Flexion into the brim of pelvis helps the baby fit through the pelvis. Flexion refers to the tucking of the baby’s chin, in this case.

Flexion, or chin tucking, is even more important than starting labor with an anterior head position!

Many posterior babies can be born with natural labor, or just a bit of Pitocin, when they begin active labor with their heads tucked.

 

Helps engagement

A tucked chin means that the baby is aiming the crown of the head into the pelvis first. This helps engagement, or dipping under the brim of the pelvis. The first baby engages about two weeks before birth, typically.

When the chin is tucked molding is easier. The crown molds more easily than the top of the head. And yet the top of the head can mold, and does so better, sometimes, than the side (asynclitic) or the forehead.

Whether a baby with her chin lifted fits depends on pelvic size, pelvic floor relaxation, strength of contractions and patience!


Pelvic tilts, walking briskly, and doing hula hooping motion while sitting on a birthing (exercise) ball in late pregnancy may help to tuck the baby's chin.

Regular pelvic rocking seems to help the pelvic tendons loosen and thereby help descent during active labor contractions.

 

Labor is easier when the baby's chin is tucked (flexed).

    Left, chin tucked to chest, crown aiming into the pelvis.

    Right, head engaged and applied to cervix.

 When the head is applied to the cervix, the cervix has an easier time to thin and open.

Head application can happen  in pregnancy or wait until labor. There is a risk that the head won't fit in the pelvis if the chin is up.

Problems can occur when the chin is up

Having the chin up is also called deflexion or extension.

When the baby's chin is up the top of the head enters the pelvis first, making the head seem bigger. The head may or may not fit the pelvis. Usually labor helps tuck the chin, but it may take time and lots of maternal movement. Once in a while, its no problem at all. Usually, there is a challenge of labor taking longer.

The baby with an extended head isn't able to help with rotation or descent as easily as when the chin is tucked.  Sometimes, a baby who has his chin is extended is not able to even get onto the cervix and open the cervix. Other times, a lip remains on the cervix for some time when pushing is about to start or is in full force. Focusing on pushing the lip away is besides the point. The problem isn't the cervix, its the angle of the head. Help the chin tuck and labor will proceed.

What to do about an extended chin

In Pregnancy

Forward-leaning inversions repeatedly throughout pregnancy

Pelvic adjustments by a Chiropractor (replaces some of the missing inversions when a woman didn't know to do them)

Balancing the lower uterine segment

Diaphragmatic Release, also called Abdominal Release

Then,

Hula hooping or belly dancing movements 

The same great hip circling movements while sitting an a somewhat firm exercise ball (hips as high or higher than knees, sit safely!)

In Labor

Do all the same things listed under the preceeding list for tucking the chin in pregnancy. Especially the Abdominal Release.

When contractions are regular enough to predict the start of the next contraction, begin a series of ten Abdominal Lift and Tucks.

Wait and let the chin tuck by changing the mother's position and letting her rest if the cervical lip is tight and anterior. (The entire rim being tight may be emotional or from cervical biopsy. Resting in a deep, warm tub may help that cervix relax.)

Hula hoops (belly dancing) on the birth ball, and the Dangle are other ways to help labor progress with an extended chin and the larger diameter such a deflexed head presents.

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