![]() Once the baby is fully rotated and descended, extension occurs when their head passes through the pelvis at the base of the neck. Standing upright and slightly bending the knees as the baby is rotating toward their optimal position in the pelvis will alleviate stress on the mother’s back and the uncomfortable weight of the baby’s descent. By the time the baby reaches the pelvic floor, their head is almost always fully rotated. This is a good opportunity to use birthing stools and balls to make squatting easier and more effective.Īs the baby’s head reaches the pelvic floor, it’s head will rotate to accommodate changes in the pelvis known as internal rotation. Squatting or sitting may help promote the baby’s descent and flexion and make labor a little more comfortable. This movement is the result of the baby’s head hitting the soft tissues of the pelvis, aligning their head with their chin toward their chest at they reach the depth of the pelvic cavity. Their little body has to begin it’s form to position correctly into the pelvis deep enough for traditional birth.įlexion and the descent go hand and hand. The baby doesn’t just have to get aligned with the mother’s pelvis, their head must descend deep into the pelvic cavity. To speed the engagement process along, sitting on a firm birthing ball moving your hips in a figure-8 motion or performing abdominal lifts during contractions may help. This is the start of the birthing process and the baby getting themselves into the position for birth. This stage is simply the diameter of the baby’s head into the mother’s pelvic cavity from ear to ear. The movements where the baby shifts themselves into position are known as the seven cardinal movements. In order to position correctly, a baby in the womb will try it’s best to shift into a direction that best facilitates birth. ![]() The first four movements (descent, flexion, engagement, and internal rotation) do not have to occur in any specific order.A baby’s position is important for birth to proceed naturally, allowing the smallest part of the baby to present first. (e) The fetus remains completely passive as it moves through the birth canal. (d) The rest of the body follows the head, which then completes expulsion. ![]() (c) The head is gently raised to deliver the posterior shoulder. (b) Gentle downward pressure by the physician delivers the anterior shoulder. (a) The top of the anterior shoulder is seen next just under the pubis. (b) This aids in internal rotation of the shoulders to an anteroposterior diameter of the pelvic outlet or shoulder rotation. (a) Once the fetus head is out, it will turn to line up with its back, revealing its position just before internal rotation of the head. During this maneuver, the fetal spine is no longer flexed, but extends to accommodate the body to the contour of the birth canal. As it moves through the vaginal canal, the chin lifts up (extends) and the head is delivered. The natural curve of the lower pelvis and the baby’s head being pushed outward forces distention of the perineum and vagina. As the previously flexed head slips out from under the pubic bone, the fetus is forced to extend his head so that the head is born pushing upward out of the vaginal canal. (d) Occasionally, the fetus may not turn to the anterior position and is born O.P. (c) If the head is in a posterior position, it may mean a turn of 180 degrees. (b) If the fetus starts to descend in LOA or LOT, rotation is only a short distance-45 to 90 degrees. (a) The amount of internal rotation depends on the position of the fetus and the way the head rotates to accommodate itself to the changing diameters of the pelvis. ![]() ![]() Before this time, it is referred as “floating.” This is when the presenting part is at the level of the ischial spines or at a zero (0) station. The occiput position allows the occipital bone in the back of the head to lead the way (smallest diameter of the head). As the fetus head descends, the chin is flexed to come into contact with the infant’s sternum. (b) In a multipara, this may not occur until dilatation of the cervix. This is referred to as “lightening.” Lay people might call this “dropping.” (a) In a primigravida, this may occur two weeks before delivery. The fetus head is pushed deep into the pelvis in a sideways position, the face is to the left and the occiput is to the right. The fetus in the vertex position makes seven adaptations or cardinal movements. The mechanism of labor in the left occiput anterior (LOA) presentation.Ī–Descent. When the presenting part reaches the pelvic bones, it must make adjustments to pass through the pelvis and down the birth canal (see figure 10-6). As the force of the uterine contractions stimulates effacement and dilatation of the cervix, the fetus moves toward the cervix. This refers to the movements made by the fetus during the first and second stage of labor. ![]()
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