Shoulder dystocia is a positional problem so making sure that baby is in a great position for the birth greatly reduces the risk of it happening. You may not even have that problem this time round either. My last baby had shoulder dystocia due to being malpositioned and all that was done was to lay me on my back and push my legs up to my chest and they gently managed to get the shoulders to pop out one by one - no tear to me and no broken bones for bub. Not sure if they used hands or not as I couldn't exactly see what was going on down there at the time.