What is the initial maneuver recommended for the management of shoulder dystocia?

The initial maneuver recommended for managing shoulder dystocia is applying suprapubic pressure. This technique involves pushing down on the mother's abdomen just above the pubic bone to help dislodge the impacted anterior shoulder from behind the pubic symphysis.

This method is particularly effective as it can create an angle that allows the shoulder to glide past the obstruction, thus facilitating the delivery of the fetus without the need for more invasive procedures. It is considered a first-line approach because it can be done quickly and often effectively in an acute situation, minimizing potential harm to both the mother and the baby.

Other techniques, like fundal pressure or conducting an episiotomy, are not recommended as first-line interventions because they can exacerbate the situation or lead to further complications. Administering oxygen may be a supportive measure for maternal well-being but does not directly address the mechanical issue presented in shoulder dystocia. Hence, suprapubic pressure is favored for its immediate effectiveness in dealing with this obstetric emergency.