North American Registry of Midwives (NARM) Practice Exam

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What occurs during restitution in a cephalic vertex presentation?

The head aligns with the back
The baby begins to descend
The shoulders rotate
The head is born

The correct answer is: The head aligns with the back

During restitution in a cephalic vertex presentation, the head realigns with the back of the baby. This process typically follows the mechanisms of labor, where the fetal head rotates during labor to navigate through the birth canal. After the birth of the fetal head, restitution occurs as the head spontaneously rotates back to its original position, which is usually aligned with the spine of the mother. This realignment helps facilitate the subsequent rotation of the shoulders during the birth process. This is an essential step in the delivery process, as it allows for the shoulders to properly align for their descent and birth, ensuring a smoother transition for the baby into the world. Other options focused on different phases of labor, such as descending or the actual birth of the shoulders or head, rather than the specific alignment of the head during the restitution phase.