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The Cardinal Movements of Labor

In anatomical drawings, the birth canal may just look like a short distance, but the process of giving birth means the baby’s journey requires a number of positional changes. During birth, the baby’s passage meets resistance from the mother’s soft tissue and bony pelvis. To fit through the mother’s pelvis, the baby’s head must go through a precise series of movements. These movements are known as the cardinal movements of labor.

At Childbirth Graphics, we have a full range of childbirth education resources, including innovative labor and birth teaching materials that cover a wide variety of labor and delivery concepts, including the cardinal movements of labor. Read on to learn more about cardinal movements and just a few of our educational products to teach about cardinal movements and other aspects of labor and birth.

What Are the Cardinal Movements?

There are seven cardinal movements a baby makes while attempting to get into the best position for birth. These movements work to allow the smallest diameter of the baby’s head to pass through the mother’s pelvis.

  • Engagement: Engagement occurs when the widest part of the baby’s head (the biparietal diameter, measured from ear to ear) enters the mother’s pelvis. The entry point of the mother’s pelvis (pelvic inlet) has its widest diameter from right to left. Engagement may occur toward the end of pregnancy or during labor.

  • Descent: Descent occurs as the baby’s head moves deeper into the mother’s pelvic cavity.

  • Flexion: Flexion occurs during descent. As the baby’s head meets resistance from the soft tissue of the mother’s pelvis, the baby’s head flexes downward so that the baby’s chin touches the baby’s chest.

  • Internal Rotation: When the baby’s head enters the mother’s pelvis (engagement), the widest diameter of the mother’s pelvis is from right to left. Now, with the baby reaching the mother’s pelvic floor, the widest diameter of the mother’s pelvis is from front to back. The baby’s head rotates to accommodate these changes in the diameter of the mother’s pelvis. Usually, the baby faces down toward the mother’s spine, although sometimes the baby faces the mother’s pubic bone.

  • Extension: Usually, the back of the baby’s head is against the mother’s pubic bone as it passes through the vaginal opening. The baby’s head must extend back to accommodate the upward curvature of the birth canal. The baby’s head, face, and chin appear outside the mother.

  • External Rotation/Restitution: Once the baby’s head is born, the baby must rotate from facing head down to either right or left to fit the shoulders around and under the mother’s pubic arch. This movement is also known as restitution.

  • Expulsion: After external rotation (restitution), the top shoulder is delivered under the mother’s pubic bone followed by the bottom shoulder, and then the rest of the baby’s body can be delivered with an upward movement by the healthcare professional.

Great Cardinal Movements Teaching Tools

Teaching students and expectant parents about the seven cardinal movements is an important part of prenatal education. Knowing about the progression of labor can help expectant mothers plan appropriate comfort measures during delivery.

Our large (28" x 22") Cardinal Movements Chart (shown above) is part of our laminated, English/Spanish Six Essential Labor & Birth Charts that cover multiple aspects of the childbirth process, including the stages of labor, pelvic station, and more. The colorful Cardinal Movements Chart lists the seven cardinal movements and artfully depicts how the baby’s head changes positions for delivery.

A smaller version (16½" x 11½") of the Cardinal Movements Chart is also available in our English/Spanish, four-chart One-to-One Chart Set.

The smaller version of the chart includes black-and-white illustrations of variations in presentation and six positions for labor and birth. Each chart in this set is laminated and includes grommets for easy display.

With 23 illustrated color panels with additional information on the reverse panels, our Childbearing: The Classic Series Desk Version Flip Chart comprehensively covers childbirth and is an ideal teaching resource to discuss cardinal movements and other aspects of childbearing, from conception to newborn appearance. The flip chart is also available in a large (23" x 20") size.

Our childbirth model sets are also perfect resources to demonstrate the cardinal movements as well as other aspects of labor and delivery. Our Cloth Pelvic Model Set (available with fetal models in beige, brown, and dark brown skin tones) includes our soft, flexible, and packable Cloth Pelvic Model, which facilitates demonstration of how the pelvis changes during labor and birth and how the fetus moves through the birth canal.

Find More Engaging Childbirth Graphics Educational Resources

With materials and models covering everything from preconception planning to early parenting, Childbirth Graphics offers a full range of childbirth education materials to teach expectant parents and students. Check our wide range of product categories, exciting new and updated products, and monthly childbirth education newsletter.

The information contained in this article is not intended to replace the advice of a healthcare professional.

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