Precipitous deliveries are one of the most stressful events an emergency physician will encounter. Fortunately, most deliveries will be normal, uncomplicated vaginal deliveries, but what if it's not? Complications such as shoulder dystocia and breech presentation have the potential to be true catastrophes for the patient, the baby, and the physician. In this hands-on simulation session, the participants will review the management of normal vaginal delivery, nuchal cord, breech presentation, and shoulder dystocia so you are ready the next time there is a baby coming in your ED!