A 26 year old female at 40 weeks gestation presents to your emergency department in labor.  During the delivery you notice retraction of the fetal head against the maternal perineum and are unable to deliver either shoulder.  Which of the following steps below should be performed first?

A) Suprapubic pressure with flexion of hips 

B) Episiotomy 

C) Rotate mother to prone position 

D) Cephalic replacement 

E) Intentional clavicle fracture 

The correct answer is (A) suprapubic pressure with flexion of hips. 

For a quick review of shoulder dystocia click here: 

https://emdaily.cooperhealth.org/content/emconf-shoulder-dystocia