Symphysiotomy to divide maternal pubic symphysis

Prior to incision, local anesthetic is injected and a bladder catheter is inserted. The clinician then manually displaces the urethra laterally. The anterior cartilage of the maternal pubic symphysis is incised with a scalpel just enough to widen the maternal pelvic ring and allow delivery of the baby. The entire thickness of the cartilage does not need to be incised.