For delivering head at Breech Presentation

  • Lift body vertically by the feet
  • Introduce index finger in the mouth
  • Let the body ride on your arm
    • On the abdomen
    • Legs hanging down on each side of the arm
  • Flex the head with index finger in the mouth
  • Apply traction with a forked finger grip posteriorly to the neck with the other hand.
  • Apply fundal pressure by assistant

Mauriceau-Levret’s maneuver


For delivering breech and transverse presentations

  • Introduce one hand in uterus
  • Search for small parts of the fetus
  • Identify one or both feet
    • Foot has a heal
    • Hand has a thumb
  • Grasp one or both feet with forked fingergrip from behind
  • Apply strong traction on the foot/feet
  • Rotate the fetus by a combination of
    • Traction on the foot/feet
    • Upward pressure on caput with the other hand on mother’s abdomen
  • Continue strong traction on foot/feet
  • Combined with pumping movements
  • Grasp the knee anteriorly with the other hand
  • Extract lower part of the body by a combination of
    • Strong traction
    • Pumping movements
  • Grasp pelvis with both hands
  • Extract upper part of body by a combination of
    • Strong traction
    • Pumping movements
  • Release the arms
  • Deliver head by Mauriceau-Levret’s maneuver
Internal Version and Extraction


In Assisted Breech Delivery

  • Release the posteriorly positioned arm first
  • Use left hand when the back is turned to the (mother’s) right
    • And vice versa
  • Place left thumb on the frontal aspect of the truncus
  • Left index and middle fingers on the back
  • Slide the hand inwards
  • Along the truncus
  • Until the thumb reaches the axilla
  • With a sweeping movement across the head
  • Bring the arm down with index and middle fingers
  • Change hands
  • Release the anteriorly positioned arm
    • Using the same technique


  • In Breech presentation
  • Let the baby hang a short moment by the head
  • To facilitate it’s descendens in the birth canal


For delivering the shoulders

  • Grasp lateral border of the scapula with four ulnar fingers of your hand
  • Rotate truncus 180°
  • Use right hand when the back is turned to the (mother’s) left
    • And vice versa
  • The birth canal is shorter anteriorly
  • Bringing the posterior shoulder anteriorly will deliver it
Loevset’s Maneuver
Loevset’s Maneuver with Delivery Hook