In 1999, Joseph Bruner, Susan B. Drummond, Anna L. Meenan, and Ina May Gaskin published, “All-fours Maneuver for Reducing Shoulder Dystocia During Labor,” in the medical journal, Obstetrical and Gynecological Survey. In the article, the authors described a birthing technique named the all-fours maneuver, or the Gaskin maneuver, and explained its effectiveness in treating fetal shoulder dystocia as compared to other maneuvers. Shoulder dystocia occurs when the neonate’s head has exited the vaginal canal, but the shoulders get stuck behind the woman’s pelvic bone, which prevents the birth of the neonate’s body. Healthcare practitioners’ use of previous methods to dislodge the fetal shoulders sometimes resulted in fetal and maternal injury. The all-fours maneuver differed from previous methods by positioning the laboring woman on her hands and knees rather than on her back. Through the article, the authors established the all-fours maneuver as a safe, fast, and effective technique for reducing shoulder dystocia.
In September 2018, the American College of Obstetricians and Gynecologists, or ACOG, published “Labor and Delivery Management of Women with Human Immunodeficiency Virus Infection,” hereafter “Labor and Delivery Management.” It appeared as ACOG Committee Opinion Number 751 in the journal Obstetrics & Gynecology. The article contains recommendations for physicians who care for pregnant people with human immunodeficiency virus, or HIV, to reduce the risk of transmission of the virus from parent to child. Those recommendations include treating pregnant people with HIV therapies, consistently testing and monitoring the levels of HIV in a pregnant person’s blood, and scheduling a cesarean section, or C-section, rather than a vaginal birth to reduce transmission risk in some cases. “Labor and Delivery Management” provides recommendations for physicians to decrease the risk of mother-to-child transmission and emphasizes that physicians and pregnant people make decisions regarding labor and delivery together.