Maternity Nursing Q 116
Immediately before expulsion, which of the following cardinal movements occur?
A. Descent
B. Flexion
C. Extension
D. External rotation
Correct Answer: D. External rotation
Immediately before expulsion or birth of the rest of the body, the cardinal movement of external rotation occurs. 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.
Option A: The baby’s head moves deep into the pelvic cavity and is commonly called lightening. 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.
Option B: Flexion 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.
Option C: 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.