Cardinal Movements – the Dance of Childbirth

Edmonton doula

As a doula in Edmonton, AB, I find myself asking why many concepts around labour and delivery are not more discussed – especially at the childbirth classes in Edmonton. The cardinal movements are one of those concepts, and for those of you who know what they are and what ways they can impact the birth experience, you’ll likely agree! Contrary to the common belief, you and your body aren’t the only active participants when trying to bring a baby earthside… your baby has a part in this dance and it’s a rather big one! And if you can better understand the “dance” that baby needs to do to be born, you can work with your body to make this whole process smooth.

So starting from the beginning – there are seven cardinal movements that babies go through to get from utero to in your arms. I won’t get into each of them specifically as this post would be the longest post from an Edmonton doula that you’ve ever seen! I’ll just list them and the important facets. Starting with engagement, your baby reaches the pelvic brim either before or during labour. Then baby travels down a bit for the descent stage, and then flexes their head for the flexion stage (this one i’ll explore in a bit, it’s quite important). Once baby is nice and low, they start to rotate (internal rotation) until they reach the outlet of the pelvis in a position thats hopefully most optimal for pushing. Once baby is close enough to push out, they start to extend their head from a tucked position (extension) and come through the vagina bit by bit. When the head is out, often times with a bit of assistance from the care provider the baby does one more rotation (external rotation) so that the shoulders can be delivered one-by-one. And after the shoulders come, the rest of the body is expelled and voila! You’ve met your babe!

You can probably notice that each movement is hard to achieve without the other happening first. Baby can’t descend when they aren’t engaged in your pelvis, and the head can’t extend if it hasn’t rotated into the best position for enough room. But arguable one of the most important facets of the cardinal movements is flexion. The baby’s head is made up of plates that overlap and mould to the shape of your birth canal, but this moulding can’t happen as easily if baby doesn’t enter the birth canal with the occiput (the upper back of baby’s head) presenting first. The occiput is the spot where these plates join and easily overlap! So flexion needs to happen, in whatever position baby is facing. Flexion comes from the pressure that contractions put on your baby to put from the head to the pelvic floor, but there will be more efficient pressure if baby’s head is optimally positioned. The best way for the pressure to happen, and the rotation if it’s needed, is by labouring in upright, open positions. A great doula in Edmonton will be able to tell you what position will work best for you at each point in your labour, and you’ll want to advocate for yourself when you find care providers being bossy about what position they want you in for things like fetal monitoring, blood pressure checks and cervical exams when they are needed.

When you can visually put together the cardinal movements, it looks a lot like a dance routine. Ok Im a bit biased, as this “Dancing Doula Edmonton” sees everything in life as a dance, but hear me out. The baby over time TWIRLS out of the pelvis! So thinking of it as a dance, and the cocktail of hormones your body is producing being the music, it only makes sense for you to dance along in your own way to keep that rhythm that’s such a big part of physiological childbirth. Being in tune with your body and understanding the movements that need to happen can empower you to do exactly what you need to do to help baby make their way to you. Dancing your baby out is literally a thing, and something I’m very passionate about!

For those of you who have had babies before, what does your labour dance look like? What positions felt the best, what ones did you try and what did they remind you of?

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