Objective To investigate the role and influence of adoption of waiting for uterine contractions for the natural childbirth technique of fetal shoulders and the preferred hands-knees prone position childbirth technique in prevention of shoulder dystocia and birth trauma.Methods Altogether 6667 pregnant women who had underwent vaginal delivery in our hospital from January 2011 to December 2014 were selected and divided into observation group and control group according to different midwifery techniques.1987 cases who accepted vaginal delivery from January to December 2014 in the hospital were selected as observation group.For pregnant women in observation group，waiting for uterine contractions for natural childbirth technique of fetal shoulder or the preferred hands-knees prone position childbirth technique at the time suspected shoulder dystocia was adopted.4680 cases who accepted vaginal delivery from January 2011 to December 2013 in the hospital were selected as control group.For pregnant women in control group，the traditional supine delivery technique of fetal shoulders was adopted，namely providing pressure on the front shoulder and support on the posterior shoulder，taking the supine position after delivery of fetal head and cleaning of the respiratory tract.The incidence of shoulder dystocia，birth trauma and neonatal severe asphyxia between two groups were observed.Results The incidence of shoulder dystocia，birth trauma and neonatal severe asphyxia in observation group was 5 cases（0.25%），1 case（0.05%）and 1 case（0.05%）vs 241 cases（5.15%），9 cases（0.19%，with 7 cases of neonatal clavicular fractures and 2 cases brachial plexus injuries），and 3 cases　（0.10%）in control group.In observation group incidence of shoulder dystocia was lower than that of in control group with statistically significant difference　（P＜0.05）.A slight superiority to control group had been seen in observation group in the incidence of birth trauma and neonatal severe asphyxia，without statistically significant difference　（P＞0.05）Conclusion Adoption of waiting for uterine contractions for the natural childbirth technique and the preferred handsknees prone position childbirth technique demonstrates great effectiveness in reduction of shoulder dystocia and without increasing the incidence of birth trauma and neonatal severe asphyxia.