What is the primary action of the McRoberts maneuver in resolving shoulder dystocia?

• A. Hyperflex the woman's legs tightly to the abdomen
• B. Apply pressure to the lower abdomen and assist the shoulders
• C. Perform episiotomy
• D. Pull the baby by the head

Answer: (A)

The main point here is how the McRoberts maneuver changes the pelvis to free a shoulder wedged during delivery. It does this by sharply flexing the mother’s hips toward the abdomen, which flattens the lumbar spine and tilts the pelvis to maximize the pelvic outlet. That positional change widens the space through which the baby’s shoulder must pass and often allows the anterior shoulder to slip under the pubic symphysis, resolving the obstruction.

Suprapubic pressure is commonly added as an assisting step to help rotate and free the shoulder once the pelvis is opened. Episiotomy may be used to enlarge the vaginal opening if needed, but it does not accomplish the primary release by itself. Pulling on the baby’s head is not a recommended first-line action because it can cause injury and is not how this maneuver frees the shoulder.