German and older English literature lists only 4 rotational movements as the cardinal movements and excludes engagement, descent, and expulsion. Anglo-American literature lists 7 cardinal movements, namely engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion. The fetus negotiates the birth canal and rotational movements are necessary for descent. Electronic address: mechanics of labor describe the forces required for fetal descent, and the movements that the fetus must perform to overcome the resistance met by the maternal bony pelvis and soft tissue. ![]() Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (Drs Kahrs and Eggebø) Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (Drs Kahrs and Eggebø) Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway (Dr Eggebø).
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