conjunction with this. It is called Suprapubic Pressure . This means that a doctor or nurse applies pressure with the palm of their hand, just below your belly button, just above your pelvic bone. This pressure is used to push the baby's shoulder that is stuck and free it.
Most importantly, when the McRoberts Maneuver and Suprapubic Pressure are used together, the success rate increases to 90%! This shows how useful this technique is.
What happens when you do this?
1. Diagnosis: First, the doctor confirms that this is a condition called Shoulder Dystocia.
2. Adjusting the position: Usually two people (doctors, nurses) will bend your legs at the knees and press them as close to your stomach as possible. You may feel a little uncomfortable at this point, but this is done to save the baby, so be patient.
3. Applying pressure (if necessary): At the same time, another person applies suprapubic pressure to the abdomen from above.
4. Delivery of the baby: This process increases the space inside the pelvis, frees the trapped shoulder, and allows the rest of the baby's body to emerge through the vagina.
What are the advantages of this method?
The McRoberts Maneuver has several key advantages:
- Being able to have a normal delivery: This reduces the need for an emergency cesarean section (C-section) .
- Minimizing potential harm to the baby: Shoulder impingement greatly reduces the risk of serious complications such as broken bones in the baby's arm, nerve damage, or lack of oxygen (asphyxia) .
- Reduced risk of harm to the mother: The risk of needing an episiotomy (an incision between the vagina and anus) is reduced.
- Simple and quick: This is a very simple method that can be done quickly, without any equipment.
Can this cause complications?
When this method is done correctly, complications are very rare. The most important rule is to never pull on the baby's head. Doing so can damage the baby's neck or spine. A skilled medical team knows this very well.
Very rarely, the mother may experience a blockage where the pelvic bones meet or temporary neuropathy in the legs. However, these are very rare.
After a successful McRoberts Maneuver, your baby is born healthy and normally through the vagina. The doctor will then carefully examine the baby to make sure there is no damage to the shoulder or arm. Most of the time, everything goes well.
Take-Home Message
- The McRoberts Maneuver is a simple, safe, and highly effective method used to release a baby's shoulder during childbirth (Shoulder Dystocia).
- This involves pressing the mother's legs against her abdomen, increasing the space in the pelvis and making way for the baby to come out.
- When used in conjunction with the Suprapubic Pressure method, its success rate increases to 90%.
- Even though this is an emergency, there is no need to panic as your medical team is well-trained for such things.
- Although there are risk factors for Shoulder Dystocia, many things can be managed by talking to your doctor about it in advance and following the necessary instructions.
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