What is the third cardinal movement in labor?

• A. Descent
• B. Flexion
• C. Internal rotation
• D. Extension

Answer: (C)

During labor, the fetal head follows a series of coordinated moves through the birth canal called cardinal movements. After engagement and descent, the head flexes to present the smallest diameter. The next step is internal rotation, where the occiput turns to align with the mother's pelvis, adjusting from a transverse position toward the anteroposterior diameter. This rotation is essential because it positions the head to pass more smoothly through the pelvis and sets up the subsequent extension as it moves under the pubic symphysis. After this, the head extends, then external rotation and expulsion complete the birth.