If the shoulders are allowed to deliver by uterus forces, most shoulders emerged over the perineum not from under
pubic arch. The traditional practice of downward force to deliver the shoulder from under pubic is not necessary and even not the right direction.
Neoadjuvant (treatment that is given before or with the primary treatment) hormonal therapy (HT) is used as a means for prostate gland cytoreduction (decrease in number of cells, as in a tumor) in order to eliminate
pubic arch (an arch formed by the pubic bones) interference and improve the ability to perform brachytherapy.
Depending on when she does it, this can effectively help the baby's head into the pelvic brim, roll the baby's head down into the posterior space or precipitate the action of the face sweeping over the perineum as the
pubic arch acts as a fulcrum for the baby's head (Banks, 1998).