North American Registry of Midwives (NARM) Practice Exam

What is the term used when the widest diameter of the presenting part has passed through the inlet?

1. Descent

2. Engagement

3. Flexion

4. Rotation

The correct answer is: Engagement

The term used when the widest diameter of the presenting part has passed through the inlet is "engagement." This concept is crucial in the process of labor and delivery, as it signifies that the fetal head or presenting part has entered the pelvic cavity in a position that allows for progression through the birth canal. Engagement typically occurs when the biparietal diameter (the widest part of the fetal head) aligns with the pelvic inlet, ensuring there's adequate space for the presenting part to navigate the pelvis during labor. Understanding engagement is vital for midwives and other birth attendants, as it helps assess fetal positioning and predict the labor progression. Monitoring engagement can influence decisions made during labor, including when to encourage certain positions or movements to facilitate the birth process. The appropriate positioning can also impact maternal comfort. Descent refers to the downward movement of the fetus into the pelvis as labor progresses and occurs after engagement. Flexion is the action of the fetal chin being brought towards the chest, allowing for a smaller presenting diameter, while rotation refers to the turning of the fetus during labor to navigate the curves of the pelvis. Each of these stages follows engagement in the sequence of labor but describes different actions of the fetus in relation to the birthing process.