The management of shoulder dystocia continued to
improve since the introduction of training at NBT in the year 2000 (Table 2). Appropriate manoeuvres (McRoberts’,
suprapubic pressure, internal rotation and delivery of the
posterior arm) were performed more frequently, and incorrect
actions (fundal pressure, lithotomy, left lateral, excessive
traction) were used less often in the late training
period (2009–12), than before training, and in the early
training period. A decade after annual training had been
introduced at least one recommended manoeuvre was used
in over 99% of cases of shoulder dystocia managed by
NBT staff.