The Shoulder Dystocia Handbook
Edited by Jan Tritten, et al.

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The implications of a true shoulder dystocia at birth are among the most frightening a student midwife-or even an accomplished midwife-must face and cope with. No matter how many times a doll and pelvis are used to practice, no matter how many times the drills are run mentally, struggling to replace fear with healthy respect and thorough preparation is a goal we must meet and maintain.

This booklet provides an excellent tool in preparing for, and dealing with, shoulder dystocia. Comprised of 22 articles by 19 different authors, two journal abstracts, information about The Birth Gazette's "Shoulder Dystocia Registry" project, and a compilation of shoulder dystocia tricks of the trade, this handbook fits easily into any birth bag for handy review and reference. There are also referrals to available audiotapes and Internet resources for the reader who wants more information from which to study and learn. While some of the articles have previously appeared in Midwifery Today magazine, many are new for this publication. At any rate, it would be difficult indeed to compile on one's own such an accessible reference.

While the principles of the Gaskin Maneuver and other standard variations of "If you can't move the baby, move the mother" are given their due course, this booklet goes well beyond any other discussion of the topic that I have come across in my studies. It does so in a format that I love: heartfelt discussions of what works for various midwives and why they believe in their techniques. Among the intriguing information included are such suggestions as relating the direction in which a mom is being rotated to hands and knees to the baby's position. This allows the chin to birth by itself rather than hooking it, a variation on the corkscrew maneuver involving the use of both full hands.

Gail Hart has written an excellent article, "Waiting for Shoulders," that references older textbooks as well as listing her own techniques. Marion Toepke McLean has contributed three articles, using her well-loved style of relating anecdotal experience to scientific research. Marina Alzugaray's story of "The Day I Graduated as a Midwife" is also here. Other respected writers include Jill Cohen, Gloria Lemay, Mayri Sagady, Sara Wickham and Sharon Glass Jonquil.

This handbook is just right for reading all the way through at once, then rereading article by article. It is ideal for studying a bit at a time to reinforce confidence and refresh the memory. Because of its wide-ranging scope of suggestions that go bravely beyond what is found in either Varney or Oxorn-Foote, it would be an ideal text to add to the required reading at any midwifery school or program. Adding in discussions and drill practices of the techniques recommended would make excellent additions to any curriculum.

When I took The Shoulder Dystocia Handbook along on a recent trip to a Jamaican maternity ward, I found it to be of great interest to the staff there: so great, in fact, that I ended up leaving my copy with them. Meanwhile, it gave us plenty to talk about and a chance to practice potential maneuvers-even without a doll and pelvis-during slow spells. While I myself have yet to experience anything beyond sticky shoulders, I know the day will come when I will be glad that I have studied this excellent little booklet.

Reviewed by Sue LaLeike, member of the class of 2001 at the Midwifery Degree Program at Miami-Dade Community College.