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    Cardinal Movements of Labor

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    Aimhigh_PPM
    The cardinal movements describe the precise positional changes the baby makes to navigate through the birth canal. They include: descent of the head into the pelvis, flexion of the head so the chin touches the chest, internal rotation so the sagittal suture is in the correct position, extension of the head as it passes under the pubic bone, external rotation so the baby's face turns to the side, and finally expulsion of the shoulders and body. These movements are critical for the baby to pass through the mother's pelvis and are guided by the resistance and changing diameters experienced during birth.

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    Cardinal Movements of Labor

    Uploaded by

    Aimhigh_PPM
    1K views2 pages
    The cardinal movements describe the precise positional changes the baby makes to navigate through the birth canal. They include: descent of the head into the pelvis, flexion of the head so the chin touches the chest, internal rotation so the sagittal suture is in the correct position, extension of the head as it passes under the pubic bone, external rotation so the baby's face turns to the side, and finally expulsion of the shoulders and body. These movements are critical for the baby to pass through the mother's pelvis and are guided by the resistance and changing diameters experienced during birth.

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    Cardinal Movements of labor

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    Cardinal Movements of labor

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    The cardinal movements describe the precise positional changes the baby makes to navigate through the birth canal. They include: descent of the head into the pelvis, flexion of the head so the chin touches the chest, internal rotation so the sagittal suture is in the correct position, extension of the head as it passes under the pubic bone, external rotation so the baby's face turns to the side, and finally expulsion of the shoulders and body. These movements are critical for the baby to pass through the mother's pelvis and are guided by the resistance and changing diameters experienced during birth.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    1K views2 pages

    Cardinal Movements of Labor

    Uploaded by

    Aimhigh_PPM
    The cardinal movements describe the precise positional changes the baby makes to navigate through the birth canal. They include: descent of the head into the pelvis, flexion of the head so the chin touches the chest, internal rotation so the sagittal suture is in the correct position, extension of the head as it passes under the pubic bone, external rotation so the baby's face turns to the side, and finally expulsion of the shoulders and body. These movements are critical for the baby to pass through the mother's pelvis and are guided by the resistance and changing diameters experienced during birth.

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    Cardinal Movements

    Labor is a physical and emotional


    event for the laboring woman. For
    the infant, however, there are many
    positional changes that assist the
    baby in the passage through the
    birth canal. Because of the
    resistance met by the baby,
    positional changes are specific,
    deliberate and precise as they allow
    the smallest diameter of the baby to
    pass through a corresponding
    diameter of the woman's pelvic
    structure. Neither care providers nor
    the laboring woman is directly
    responsible for these position changes. The baby is the one responsible
    for these position changes ~ the cardinal movements.

    Descent
    The baby's head moves deep into the pelvic cavity. This movement,
    commonly called lightening, is preceded by Engagement or the
    entering of the biparietal diameter (measuring ear tip to ear tip across
    the top of the baby's head) into the pelvic inlet. The baby's head
    becomes markedly molded when these distances are closely
    the same. When the occiput is at the level of the ischial
    spines, it can be assumed that the biparietal diameter is
    engaged and then descends into the pelvic inlet.

    Flexion
    This movement occurs during descent and is brought about
    by the resistance felt by the baby's head against the soft
    tissues of the pelvis. The resistance brings about a flexion in
    the baby's head so that the chin meets the chest. The
    smallest diameter of the baby's head (or
    suboccipitobregmatic plane) presents into the pelvis.

    Internal rotation
    As the head reaches the pelvic floor, it typically rotates to
    accommodate for the change in diameters of the pelvis. At the pelvic
    inlet, the diameter of the pelvis is widest from right to left. At the
    pelvic outlet, the diameter is widest from front to back. So the baby
    must move from a sideways position to one where the sagittal suture is
    in the anteroposterior diameter of the outlet (where the face of the
    baby is against the back of the laboring woman and the back of the
    baby's head is against the front of the pelvis). If anterior rotation does
    not occur, the occiput (or head) rotates to the occipitoposterior
    position. The ocipitoposterior position is also called persistent
    occipitoposterior and is the common cause for true back labor.

    Extension
    After internal rotation is complete and the head
    passes through the pelvis at the nape of the neck, a
    rest occurs as the neck is under the pubic arch.
    Extension occurs as the head, face and chin are
    born.

    External rotation
    After the head of the baby is born, there is a slight
    pause in the action of labor. During this pause, the
    baby must rotate so that his/her face moves from
    face-down to facing either of the laboring woman's
    inner thighs. This movement, also called restitution,
    is necessary as the shoulders must fit around and under the pubic
    arch.

    It is at this point that shoulder dystocia may be identified. Shoulder


    dystocia occurs when the baby's shoulders are halted at the pelvic
    outlet due to inadequate space through which to pass. Mother's
    birthing babies who are identified as macrosomatic (in excess of 9.9
    lbs.) are more likely to experience shoulder dystocia. Additionally, 15-
    30% of macrosomatic babies experiencing shoulder dystocia sustain
    some injury to the brachial plexus. Most of these injuries (80%) resolve
    by the baby's first birthday.

    Commonly, the McRobert's technique is used to resolve shoulder


    dystocia. This technique involves a sharp flexing of the maternal thighs
    against the maternal abdomen to reduce the angle between the
    sacrum and the spine.

    Expulsion
    Almost immediately after external rotation, the anterior shoulder
    moves out from under the pubic bone (or symphisis pubis). The
    perineum becomes distended by the posterior shoulder which is then
    also born. The rest of the baby's body is then born, with an upward
    motion of the baby's body by the care provider.

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