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Mechanism of labour – the interaction between the maternal pelvis and fetal skull


This resource considers the anatomy and physiology underpinning the mechanism of labour in terms of the amazing journey the fetus completes through the maternal pelvis. This will be outlined in relation to normal birth and the long and short rotations undertaken in an occipito posterior position.

Learning aims and objectives

This resource aims to provide midwives and midwifery students with information they can use in practice to understand how the maternal pelvis and fetal skull interact to complete the mechanism of labour.

On completion of this resource, midwives and student midwives should:

  • Have thorough knowledge of:
    • the maternal pelvis;
    • the external structure of the fetal skull;
    • how the presentation and attitude of the fetus determine the presenting diameter of the skull;
    • the definition and features of moulding of the fetal skull.
  • Be better able to recognise deviations from the norm
  • Be able to make appropriate referrals to ensure maternal, fetal and neonatal wellbeing

Keywords and linking topics

Maternal pelvis, fetal skull, mechanism of labour

Questions at the end of this resource will enable you to assess your knowledge and reflect on how you can incorporate it into your own practice. In the following questions, please select the answer that you believe to be correct. This will be marked and then you can move on to the next question. If you wish, at the end you can return for a further attempt at the questions.

Upon completion of the module, you will be able to download and save or print a certificate to include in your CPD/revalidation portfolio.

The Practising Midwife featured article 

Uppal E (2017) Mechanism of labour - the interaction between the maternal pelvis and fetal skull. TPM 20(3):8-12