Objective: To evaluate the preventive effect of shoulder dystocia midwifery techniques combined with predictive nursing on shoulder dystocia. Methods: A total of 82 high-risk pregnant women with shoulder dystocia admitted for childbirth from January 2022 to January 2025 were selected and equally divided using a random number table. The experimental group received shoulder dystocia midwifery techniques combined with predictive nursing, while the reference group received routine midwifery care. Indicators such as the preventive effect on shoulder dystocia were compared between the two groups. Results: The incidence of shoulder dystocia in the experimental group was lower than that in the reference group, the duration of labor was shorter, the amount of intra-partum bleeding was less, the incidence of adverse delivery outcomes was lower, and the score for fear of childbirth after intervention was lower than that in the reference group (p < 0.05). Conclusion: Implementing shoulder dystocia midwifery techniques combined with predictive nursing for high-risk pregnant women with shoulder dystocia can prevent shoulder dystocia and other adverse delivery outcomes, shorten the duration of labor, reduce intra-partum bleeding, and alleviate pregnant women’s fear of childbirth, demonstrating high nursing value.