What does the term "turtling" refer to in the context of shoulder dystocia?

The term "turtling" in the context of shoulder dystocia specifically refers to the retraction of the fetal head against the perineum after it has delivered. This phenomenon occurs when the fetal shoulders are impacted behind the pubic symphysis, preventing further descent and causing the head to appear as though it is retracting back into the birth canal, resembling a turtle retreating into its shell. Recognizing turtling is an essential part of diagnosing shoulder dystocia during delivery, as it indicates that immediate and specific interventions may be necessary to safely deliver the baby. Understanding this concept can help healthcare providers quickly identify and respond to this obstetric emergency.