Where the top of the pelvic bowl was wide side to side, the pelvic floor muscles of the levator ani are open front to back in the pelvis. As the head descends and begins to open the cervix, the baby moves into the middle area of the pelvis, which is governed by the pelvic floor. I think this is the one we are simultaneously the most and the least aware of when it comes to labor. Even a “very large” baby, will usually be able to navigate its mother’s pelvis, if its head flexes into its chest. In my experience as a doula, it is far less about the baby’s size and much more about how flexed in the chin combined with the next cardinal movement that can impact the course of labor. This is a key step because a head with the chin tucked into the chest literally presents a smaller circle to the pelvic bones around it, where a head that is extended- that is with the chin lifted away from the chest- will seem to be larger even though the baby is in fact the same size. This downward pressure helps to flex the baby’s neck more fully, bringing the chin into solid contact with the chest. Once the head is through the inlet of the pelvis the baby is moved further down against the opening cervix by the contractions of the uterine muscle fibers. So the direction with the most space has the baby looking to the side, hopefully with the spine slightly towards the front side of the body because of what happens later in the cardinal movements. This is because the inlet of the pelvic bowl (the circle formed by the pubic bone, illium, and sacral promontory, is wider from side to side than front to back, and the baby’s skull is wider front to back that side to side. The head will often initially engage looking to the right (ideal) or left of the pelvis. For some births this may occur before labor has begun, and for some it will not occur until much later. This begins with the baby’s head moving into the upper oval of the lower pelvic bowl. The first thing that must happen for the baby to navigate the birth path is they have to get into it. Rotation (sometimes called internal rotation) Understanding how baby moves within and is guided by the structures of the pelvis can be immensely helpful in learning to work with your own individual labor. Far from being a straight channel, the pelvic birth path is in fact curved from the top to the base, as well as different widths depending on which level of the pelvis the baby is moving through. Called the Cardinal movements, these extensions and rotations help the baby find the best fit to spiral down and out of the body. Similarly, while it might seem like a baby simply slides through its mother’s pelvis to be born in fact the baby makes a series of twists and turns in order to emerge. The cardinal movements of labor are the mechanism by which the fetus moves progressively through the birth canal.When we unlock the front door to our homes the key we insert into the lock fits in one specific way, and it must turn at the right time in order to release the tumblers within the lock mechanism and open the door.Uterine Contractions External tocodynamometry Internal tocodynamometry Correct hypotension or other maternal conditions.Nadir occurring after the peak of the contraction įetal Monitoring(Late Decelerations) Treatment.Nadir occurring simultaneously with the peak of the contraction.> 10 minutes in duration: change in baselineĭECELERATIONSFetal Monitoring (Variables).Onset to peak: 32 weeks: >15 bpm X >15 secs.
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