(b) This aids in internal rotation of the shoulders to an anteroposterior
diameter of the pelvic outlet or shoulder rotation.
(7)
Expulsion.
(a) The top of the anterior shoulder is seen next just under the pubis.
(b) Gentle downward pressure by the physician delivers the anterior
shoulder.
(c)
The head is gently raised to deliver the posterior shoulder.
(d) The rest of the body follows the head, which then completes
expulsion.
(e) The fetus remains completely passive as it moves through the birth
canal.
c. Movement. The first four movements (descent, flexion, engagement, and
internal rotation) do not have to occur in any specific order.
10-4. CLOSING
A general understanding of how the fetus may present itself during labor will help
you to understand why some labors are so long and difficult. In addition, this will help
you in understanding what the fetus must go through during the process of presenting
himself out of the patient's womb.
MD0921
10-11