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Now, with the snare over the lamb's head, push the head back until you are able to reach past it and then bring the front legs forward, one at a time. Then put the ewe back into the normal reclining position, and start the head and legs through the pelvic arch and gently pull downwards and the lamb is on its way.

Both legs protrude, but the head is turned back:
This is one of the most difficult situations to deal with. More often than not, a vet is called into perform a cesarean section.

The position of the head can be turned back to one side along the lamb's body, or else down between its front legs. If the front legs are showing, slip a noose of heavy cord over each front leg, then push the lamb back until there is enough room to insert your clean, lubricated hand and feel for the position of its head. Having located the head, bring it forward into its normal position. Now pull gently in a downward direction on the legs, and guide the head so that it passes through the opening of the pelvic cavity at the same time that the feet emerge outside.

Should the head refuse to come out easily, it is either too large or the lamb may be turned on its back with its back down toward the ewe's stomach. With the cords still attached to the legs, you may have to push it back in again and gently give it a half turn so that the lamb's legs are pointing down in the normal position.

If you experience difficulty in getting a grip on its slippery head to bring it into position, try to get a cord-noose over its lower jaw. Insert your hand with the noose over your fingers, then slip it off onto the chin, be very careful not to catch part of the ewe's inners when doing this because it can tear tissues. By pulling on the noose that you placed over the chin, you can guide the head into position with greater ease.

Hind feet coming out first:
When this occurs, pull gently, because the lamb might get stuck when it is halfway out. If this should happen, swing the lamb from side to side while pulling, until the ribs are out, and then pull it out quickly.

Sometimes it is easier on the lamb to twist it a half turn, so that its back is toward the ewe's stomach, or rotate it a quarter turn while it is being pulled out.

Pulling the lamb out quickly is of utmost importance, because the umbilical cord becomes pinched once the lamb is half way out, and this means that the lamb will inhale mucus if its tries to breathe. As the nose appears, the mucus covering it must be immediately wipe away to prevent suffocation.