Gaskin Maneuver

What is the Gaskin maneuver?

The Gaskin maneuver is a technique healthcare providers may use to deliver a baby with shoulder dystocia. Shoulder dystocia occurs when a baby’s head exits the vagina, but one or both of their shoulders gets stuck behind the birthing parent’s pelvic bone. This can lead to serious complications for both the baby and the birth parent.

The Gaskin maneuver involves moving the birthing person to their hands and knees to give birth. It’s named after Ina May Gaskin, a midwife who first introduced the method.

What’s the purpose of the Gaskin maneuver?

The purpose of the maneuver is to widen the birthing parent’s pelvis to dislodge the baby’s shoulder from under their pubic bone. When a baby’s shoulder is lodged underneath the pubic bone, they’re at risk for serious injuries.

What’s another name for the Gaskin maneuver?

Some providers may refer to the Gaskin maneuver as the “all fours” method.

How does the Gaskin maneuver help with delivery?

The Gaskin technique is a maneuver to free a baby’s shoulder when it’s wedged or stuck behind the birthing parent’s pelvic bone. When this happens, the baby can’t continue down the birth canal for delivery. Once the baby’s shoulder is free, the delivery can continue.

What are the steps to the Gaskin maneuver?

Typically, a vaginal delivery begins with the birthing person on their back, with their legs open and folded outward (with their feet in stirrups). If shoulder dystocia occurs and your provider wants to try the Gaskin method, they may do the following:

• Flip or roll the birthing person over to an all-fours position. This means your knees and hands are on the ground and your butt and hips are off the ground. This alone can sometimes resolve shoulder dystocia and delivery can continue.
• If that doesn’t work, the next step may be to lift one leg toward your shoulder from an all-fours position. To get a visual of this position, imagine a runner before a race or a “running start” position where one leg is bent back and the other is bent forward in a lunge position. This further widens the pelvis.
• If the runner’s lunge position doesn’t relieve the shoulder dystocia, your provider may insert their fingers into the birth canal to rotate the baby’s shoulder from underneath the birth parent’s pelvic bone.

It’s important to note that your healthcare provider determines the best method to deliver your baby if shoulder dystocia is present. Sometimes other methods are safer, and your provider tries those first.

What are the benefits of the Gaskin maneuver?

The benefit of the maneuver is that it allows for the birth to continue (if successful) because the baby’s shoulder is free. It’s generally safe and low-risk because it doesn’t involve applying additional pressure to the birthing person’s abdomen or other physical manipulation of the baby.

Some pregnancy care providers may use the Gaskin maneuver (and other methods) to deliver a baby with shoulder dystocia before moving on to other, more complicated delivery methods like a C-section (Cesarean delivery) or symphysiotomy (cutting the cartilage between the pubic bones).

What are the risks or complications of the Gaskin maneuver?

The biggest risk is that the method doesn’t work, and your provider must try different maneuvers for relieving the shoulder dystocia.

A note from Cleveland Clinic

The Gaskin maneuver is a technique pregnancy care providers may use to deliver a baby with shoulder dystocia. Your pregnancy care provider is the best person to determine what’s safe during delivery. Try not to worry too much if you hear your baby is stuck. Trust your healthcare team’s judgement. They’re there to make sure your baby comes into the world safely.