North American Registry of Midwives (NARM) Practice Exam

Which mechanism of labor occurs throughout the entire labor process?

1. Engagement

2. Descent

3. Flexion

4. Internal rotation

The correct answer is: Descent

Descent is the mechanism of labor that occurs throughout the entire labor process. This phase refers to the movement of the fetus downward through the pelvis, which begins early in labor and continues until the baby is fully born. Descent is crucial as it allows the presenting part of the fetus to descend progressively with each contraction, facilitating the opening of the cervix and passage through the birth canal. In contrast, engagement typically occurs at the beginning of labor when the widest part of the baby's head enters the pelvic inlet. Flexion happens when the fetus's chin is tucked toward its chest, which occurs as the head descends and engages. Internal rotation is a specific movement that follows descent, where the fetus rotates from a transverse or oblique position to an anterior or posterior position as it moves toward the birth canal. Understanding that descent is a continuous process throughout labor highlights its importance in the progression of childbirth, underpinning the stages and movements that facilitate a successful delivery.