Cardinal Movements- pg 311-312

§ Descent-Station
§ Progress of presenting part through pelvis
§ Preferably occiput
§ Measured by station during vaginal exam as either:
• Negative (-) station: measured in centimeters if superior to station
0 & not yet engaged
• Positive (+) station: measured in centimeters if inferior to station 0
§ Engagement
§ Presenting part passes pelvic inlet at level of ischial spines
§ Usually biparietal (largest) diameter of fetal head
§ Referred to as station 0
§ Flexion- HEAD MEETS SOFT TISSUE
§ fetus descends, the fetal head is flexed farther as it meets resistance from
the soft tissues of the pelvis
§ head flexion presents the smallest anteroposterior diameter
(suboccipitobregmatic) to the pelvis
§ When fetal head meets resistance of cervix, pelvic wall or pelvic floor
§ Head flexes, bringing chin close to chest
§ Presenting smaller diameter to pass thru pelvis
§ Internal Rotation- TRANSVERSE TO OBLIQUE OR DIAGONAL TO
ANTERIOR/POSTERIOR
§ Fetal occiput ideally rotates to lateral anterior position as it progresses
from ischial spines to lower pelvis
§ Corkscrew motion to pass thru pelvis
§ Extension
§ Fetal occiput passes under symphysis pubis
§ Head is deflected anteriorly
§ Born by extension of chin away from fetal chest
§ External Rotation
§ Restitution- HEAD REALIGNS WITH SHOULDERS
§ After head is born, it rotates to position it occupied as it entered pelvic
inlet in alignment w/ fetal body
§ Completes a ¼ turn to face transverse as anterior shoulder passes under
symphysis
§ Expulsion
§After birth of head & shoulders, trunk of neonate is born by flexing
towards symphysis pubis
§ Expulsion of the fetal shoulders and fetal body
§ SHOULDER ROTATION – SHOULDERS ROTATE TO AP POSITION
**The mechanisms of labor are different in presentations other than the vertex, but the reason is the
same: to effectively use the available space in the maternal pelvis.